What an exciting time to be involved in Emergency and Critical Care veterinary medicine! Our ability to provide exceptional care to ill and injured animals has advanced over time through the efforts of many groups and individuals with a passion to improve veterinary care. Two new efforts working to continue improving emergency and critical care include the Veterinary Emergency and Critical Care Society (VECCS) Facility Certification and the Veterinary Committee on Trauma (VetCOT) Veterinary Trauma Center (VTC) network.
What is VECCS Facility Certification?
The VECCS Facility Certification program is open to veterinary facilities that provide emergency and critical patient care. The purpose of this program is to recognize hospitals that meet the minimum requirements established by VECCS for veterinary emergency and critical care facilities. The goal of this program is to not only raise the level of patient care but also increase public and professional awareness in the area of veterinary emergency and critical patient care.
The VECCS Facility Certification program identifies 3 levels (I through III) for certification based on facility equipment and supplies, operating hours, and staffing. A detailed description of levels and requirements can be found at www.VECCS.org under the Facility Certification tab. In summary:
The Level III facility is an acute care facility with the medical staff, personnel and training necessary to provide emergent and critical patient care. The facility is open nights, weekends, and holidays, 365 days a year and must meet the minimum requirements and guidelines published by the VECCS.
The Level II facility is a 24-hour acute care facility with the medical staff, personnel and training necessary to provide emergent and critical patient care. The facility is open 24 hours a day, 365 days a year and has additional requirements for equipment and supplies.
The Level I facility is a 24-hour acute care facility with the resources and specialty training necessary to provide sophisticated emergent and critical patient care. The facility is open 24 hours a day, 365 days a year, has further requirements for equipment and supplies and also must have a Diplomate of the American College of Veterinary Emergency and Critical Care (DACVECC) on staff full time and available for consultation.
What is the VetCOT VTC initiative?
The VetCOT’s vision is to create a network of lead hospitals that seed development of trauma systems. These hospitals will work collaboratively to define standards of care and disseminate information that improves trauma patient management efficiency and outcome. VTC’s will contribute to a trauma registry that allows for continued advancement of trauma patient care. The goals of this program are to enhance trauma patient care, promote research collaborations, expand and formalize education of veterinary trauma, and enhance the visibility of veterinary specialty colleges. The development of the VTC network is a “work in progress”, with a very purposeful, gradual expansion planned to ensure processes at and between centers are solidified and validated as the network expands.
The VetCOT designates 3 levels (I through III) of Veterinary Trauma Centers for verification. Hospitals must hold VECCS Facility Certification, and meet the requirements for additional specialty staffing, internal performance improvement programs, education and collaboration with other VTC. A detailed description of the different levels is provided at https://sites.google.com/a/umn.edu/vetcot/ under Guidelines. In summary:
A Level III VTC is a facility that is primarily involved in the stabilization of severely traumatized patients and management of less severely injured trauma patients. It is not required to be open 24 hours a day or to have veterinarians with specialist qualifications on staff.
A Level II VTC is an acute care facility that has specialists in emergency and critical care, surgery and internal medicine on staff, and a radiologist available for consultation. Level II VTC’s have the responsibility of contributing to research, and are open 24 hours a day, 365 days a year.
A Level I VTC has the ability to provide total care for every aspect of the management of the small animal trauma patient from emergency stabilization through definitive medical and surgical care and rehabilitation. Specialists in the field of emergency and critical care, surgery and radiology are on staff and available for consultation 7 days a week, with specialists in anesthesiology, neurology, internal medicine, cardiology, ophthalmology on staff and available during standard business hours. Level I VTC’s have the responsibility of providing leadership in education, training veterinarians and veterinary technicians, and contributing to research. They are open 24 hours a day, 365 days a year.
What are the similarities and differences between VECCS Facilities Certification and the VetCOT VTC initiative?
Both efforts are centered on ensuring exceptional veterinary care for ill and injured animals, improving patient care delivery, promoting increased professional and public awareness and ensuring that physical (facility) resources are available to veterinary patients. Level I, II and III designation relates to depth of resources and operating hours (not staff capabilities).
The differences are as follows. The application process for VECCS Facility Certification is through the VECCS. It identifies a hospital as having the required physical resources and staffing to treat emergent and critically ill veterinary patients. The VetCOT VTC initiative is supported by the American College of Veterinary Emergency and Critical Care (ACVECC), and exemplifies the team-based approach to trauma care. It recognizes veterinary hospitals that have a commitment to continual process improvement, education enhancement and internal (between specialty groups) and external (between trauma centers) collaborations. Level I or II VTC’s will have a diverse team of specialists and staff that play an integral role in the stabilization and recovery of veterinary trauma patients.
Current Status Of Both Programs
VECCS Facility Certification Program
There have been over 200 requests for certification application documents. As of the date of this newsletter, 15 hospitals have been certified.
VetCOT VTC Initiative
The first 9 centers were provisionally selected based on the likelihood they would become a Level I VTC in a blinded review process. These centers have all participated in the VetCOT coordinated veterinary trauma registry which has captured data on >2000 trauma cases in 10 months. The provisional VTCs have recently submitted documentation to the VetCOT that is currently under review. Once the application information is reviewed, the provisional VTCs will become verified as Level I, II or III VTCs by September 2014.
The initial goal is to grow a foundation network of Level I+II VTCs. During the first 3 years (through 2015), invitation for application will be sent to the DACVECC list. Following this, applications will be opened for all levels. The committee anticipates identifying another round of 5-10 VTCs in 2015, and expansion to 40 to 50 VTCs in the next 5 years (including Level II and III centers). Visit the VetCOT website https://sites.google.com/a/umn.edu/vetcot/ to review the Newsletters and the “Overarching Vision” document, which summarize the efforts of the VetCOT.