Previous Award Winners
The RCVS Knowledge Awards celebrate achievements across the profession for activities that contribute to advancing the quality of veterinary care.
Find out more about the RCVS Knowledge Awards.
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2024 Awards
The 2024 RCVS Knowledge Awards had two categories, Antimicrobial Stewardship (AMS) and Quality Improvement (QI).
Champion Award Winners
Antimicrobial Stewardship Champions
The Award winner is CVS South 4 Region.
CVS South 4 Region used ‘Plan, Prevent, Protect’ to devise strategies to reduce antibiotic use, including team training and guidance documents. The team achieved an impressive 70% reduction in the use of long-acting antibiotics in the treatment of bite wounds and superficial skin infections in cats, without compromising patient welfare. This improved their overall responsible use of Highest Priority, Critically Important Antibiotics (HPCIAs), achieving a 65% reduction in their average use.
Quality Improvement Champions
The Award winners are Group Hub Clinical Leadership Team (CVS UK Ltd), White Lodge Veterinary Surgery and Yorkshire Vets.
Group Hub Clinical Leadership Team, CVS (UK) Ltd
For carrying out a clinical audit into blood pressure in cats on a national scale. The team created a wide range of guidance documents and provided team training. The nationwide initiative led to an increase in blood pressure monitoring, enabling earlier identification and treatment of hypertension in cats aged 7 years or older.
Read the Clinical Leadership Team case example here.
White Lodge Veterinary Surgery
Picking up an RCVS Knowledge Award for the second year in a row after winning an Antimicrobial Stewardship Award in 2023, the team looked at pain-scoring in bitch spays. Team training and updating pain management protocols enabled them to both improve their pain scores and reduce the number of dogs requiring rescue analgesia to just 10% of patients.
Read the White Lodge Veterinary Surgery case example here.
Listen to the Knowledge Natter: Post-operative pain scoring bitch spays: A Clinical Audit, a friendly and informal discussion about White Lodge Veterinary Surgery's project.
Yorkshire Vets
For an initiative to reduce the use of oxygen and volatile anaesthetic gasses by auditing fresh gas flow rates within the practice. This nurse-led initiative included team training leading to a substantial overall reduction in oxygen and isoflurane use. The reduction in carbon footprint is equivalent to driving 2,023 miles (Leeds to Andorra, or London to Rome, and back!).
Read the Yorkshire Vets case example here.
Access the Yorkshire Vets Fresh Gas Flow Rate Calculator they designed for their audit.
Listen to the 'Knowledge Natter: Could we improve our carbon footprint?', a friendly and informal discussion about Yorkshire Vets project.
Highly Commended Runners-up
Antimicrobial Stewardship - Highly Commended
Lauren Green from Warren House Veterinary Centre decided to audit antibiotic use in surgical cases. This student nurse led initiative included a holistic approach to engaging the whole team. Team training along with creating new protocols and guidelines on peri-operative antibiotic selection led to a reduction of antibiotic use in routine surgeries from 25% to just 6% without compromising patient welfare.
Orchard Veterinary Surgery for their clinical audit to identify where improvements could be made to their responsible use of antibiotics, and introduction of Antibiotic Rounds discussing cases where antibiotics had been prescribed. The team developed strategies based on ‘Plan, Prevent, Protect’ to responsibly reduce the use of Highest-Priority, Critically-Important Antimicrobials (HPCIAs), resulting in a 76.6% reduction in HPCIA use.
PDSA for producing their first Antimicrobial Stewardship (AMS) Report, aimed at raising the profile of and informing discussions around AMS initiatives across the professions. The Report details the impact of PDSA AMS activities, including the introduction of protocols and guidelines on a range of topics since 2010. More specifically, the Report demonstrates an overall 67% reduction in antibiotics used in preventative surgeries.
Quarry Veterinary Group, VetPartners, reviewed aspects of the BSAVA Protect ME Poster to facilitate discussions on their antimicrobial stewardship activities and rational use of antibiotics in eye and skin conditions. This led to several initiatives including all team training and new guidelines, resulting in an impressive 89% reduction in long-acting antibiotic use.
Read the Quarry Veterinary Group case example here.
Listen to Lizzie Booth from Quarry Veterinary Group give an overview of her teams initiative: Knowledge Award audio overview: The Protect Me poster project and reducing our cefovecin use.
Quality Improvement - Highly Commended
Amy Campbell from Parkside Veterinary Group for her audit assessing the effects of different pre-medication protocols on blood pressure in cats under general anaesthetic for dental treatment. The audit revealed that 84.6% of patients remained within the normal range with the updated protocols becoming adopted as standard within the practice.
Fiona Thomson from Roundhouse Referrals, for her process and outcome audit to assess clinical outcomes and client experience with Laparoscopic Ovariectomy. This project is in its second year, demonstrating that updated checklists and guidance for both clinical teams and owners led to improvements from the 2023 baseline audit data.
Francesca Pritchard (nee Beorby) from Putlands Veterinary Surgery for her audit on hypotension in dogs and cats under general anaesthesia. Sharing and discussing the baseline data as a team led to a new pre-medication protocol and a second audit to assess the outcome showed a reduction in the number of patients becoming hypotensive.
Read Francesca's case example here.
Hannah Jones from Avenue Veterinary Centre (Malvern) for her prospective audit using post-operative pain scoring to assess the analgesia protocols for neutering in feline patients. A change in the protocols led to a 61% reduction in the number of cats requiring rescue analgesia post-operatively.
Harriet Peck from McMurty and Harding Veterinary Practice looked at the prevalence, duration and management of hypotension during canine and feline anaesthesia. The audit process and subsequent new hypotension troubleshooting documents empowered the team to make positive changes in the way they approach hypotension.
Lauren Jobson from Cogges Veterinary Surgery for her audit to reduce their carbon footprint from isoflurane use in routine neutering. Team training and the introduction of a new protocol for using local anaesthetic at the site of surgery helped to reduce their carbon footprint related to oxygen and isoflurane use and improved patient recovery times.
Leanne Morrison from Donview Veterinary Centre used a process audit to assess their repeat prescription processes. This led to an improvement in pharmacy organisation and stock rotation, reducing errors, and financial waste by 41%. The audit also identified further areas for improvement.
Maxine Richards from Straid Veterinary Clinic, IVC, audited the use of blood pressure monitoring equipment during anaesthesia. Team discussions and further training on new equipment led to 100% of patients having their blood pressure monitored under anaesthetic.
Megan Orr from Roundhouse Veterinary Hospital assessed how well a new surgical safety checklist had been introduced in her nurse-led audit. Monthly data collection on its use and adaptions based on team feedback achieved an impressive 94% compliance with completing checklists, benefitting patient safety and team communication.
Read Megan's case example here.
Listen to Megan give an overview of her initiative: Knowledge Award audio overview: Introduction and compliance of surgical checklist use.
Peter O’Hagan, at Aireworth Vets, and the Central Clinical Board Team, VetPartners, for a process audit to improve adherence to drug data sheet recommendations in dogs.
Rachel Clay from Cedar Veterinary Group, for leading a collaborative effort with other practices in the XL Vets group to address compliance with new protocols for recording prescriptions of parasiticides in line with the Under Care Guidelines.
Rosemullion Veterinary Practice used clinical audit to assess the type, frequency and patterns of errors and near misses with dispensing medication to inform changes to avoid them happening again. Team training and updated protocols for all teams led to a reduction in errors. Near misses associated with ‘look alike’ medication were fed back to the pharmaceutical company, helping to inform a design change in the packaging.
Roundhouse Referrals for their TPLO + Quality Improvement project, now in the fourth year of their project. A retrospective audit was carried out to assess adaptations in their service provision since their 2023 audit, demonstrating a number of improvements.
Southfields Veterinary Specialists for several initiatives to assess client satisfaction, workflow, accurate record keeping and client care. This series of audits showed that Quality Improvement is becoming embedded in the daily activities of the hospital.
Victoria Woods from Tone Veterinary Centre assessed the use of ultrasonography as a diagnostic tool. A group-wide initiative to improve training and confidence in performing ultrasound scans resulted in increased use by both vets and nurses.
Wendover Heights Veterinary Centre for a process audit looking at pain scores in cats and dogs undergoing ovariohysterectomy and ovariectomy. Interventions included further team training and the introduction of the feline grimace scale to aid pain scoring in cats, resulting in improved compliance with pain scoring protocols to over 80% in cats and 100% in dogs.
Highly Commended Ones to Watch
Antimicrobial Stewardship - One to watch
CVS Equine for their audit across a number of practices within the group to assess their antibiotic use in equine first-opinion practice. The baseline data they collected allowed the team to quantify the type and frequency of antibiotics that were prescribed to raise awareness of responsible antibiotic use.
Quality Improvement - Ones to Watch
Integrated Care Council, CVS, for the development of an organisational clinical governance framework. The framework was designed to identify what matters to frontline teams and provide support and guidance for improvement activities.
Mary Fraser from Girling and Fraser Ltd for developing an online CPD course for nurses, providing students with the knowledge and resources to apply QI techniques to the care of exotic patients.
Medivet Group for an initiative to support embedding Quality Improvement techniques throughout the organisation. This initiative led to forming Divisional and National Committees to foster the use of Clinical Audits, Benchmarking and Significant Event Audits as part of their day-to-day activities.
Mia Williams from Warren House Veterinary Centre for conducting a Significant Event Audit, and Root Cause Analysis after a serious incident. The nurse-led review and team discussions demonstrated a strong learning culture.
2023 Awards
Champion Award Winners
Antimicrobial Stewardship Champions
Paragon Veterinary Referrals
Paragon focused on the protection of critically important antimicrobials by bringing together an Antimicrobial Stewardship Team, creating guidelines based on the Plan Protect Prevent mantra and running in-house CPD. The team found improvements in prescribing culture, communication and a more open environment when discussing the appropriate use of antibiotics.
Read the Paragon Referrals case example here.
Rachel Forster
Rachel Forster from Market Veterinary Group, IVC, used the Farm Vet Champions mantra Plan Prevent Protect to reduce prophylactic antibiotic use in neonatal lambs. With the introduction of CPD materials, audits and team meetings for practice teams, as well as client awareness meetings and support materials for farmers, the initiative saw a reduction in neonatal antibiotic use of 75%.
Tonia Simms
Tonia Simms from The Farm Vets at Hampden Veterinary Hospital (VetPartners), explored the use of antibiotics in surgical calf castrates. Tonia created a risk assessment and policy to reduce the routine use of prophylactic antibiotics. The actions of the team following the introduction of the interventions led to an increase in morale and confidence around not prescribing prophylactic antibiotics without compromising welfare.
Listen to the Knowledge Natter: Antibiotic use in surgical calf castrates, a friendly and informal discussion about Tonia's project.
Read Tonia's case example here.
White Lodge Veterinary Surgery
White Lodge Veterinary Surgery, CVS, carried out a prospective audit to review the use of antibiotics, with a focus of antibiotic use in cat bite abscesses. With the introduction of checklists and in-house CPD they were able to treat 86% of their patients successfully without antibiotics without compromising welfare.
Quality Improvement Champions
David Charles
David Charles, from Scarsdale Vets, part of the IVC Evidensia Farm Vets group, carried out an audit across a number of practices within the UK to collect baseline data on ovine lambings and caesareans. David introduced training and how-to guides, used SMART goals and put several recommendations on the provision of analgesia, selection and use of antibiotics and the use of adjunctive medications in place for the team to follow. The strong adoption of the recommendations across the practices resulted in a reduction in prophylactic antibiotic use, with improved use of local anaesthetics and the provision of analgesia.
Read David's case example here.
Leanne McLeod
Leanne McLoed from Earlswood Veterinary Hospital introduced a hypothermia audit with a focus on pre-warming patients before general anaesthesia. By introducing new protocols for the provision of passive warming from pre-medication, her team reduced the incidence of hypothermic patients from 100% to 16%.
Read Leanne's case example here.
Rosemullion Veterinary Practice
Rosemullion Veterinary Practice carried out an audit to improve infection control and cleaning methods in all areas. By updating protocols and products, providing hand sanitising stations and cleaning materials in high-touch areas and improving training and education, the team significantly decreased the risk of environmental contamination. The project is now being used as an example for other practices.
Royal Veterinary College
Royal Veterinary College (RVC) incorporated Quality Improvement (QI) within their post-registration qualifications through a number of measures to help guide students through QI initiatives. These included activities on how to write a Knowledge Summary, plan a clinical audit proposal, how to conduct and reflect on the results of an audit, and group discussion and knowledge sharing sessions. Students have used the teaching and resources to perform audits and QI projects in their practices, submitted to peer review journals and presented at conferences.
Highly Commended Runners-up
Antimicrobial Stewardship - Highly Commended
Animal and Plant Health Agency (APHA) carried out an on-farm mastitis testing project. The project included CPD and using the Plan Prevent Protect method which resulted in increased knowledge and awareness about On Farm Testing and antimicrobial resistance activities.
CVS Equine Group carried out repeated point prevalence surveys of antimicrobial use in first-opinion equine practice and introduced QI leads to each practice which helped create a baseline audit and raise awareness of antimicrobial stewardship.
Kate Matthews from Kite Consulting carried out a cross-industry antibiotic monitoring and reduction programme which included regular meetings with farmers to provide training on the use of antibiotics and reviewing usage on farms. Farmers are able to receive individual feedback on their usage and Kite Consulting have found an overall reduction in trends showing a successful industry collaboration.
Tracy Latham from Moorland Veterinary Centre used Farm Vet Champion CPD to update herd and flock health plan templates and focused on reducing antibiotic usage. This resulted in setting SMART Goals to involve farmers in discussions surrounding antibiotic use.
Warren House Veterinary Centre carried out a clinical audit to measure otitis externa cases treated without justification from culture and sensitivity results. All staff undertook a veterinary prescriber’s course and carried out an audit which showed a reduction in sales of antibiotics.
VetPartners Ltd carried out an antibiotics stewardship project which aimed to identify how many antibiotics were being used, and how they were being used and draw up a plan to reduce and refine use. Their project resulted in a 14.3% reduction in antibiotic use.
Quality Improvement - Highly Commended
Active Vetcare, CVS, focused on re-finding Joy in Work by carrying out a baseline survey to discover how the team felt about working at the practice. They introduced ‘What Matters to You?’ training and followed the Joy in Work framework. They introduced a Joy in Work Board, a Joy-O-Meter and a suggestion box. The team felt more engaged and felt they were being listened to and the Practice has a productive approach to addressing issues.
Read the Active Vetcare case example here.
Aireworth Vets, VetPartners, Introduced a number of processes to the practice such as monthly meetings and data entries on the PMS for serious errors and surgical complications, and the creation of surgical checklists and updating protocols.
Fiona Thomson from Roundhouse Referrals, Linnaeus, created a process and outcome audit to assess clinical outcomes and client experience in relation to Laparoscopic Ovariectomy. This was a successful baseline audit.
Hayley Potter from Old Golf House Vet Group introduced a ‘What Matters to You?’ initiative to improve workplace wellbeing with Joy in Work resources used to aid the change. The introduction of wellbeing meetings brought about several interventions to help boost morale and Net Promoter Score (NPS) score.
Read Hayley's case example here.
Lesley Moore from IVC Evidensia carried out an Ear cytology Pilot with the aim to increase proactive identification and treatment. The initiative saw a decrease of 70% in the use of antibiotics and an improvement in the use of cleaners and steroids.
Nicole Dyer from Ash Tree Vets, VetPartners, carried out an outcome audit to measure the effects of introducing lidocaine to analgesia protocol for dog castrates after reading an RCVS Knowledge Summary. The audit showed a positive impact both financially and environmentally.
Old Golf House Veterinary Group submitted a sustainability application looking at various ways of reducing their carbon footprint. They focused on auditing the consumption of energy and consumables and a true data set will be analysed over a 12-month basis.
Roundhouse Referrals, Linnaeus, submitted two applications. The first application focused on improving infection control by looking at the frequency of punctures of their surgical gloves and changing their gloves to ones that punctured less.
Their second application was their TPLO + Quality Improvement project, the third year of their project and was a retrospective audit to assess adaptations since their 2022 applications. There were a number of improvements from their 2022 audit.
Samantha McGaw from Queen Mother Hospital for Animals, RVC created a clinical audit on nutrition for the ECC patient. Samantha carried out a retrospective process audit to assess the current nutritional support provisions and measure interventions which saw a greater awareness and improved prioritisation of nutritional support.
Tawny Kershaw from IVC Evidensia carried out a hypothermia audit for peri-operative temperatures by looking at the processes in place and measuring updated protocols. Their numerous interventions created an improvement in all audit measures.
The Queens Veterinary School Hospital of the University of Cambridge developed structures and systems to help the integration of QI across the teaching hospital environment. This included the audit of QI activities, adoption of VetSafe and the introduction of a new role to focus on the implementation of QI. Off the back of the review, a number of recommendations have been implemented and feedback from hospital staff has been positive.
VetsNow Sheffield initiative focused on reducing errors and improving customer service when dealing with individual cremations through a process and outcome audit of procedures for handling cremations. A baseline audit of processes resulted in a new Standard Operating Procedure and no major incidents have occurred since the audit came about.
Highly Commended - Ones to Watch
Quality Improvement - Ones to Watch
BARTA provided evidence-based guidelines and training for emergency first responders to provide pre-veterinary immediate care and developed a handover checklist to use when handing over to veterinary professionals. They provided a training centre for first responders and have seen an increase in the use of Smokey Paws Oxygen Therapy Kits.
Emmeline Macedo from Blue Cross carried out a process and outcome audit for anaesthetic fresh gas flow rates to gain insight and evidence to drive team training on anaesthetic circuit use. After providing training and creating ‘cheat sheets’ etc., reaudit results show a general improvement in correct flow rate use.
2022 Awards
Quality Improvement Champions
Vets Now Ltd
Vets Now Ltd took feedback from their wider team and identified room for improvement in the care of dystocia cases. Due to an increase in the number of dystocia cases being seen, the team requested updated guidelines and training. A working group was created to support this. The group began by auditing and capturing benchmarks for dystocia cases across Vets Now Ltd. With the aim of supporting clinicians with decision-making and improving patient welfare, the group used these data to inform guidelines and resources relevant to care provided by Vets Now Ltd. Both the data and the resources were disseminated to the team via training. The level of engagement in the audit highlighted team-wide commitment to improving patient outcomes.
Read the full published article: Leicester, L. et al. (2022) Applying clinical audit for quality improvement in canine dystocia cases seen at a UK primary-care emergency practice. Veterinary Record, p. e2485. https://doi.org/10.1002/vetr.2485 (CPD: 40 minutes)
Watch the Knowledge Natter: Dystocia Dilemmas, a friendly and informal discussion about the Vets Now Ltd project.
Read the Vets Now Ltd case example here.
Donview Veterinary Centre
Donview Veterinary Centre demonstrated a strong learning culture through an initiative aimed at improving post-op temperatures. Working together, the team performed an audit, and used the results to assess where they could improve. Suggestions from the team were successfully implemented across the practice, and investments in new equipment were made. The audit showed a robust dedication to improvement, with the whole team working together to identify gaps in care.
Read Donview Veterinary Centre's case example here.
Anderson Moores Veterinary Specialists
Anderson Moores Veterinary Specialists introduced a Notice to Anaesthetists (NOTAN), a notice inspired by the aviation industry that highlights any changes that might have safety implications. The NOTAN was introduced after a team survey identified gaps in knowledge about the latest information on anaesthesia practice, protocols, and equipment. The team agreed that an electronic notification would be an effective change and increase confidence. Follow up team engagement showed that a simple, effective initiative can create measurable improvements.
Read Anderson Moores Veterinary Specialists case example here.
Eloise Collins
Eloise Collins, Head Veterinary Nurse at Beech House Veterinary Centre, used checklists, auditing, benchmarking, team meetings and journal clubs to help improve patient care and outcomes and to improve practice culture. Eloise helped to create psychological safety amongst the team through her open and honest approach. The application showed an improvement culture involving the entire team creates positive change.
Quality Improvement - Highly Commended
Filham Park used clinical audit to review their use of the dental x-ray machine, identifying gaps in x-ray provision and providing clients with appropriate estimates. Training was implemented to improve skills and confidence, leading to an increase in service provision on repeat audit, and increased client satisfaction.
Read Filham Parks case example here.
Manchester Veterinary Specialists performed an anaesthesia service review to address any gaps in care, improve team roles and morale, and report practice anaesthetic-related mortality rates.
Okeford Veterinary Centre for embedding QI into their daily routine with the use of morning rounds, huddles, checklists, and audit. The application showed a good culture towards improvement.
PDSA audited their provision of remote consultations and services during the pandemic, to ensure that they were complying with RCVS COVID guidelines, and whether the service being provided was satisfactory to clients. Their audit reassured the team and stakeholders that they were complying with guidelines, ensuring good clinical care, and maintaining animal welfare throughout the pandemic.
Roundhouse Referrals continued to audit their provision of their TPLO+ service throughout the pandemic, using their previous outcomes measure scores and client satisfaction scores as a benchmark.
Silverton Vets used a literature review to encourage the purchase of dental radiography and held dry lab training sessions remotely to train their team on its use. Audits were performed monthly to monitor its use. Separate audits were undertaken that identified an increase in revenue, diagnosis (and therefore patient care), team confidence, and client satisfaction.
Small Animal Division CVS UK developed guidelines for common conditions and presentations for use at a first opinion practice level. The 43 guidelines allow the provision of a more consistent service and offer support to less experienced team members.
Quality Improvement - Ones to Watch
CVS Equine established a QI team within the equine division, to support equine practices with QI in practice. The application demonstrated a team approach with good leadership and implementation of QI projects.
Rosemullion Vets performed a process audit on the use of surgical safety checklists showing an increase in the understanding and use of the lists from the team.
Putlands Veterinary Surgery developed a QI group with members from the vet, nursing, and reception team. They started to look at patient safety checklists, significant event audits and auditing analgesia for neutering procedures.
VetPartners submitted two applications, one auditing the number of adverse events after equine vaccinations, and the other auditing the outcome of cow caesareans. The adverse events after equine vaccinations allowed the collection of data which improved the information relayed to clients, allowing them to make more informed decisions. This baseline audit has provided good benchmarks. The outcome of cow caesareans showed good planning and data.
Vetled performed observational audits within practices, to offer a fresh perspective on non-technical skills within everyday practice. The observational audits looked at whether QI tools have been adapted and implemented successfully, to ensure continuous improvement cycles.
2021 Awards
Quality Improvement Champions
Dr Jessica Pennock
Dr Jessica Pennock from CVS South Hub was awarded as a Knowledge Champion for her outcome audit on peri-operative hypothermia. The audit was inspired after the practice purchased a warm air circulating blanket for anaesthetic procedures, prompting the team to perform a process audit to ensure that the equipment was being utilised, and an outcome audit to see if the equipment was having a positive effect on patient care and recovery. The results demonstrate what can be achieved with an accessible audit that will have a positive impact on patient welfare.
Read Jessica's case example here.
Samantha Fontaine
Samantha Fontaine from the University of Glasgow was awarded as a Knowledge Champion for implementation of a new course that teaches QI to veterinary nurses, including those in practice and education. For the first time, there is a QI route to achieving the RCVS Certificate in Advanced Veterinary Nursing (CertAVN). The course covers Quality Improvement in Veterinary Nursing, Research and Evidence-based Veterinary Nursing and Developing Evidence-Based Practice through Reflection. The curriculum has equipped national and international students with the confidence and ability to apply quality improvement initiatives to their work.
Read Samantha's case example here.
Plymouth Veterinary Group
Plymouth Veterinary Group created guidelines for performing cytology on patients presenting with ear pathology, utilising the whole teams’ skillset to improve the patient journey for a common and often persistent presentation. The application showed a bottom-up approach – increasing training, utilising RVN skills and demonstrating strong evidence that their changes led to an overall decrease in the number of antibiotics prescribed.
Read Plymouth Veterinary Group's case example here.
Read the Knowledge Natter Q&A here.
CVS Small Animal Team
The Small Animal Team within CVS audited small animal ear cytology on a national scale, over a long period, resulting in an increase in diagnostic tests and a reduction in antibiotic use across a wide range of practices. One of the key outcomes of introducing this QI initiative was the widespread improvement in the knowledge and skill of vets and nurses in all stages of their careers. Their audit demonstrated strong leadership for QI initiatives and highlighted that meaningful culture change can take time.
Read the CVS Small Animal Teams' case example here.
The School of Veterinary Medicine, University of Nottingham
The SVMS at the University of Nottingham was also named a Champion Team for teaching QI to undergraduate and postgraduate students. QI and evidence-based veterinary medicine (EBVM) is integrated within the curriculum, with the SVMS being one of the first of the UK Veterinary institutions to offer postgraduate courses to veterinary surgeons, focused on both QI and EBVM and providing the only veterinary curriculum to use QI within formative assessments for undergraduates. QI and EBVM have been integrated across both their undergraduate and postgraduate curriculums, often in a novel way, which has been informed by a research-led agenda focused on the application of QI and EBVM into veterinary clinical practice. Embedding QI in the curriculum in such a comprehensive way is an important introduction for students to see the benefit that QI can bring to their future careers.
Read the SVMS, University of Nottingham's case example here.
Quality Improvement - Highly Commended
Samantha Morgan-Hourd from Abbeydale Vetlink Veterinary Training Ltd for teaching students how to perform audit within the CQ Level 3 Diploma in Veterinary Nursing course. Students are given the tools to research EBVM protocols and then perform process audits within their placement practice.
Charlotte Thomas from Rosevean Veterinary Practice identified a need for a new admission form protocol during the COVID-19 pandemic. The implementation and repeat audit showed an improvement in completion of admission forms by 60% and an overall improvement in informed consent.
Read Charlotte's case example here.
Hannah Almond from Pauline Brown Clinical Skills Centre, University of Cambridge introduced practical simulations for CPR with a debriefing process, allowing for student discussion and for an audit of the teaching.
Ross Allan from Roundhouse Referrals for auditing ‘TPLO outcomes and client satisfaction’. An audit was completed on customer service and clinical outcomes post-TPLO procedure. The practice used a literature search to identify a benchmark and worked towards making improvements. Clinical outcomes between 2019 and 2020 improved greatly with clients feeling informed and supported throughout the referral process.
Read Ross's case example here.
ChesterGates Veterinary Specialists for ‘auditing theatre efficiency’. A ‘Golden Patient’ initiative was introduced as an incentive for the team to improve theatre efficiency.
Read ChesterGates Veterinary Specialists case example here.
Kathryn Wale from YourVets referral service (CVS) audited surgical site infections and gastro-intestinal complications, involving the whole team from the outset. Monthly audits monitored infection rate and reduced both complications by 42%.
Arbury Road Vets audited peri-operative pain. The case example showed how the practice reviewed their analgesia processes against the latest evidence and audited their processes. The figures showed an achievement in implementing the new protocols and an improvement in patient care.
Equicall audited their emergency attendance times. Calls were categorised into different degrees of importance and were audited on the average time taken to reach each call category. Reasons for delays in times were investigated, resulting in an improvement in the time taken to reach high-risk category patients.
Regan Vet Group created pre-operative surgical information client sheets to reduce errors. Regan vet group identified that time constraints due to COVID-19 were affecting pre-operative surgical discussions. To combat this a pool of pre-operative surgical information sheets were created for clients to receive detailing information on surgeries their pet would be receiving.
Quality Improvement - Ones to Watch
Linnaeus post-registration team developed a programme to equip early career nurses with the skills and knowledge to drive Quality Improvement measures in practice. The programme was started in 2020 and has set a good foundation for Quality Improvement within the practice.
VetPartners Ltd audited QI initiatives that were being undertaken across the group with the aim of bolstering areas that require support and learning from activities that can be replicated in other settings. This has provided the group with their baseline, which the group have used to inform their targets. Their first intervention has been to create a common language for QI.
Kathrine Blackie from Linnaeus for auditing patient safety reporting. There was involvement in the initiative across practice team members and there has been an increase in reports submitted since the beginning of the initiative, helping to promote a just culture.
2020 Awards
Quality Improvement Champions
Louise Northway VNCertECC NCert(Anaesth) RVN
Louise Northway of Wendover Heights Veterinary Centre, known online as ‘Lou the Vet Nurse’ from her successful Facebook page, is a winner for the second year in a row; for her lead in auditing post-operative neutering complications and using evidence-based veterinary medicine to implement updated guidelines to reduce complication rates by half.
Read Louise’s case example here.
Small animal theatre team at Animal Health Trust
The Small Animal theatre team at Animal Health Trust received their award for their creation, implementation and continued use of the surgical safety checklist; improving unity in communication; a reduction in serious surgical errors and greater compliance in swab and instrument counts.
Read Animal Health Trusts case example here.
Vale Vets
Vale Vets won for their introduction and continuation of clinical meetings and QI initiatives that help the team to work as one. Their application discussed their work on several audits, but in particular post-operative complications and hand hygiene; using pre-existing guidelines and developing their own checklists. Vale Vets encourage all team members to get involved in QI, allocating time during quiet shifts for data collection, and have promoted a just culture within the practice.
Read the hygiene audit case example here.
Read the post-operative complication audit case example here.
PDSA
PDSA picked up a Practice Champion award for their national auditing of pain relief guidelines, cruciate surgery outcomes and incident reporting. Their work in this area showcased improvements in adherence to pain relief protocols; reductions in lost to follow-up cases for post-cruciate surgery patients; and the role of audits in providing an evidence base at a practice level for treatment options.
Read the cruciate surgery outcome audit case example here.
Read the clinical incident reporting case example here.
Read the analgesia process audit case example here.
Quality Improvement - Highly Commended
Meghan Conroy of Brook House Vets for her clinical audit on ear cytology, identifying a gap in care and providing training to the whole team. Results were shared with local practices and promoted more responsible medication prescribing.
Sandra Hunt of The Laurels for the introduction of anaesthetic and wound care checklists after significant events. Other QI initiatives included hand hygiene and hypothermia audits. This application included a huge amount of data which showed data collection being performed regularly.
Liron Levy-Hirsch of Vets Now for his introduction of root cause analysis after significant events. These identified required system changes including shift changes, promoting a better work-life balance, updates to guidelines and the introduction of checklists to improve patient safety.
Kay Lockwood of Riversbrook Vets for the introduction of clinical governance meetings that instigated updates for anaesthetic monitoring, crash protocols, post-operative complication audits and auditing of infection control.
Sam Thompson of North Downs Specialist Referrals for her post-operative temperature audit, increasing the average patient post-operative temperature from 36.7° to 37°. This audit also identified areas of focus for specific guidelines to help improve temperatures after certain procedures.
Holly Warrilow of White Cross Vets for her post-operative temperature audit which started out as a process audit, and, after identifying a gap in care and introducing guidelines, identified the need for an outcomes audit. The audit cycle saw a decrease in patients that returned from theatre hypothermic.
Lizzy Whiting of City Road Vets for her change management by introducing clinical governance meetings to a well-established practice. These meetings provided a place to discuss guidelines and protocols and approach the updating technical skills to improve not only the team member’s confidence but patient care. This approach to evidence and a learning culture initiated training and team confidence to expand their scope of service and provide an increased range of surgical options and geriatric clinics.
Quality Improvement - Ones to Watch
Millhouse Veterinary Surgery and Hospital for their areas of responsibility system change. By instigating an entire system change within the practice, they placed responsibility into the hands of the team, improving teamwork and promoting changes from the bottom-up. This initiative also increased awareness of QI in each area across the board.
Newnham Court Equine Clinic for their implementation of a surgical safety checklist. An initial process audit has been completed, which gave initial numbers of compliance and identified that further training was required. A checklist champion was appointed and a further audit is due in 2020.
2019 Awards
Quality Improvement Champions
Louise Northway VNCertECC NCert(Anaesth) RVN
Louise, Clinical Nurse Lead, won for her dedication to continuously improving care by undertaking clinical audits; setting and reviewing protocols based on evidence; and instigating discussion and adoption of QI by the entire practice team.
Read Louise’s case example here.
Alsion Thomas BVSc CertSAM MRCVS
Alison, Head of Veterinary Services at Blue Cross, won for her project to deliver a consistent approach to diagnosis and treatment throughout the charity by developing guidelines for more than 60 common syndromes and conditions. The guidelines were based on the best available evidence and took into account ethical and quality of life (QOL) considerations. Their introduction coincided with significant cost savings for the charity, placing them on track to treat an additional 2,639 animals.
Read Alison’s case example here.
Angela Rayner BVM&S MRCVS
Angela, Clinical Services Manager at CVS Group plc, was recognised for her role in cementing an annual controlled drugs audit across the group’s practices. In just one year, CVS’s drug discrepancies for ketamine and methadone improved more than ten-fold and six-fold respectively, and improved still further the following year.
Read Angela’s case example here.
Vets Now Macclesfield
The nursing team at Vets Now Macclesfield won the practice award for their work on improving general anaesthetic monitoring in an emergency setting. The introduction of a quarterly clinical audit and tailored training for nurses elevated the practice’s general anaesthesia and sedation monitoring to a comprehensive level of excellence, incorporating detailed notes and patient observations. As a result, the practice suffered zero patient deaths or significant events related to anaesthesia or sedation.
Read the case example from Vets Now here.
Quality Improvement - Highly Commended
ChesterGates Veterinary Specialists established a QI initiative which set out to improve patient care, use of resources, productivity and theatre efficiency. The initiative has resulted in more consistent data recording and improved retrieval of data for audit purposes.
Optivet Referrals Ltd developed a system for capturing the adverse events that arise in patients following anaesthesia.
Vets Now Referrals Glasgow was highly commended for its clinical audit which assessed adherence to WHO hand washing guidelines.
Read this team's case example here.
Elisa Best BVSc CertSAS MRCVS created a sealed emergency ‘BOAS box’ to be prepared for a BOAS patient in crisis. Each box contains a tracheostomy tube, an endotracheal tube, a pulse oximeter, a spay hook, a pre-drawn induction agent, post-BOAS treatment guidelines and a drug dosage list.