HOOK


University life as a veterinary student
- leisurely surgery, lots of manpower
- possibly no lectures on the management of a practice including KPI, productivity and efficiency for a new vet in practice.
  
Video of University campus & graduation in Australia, UK, USA, France, Canada ---- Campus life, spring, summer, autumn, winter. Flowers in Spring, Summer holidays, Studying hard for examinations at the last minute. Lots of caffeine to keep awake during lectures. Youthfulness. Idealism. Change the world. 


Realities of the private practice
- competition is common in any business.  Over 50 veterinary practices in Singapore in 2013 and more being opened. The discerning pet owner now picks and choose. Proximity is important for most if there are no nearby practices.  What is the practice's USP (Unique Selling Proposition) and the owner's perception of the competency of the vets in the practice?
 
- high rental, labour & drug costs increasing every year.  Landlords and the bureaucrats want more income every year.

- Need to earn sufficient to sustain the practice and invest in upgrading equipment and maintenance
- Performance of the new vet is assessed by the seniors. Getting fired for poor performance is a fact of life for all employees of any business.   

1. What is KPI?
2. Why is KPI important in veterinary surgery?
 

3. How are KPI measured at Toa Payoh Vets?

3 case studies:

Case 1.  KPI - How long it takes to remove one bladder stone from a 10-year-old female poodle?

Case 2.  KPI - How long it takes to remove one bladder stone from a 9-year-old male Jack Russell?

Case 3.  KPI - How long it takes to remove one big fast-growing skin tumour from a 10-month-old poodle?

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CASE 1.
www.sinpets.com/F5/20130615stones_urinary_poodle.htm

Removing one bladder stone in a female poodle A: Injection of Induction Drugs  2.50 pm B:  Isoflurane gas first given:     2.55 pm C: Isoflurane gas stopped:         3.39 pm D: First skin incision:                3.11 pm E: Completion of skin stitching   3.41 pm E-D = 30 minutes of surgical time for a vet with 40 years of experience.  E-A = 51 minutes for the whole process excluding pre-op preparations C-B = 44 minutes of isoflurane gas + oxygen used.

CASE 2.
Video
Recent case operated. Refer to medical records.

 

Removing four bladder stone in a male Westie A: Injection of Induction Drugs  B:  Isoflurane gas first given:     C: Isoflurane gas stopped:         D: First skin incision:                E: Completion of skin stitching   E-D =      minutes of surgical time for a vet with 40 years of experience.  E-A =      minutes for the whole process excluding pre-op preparations C-B =      minutes of isoflurane gas + oxygen used.

 

CASE 3. 
Video
Recent case operated. Refer to medical records.
 

Removing one large skin tumour from a 9-month-old  male Poodle A: Injection of Induction Drugs  B:  Isoflurane gas first given:     C: Isoflurane gas stopped:         D: First skin incision:                E: Completion of skin stitching   E-D =      minutes of surgical time for a vet with 40 years of experience.  E-A =      minutes for the whole process excluding pre-op preparations C-B =      minutes of isoflurane gas + oxygen used

 

CONCLUSION SAC (Speed, Accuracy and Completeness). These 3 factors are important in surgery. The KPI measures speed mainly. However, Accuracy and Completeness depend much on the vet's knowledge, skill and expertise. A good surgical and clinical outcome from Accuracy and Completeness will satisfy the pet owner. This results in more referrals for the veterinary surgeon and sustain the practice in the long term.  Over the past 3 decades, no KPI were formally practised during veterinary surgeries in Toa Payoh Vets.. Since 2010, I have introduced the KPI in the anaesthesia and surgery of all patients operated at Toa Payoh Vets to achieve the my mission of making Toa Payoh Vets one of the top 3 veterinary surgeries in Singapore. KPI measurements takes time to be accepted by the associate vets as most people do not like change and it is likely that the veterinary professors do not lecture on this topic to the impressionable students.  The reputation and stature of the practice depends on good vets and affordable value for money fees, as perceived by the heartlander pet owner in Singapore. KPI are a very important direction to ensure a consistent and high standard of veterinary surgery at Toa Payoh Vets to sustain the survival of the practice over the years.  PREVIOUS DRAFT Script for video - KPI - interns