Applying clinical audit for quality improvement in canine dystocia cases seen at a UK primary-care emergency practice

BackgroundThe paucity of published veterinary clinical audits suggests that clinical audit is an under-used tool for quality improvement (QI) in the veterinary profession. Therefore, a continuous QI process was designed and implemented at a UK multisite small animal emergency practice, focusing on audit of clinical management of canine dystocia. MethodsData collection phases were undertaken in 2014, 2019 and 2021, with intervening knowledge dissemination activities. Nine variables relating to clinical management of canine dystocia were selected as audit criteria in the initial dataset, and 21 variables were measured in each subsequent phase. ResultsBetween 2014 and 2021, statistically significant increases (p < 0.05) were demonstrated in recording of bodyweight, use of diagnostic imaging, use of ultrasonography, recording of fetal heart rates, use of calcium gluconate, and use during caesarean section of intravenous fluid therapy, multimodal analgesia, full agonist opioids, paracetamol and local anaesthesia. Statistically significant decreases were demonstrated in median first quantity and median first dose of oxytocin, and in the use of NSAIDs during caesarean section. A clinical audit planning template was created for future audits. LimitationsTypical case presentation and management of canine dystocia cases may vary between dedicated emergency and non-emergency primary-care settings. ConclusionThis study demonstrates the feasibility of large-scale veterinary clinical audit and suggests that the application of the clinical audit process promotes learning within the veterinary team and improved clinical outcomes.

Automated summary

This study demonstrates the feasibility of conducting large-scale veterinary clinical audits, focusing on the clinical management of canine dystocia. The results showed significant improvements in various aspects of clinical management between 2014 and 2021, such as recording bodyweight, use of diagnostic imaging, and recording fetal heart rates.