Capturing the complexity of first opinion small animal consultations using direct observation

Abstract

Various different methods are currently being used to capture data from small animal consultations. The aim of this study was to develop a tool to record detailed data from consultations by direct observation. A second aim was to investigate the complexity of the consultation by examining the number of problems discussed per patient. A data collection tool was developed and used during direct observation of small animal consultations in eight practices. Data were recorded on consultation type, patient signalment and number of problems discussed. During 16 weeks of data collection, 1901 patients were presented. Up to eight problems were discussed for some patients; more problems were discussed during preventive medicine consultations than during first consultations (P<0.001) or revisits (P<0.001). Fewer problems were discussed for rabbits than cats (P<0.001) or dogs (P<0.001). Age was positively correlated with discussion of specific health problems and negatively correlated with discussion of preventive medicine. Consultations are complex with multiple problems frequently discussed, suggesting comorbidity may be common. Future research utilising practice data should consider how much of this complexity needs to be captured, and use appropriate methods accordingly. The findings here have implications for directing research and education as well as application in veterinary practice.

Accuracy of the electronic patient record in a first opinion veterinary practice

“…The small sample size means the 256 interpretation of the inferential statistics needs to be cautiously done. The observation method 257 (Robinson et al, 2015a), is time consuming and expensive to undertake therefore it is difficult to 258 undertake on a large scale. It also affects the running practice so placing an observer in the practice 259 for a long period of time is not appropriate.…”

Power of practice: using clinical data to advance veterinary medicine

“…Also reported by Robinson and others (2014) and by Shaw (2008) is the finding that significantly more problems are discussed during preventive care visits. Preventive care visits represented nearly a third of all encounters.…”

Retrospectief onderzoek naar de activiteiten van de Vlaamse gezelschapsdierenpracticus met het oog op aanpassing van het curriculum diergeneeskunde

“…Deze informatie is onder andere nodig voor het aanpassen van het curriculum in functie van het belang van de verschillende, klinische disciplines en voor het bepalen van welke vaardigheden absoluut moeten verworven worden tijdens de opleiding. In de literatuur zijn slechts acht studies beschikbaar waarin de meest voorkomende consultaties in de gezelschapsdierenpraktijk worden beschreven: zes studies uit het Verenigd Koninkrijk (Evans et al, 1974;Lund et al, 1999;Hill et al, 2006;Robinson et al, 2015a;Robinson et al, 2015b;Robinson et al, 2016a) en twee studies uit de Verenigde Staten van Amerika (O'Neill et al, 2014a;O'Neill et al, 2014b).…”