Standardized Workflow for Optimal Utilization

Table 5.2

Table 5.2 is an example of a standardized workflow for optimal utilization that improves practice efficiency and maintains team alignment. Areas where protocols can be created to enhance workflow include:

Triage calls (first aid, primary response) and direction to available care
Follow-up calls for surgical cases and recent hospitalizations, or returning client calls
Nutritional/behavioral/hospice/chronic pain management consults with clients
Preapproved/identified diagnostic tests (sample collection, in-house tests)
Recheck diagnostics
Care of in-house patients with routine updates to attending veterinarian
Auxiliary care appointments such as glucose curve tests and bandage changes or suture removal
Preplanning of next-day appointments

Click here to download a PDF of Table 5.2

Category	Roles
Appointments/Initial Assessments	CSR: Obtains initial information, reason for visit, previous medical records
	CrVT (with VA): Collect data Obtain the relevant history Perform initial triage Note problems found Create preliminary diagnostic plan (i.e., if patient is pale, order CBC) Start basic level of care or initial diagnostics (i.e., collect ear swab samples for cytology) Present case to veterinarian
	Veterinarian & CrVT: Patient assessment and agreement/prioritization of problem list
	Veterinarian: Gives presumptive or working diagnosis Creates therapeutic plan and recommendations Predetermines case management check-ins with CrVT Writes prescriptions and/or performs surgery
	CrVT & Team: CrVT creates and facilitates nursing plan CrVT develops and facilitates/delegates patient discharge information and keys to clinical outcome success CrVT sets and performs follow up & recheck appts
Initial Assessments/ Emergency Situations	CSR: Obtains initial information, reason for visit, previous medical records
	CrVT (with VA): Collect data Obtain the relevant history Initial triage and patient assessment Note problems found Create therapy plan based on agreed protocolized medicine (algorithm) (SOPs, i.e., if/then steps) Order diagnostics (i.e., if patient is pale, order CBC) Initiate basic level of care (i.e., if patient is blue, start oxygen) Present case to veterinarian
	Veterinarian & CrVT: Patient assessment and agreement/prioritization of problem list
	Veterinarian: Gives presumptive or working diagnosis Creates therapeutic plan and recommendations Predetermines case management check-ins with CrVT Writes prescriptions and/or performs surgery
	CrVT (with VA): Carries out diagnostics and therapeutic plan
	CrVT & Team: CrVT creates and facilitates nursing plan CrVT develops and facilitates/delegates patient discharge information and keys to clinical outcome success CrVT sets and performs follow up & recheck appts
Anesthesia and Surgery	CrVT (with VA): Conducts patient assessment Initial pain score Prepares anesthesia/analgesia protocol (as per protocol(algorithm)/veterinarian direction) Creates surgical plan Equipment Preoperative preparation Monitoring Incision documentation Postoperative pain score
	Veterinarian: Performs surgery
	CrVT Monitors anesthesia and pain Incision documentation and surgical record keeping Postoperative pain score Facilitates nursing care with team Communicates patient updates to clients Prepares and gives discharge instructions Creates a follow up and recheck appointment plan
Triage & Teletriage* (with established VCPR)	All Team Members: Demonstrate a clear understanding of definitions for Telehealth/Triage/VCPR See the AAHA/AVMA Telehealth Guidelines at aaha.org/telehealth for definitions and more information.
	CSR: Initial response (collects signalment and historical information); or Automated information collection for what can be collected
	CrVT Performs teletriage: Asks questions to collect more clinical information, photos, and video Uses critical thinking skills to ask differentiating questions Synthesizes generalized problem list Makes recommendation on action: ER, schedule in-person appointment with veterinarian, home care/education, and/or builds plans from SOPs previously approved by a veterinarian
	Veterinarian: Diagnoses problem and reviews tests Prescribes treatment
	CrVT Performs teletriage: Schedules necessary tests, communicates with client, performs treatments, prepares discharge & educational information for client Prepares follow up plan
Telehealth* (follow up appointments and check ins, rechecks)	CSR: Schedules telehealth appointment with CrVT based on treatment or discharge plans
	CrVT Performs telehealth appointments remotely— can include: Post-operative rechecks (such as incision checks) Post diagnosis Check in visits for chronic diseases/senior pet care: Restates disease pathophysiology Restates outcome/prognosis discussions Reinforces the timing of repeat labs & reasoning for continued monitoring Schedules appointments for sample collection when deemed necessary Reinforces medication expectations/compliance and discusses: Challenges to compliance Lifestyle changes Exercise routines Nutrition

*See also Resources at aaha.org/technician-utilization
CBC, complete blood count, CSR, client service representative; CrVT, credentialed veterinary technician; VA, veterinary assistant; VCPR, veterinarian-client-patient relationship

Home

Guidelines Contributors

Introduction

SMART Goals to Implement CrVT Utilization and Team Optimization (Table 5.1)

Standardized Workflow for Optimal Utilization (Table 5.2)

Veterinary Team Member Utilization Assessment Tool (Table 5.3)

Levels of Veterinary Technician Utilization and Examples of Specific Skill Sets (Table 6.1)

CrVT Utilization Sample Open-Ended Questions (Figure 7.1)

What It Takes to Become a CrVT (Figure 7.2)

Resource Center

Developing the Guidelines

The 2023 AAHA Technician Utilization Guidelines are generously supported by CareCredit, Hill’s Pet Nutrition, and IDEXX.