- Should the kennel cough vaccine be given during COVID-19?
- Can cats transfer COVID-19 to other animals, and is there a risk of zoonosis
- What's the difference between FCoV and COVID-19?
- What can we clean a patient with, and will this kill COVID-19?
- Does ultraviolet light actually kill COVID-19?
- Will good weather affect infection rates of COVID-19?
- When should we test an animal for COVID-19?
- How do Face Coverings work?
- What evidence supports use of face coverings?
- How and when to wear a face covering
- Do ferrets and other mustelids pose a zoonotic risk for COVID-19?
- Mink and COVID-19: The Denmark mutation
- What advice should we give owners of ferrets during COVID-19?
- How can we offer a cat friendly environment during COVID-19?
- How should we handle a ferret in the practice or rescue environment?
The RCVS Knowledge Awards for Quality Improvement showcase the implementation of Quality Improvement (QI) techniques which drive improvement in the profession.
New for this year is the expansion of the awards, including:
Read about our previous winners below.
2022 Knowledge Award Quality Improvement Champions
The fourth RCVS Knowledge Awards focusing on QI were awarded in 2022.
The Award Winners were, Vets Now Ltd, Donview Veterinary Centre, Anderson Moores and Eloise Collins from Beech House Veterinary Centre.
Seven applicants were highly commended for their QI initiative and five applicants were highly commended- ones to watch.
2022 Knowledge Award 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.
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.
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.
Eloise Collins RVN
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.
2022 Knowledge Awards Highly Commended
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.
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.
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.
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.
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.
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.
2022 Knowledge Awards Highly Commended Ones to Watch
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.
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.
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, and reflection on the barrier to performing QI in a non-clinic setting.
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.
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.
2021 Knowledge Award Quality Improvement Champions
The third RCVS Knowledge Awards focusing on continuous quality improvement (QI) were awarded in 2021. In addition to those from a practice setting, for the first time, applications were welcomed from undergraduate and postgraduate educators and learners who enhance the awareness and development of QI skills in the veterinary professions.
The Knowledge Award winners were, Dr Jessica Pennock, Samantha Fontaine, Plymouth Veterinary Group, CVS Small Animal Team and The School of Veterinary Medicine at the University of Nottingham (SVMS).
Nine applicants were highly commended for their QI initiative and three applicants were highly commended - ones to watch.
2021 Knowledge Award 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.
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.
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.
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.
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.
2021 Knowledge Awards 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.
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.
ChesterGates Veterinary Specialists for ‘auditing theatre efficiency’. A ‘Golden Patient’ initiative was introduced as an incentive for the team to improve theatre efficiency.
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.
2021 Knowledge Awards Highly Commended 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 Knowledge Award Quality Improvement Champions
The second RCVS Knowledge Awards focusing on continuous quality improvement (QI) were awarded in 2020. One individual was crowned a ‘Knowledge Champion’ and three veterinary teams crowned ‘Champion Practice’s’.
Seven individuals were highly commended for their QI initiative and this year we introduced a new sector, highly commended ones to watch, aimed at those applications whose QI journeys are in their infancy, but whose implementation has been strong and has laid good foundations for upcoming initiatives.
2020 Knowledge Award 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.
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.
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.
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.
2020 Knowledge Award Highly Commended runners up
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.
2020 Knowledge Award Highly Commended 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.
The first RCVS Knowledge Awards focusing on continuous quality improvement (QI) were awarded in 2019. Three individuals were crowned ‘Knowledge Champions’ and one veterinary team the ‘Champion Practice’. Three practices and one individual were highly commended for their QI initiatives.
2019 Knowledge Award 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.
Alison 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.
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.
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.
2019 Knowledge Award Highly Commended runners up
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.
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.