Pet-Specific Care for the Veterinary Team. Группа авторов

their entertainment, and receiving many of their purchases by home delivery.

      Clients have also changed dramatically in terms of their knowledge of infectious disease transmissibility, hand washing, physical (social) distancing, premise disinfection, contact tracing, and the wearing of facemasks. This type of vigilance and anxiety tends to continue until they feel completely safe, and pet owners will be looking for some assurance that the veterinary hospital is a safe place to visit.

      Some clients will have prolonged trepidation about visiting businesses, including their own physicians, and so veterinary hospitals should not consider themselves unaffected by this. Client anxiety may be heightened if they do not have access to a vehicle but are still hesitant about the inherent risks of using public transportation or ridesharing. This apprehension can be allayed if teams explain all the protocols in place to keep those anxious clients and their pets safe, and this might include telehealth options based on telephone triage with clients.

      For pets that need to be seen in hospital, clients should receive instructions on how this can be done safely, and expectations should be established for how the visit will be conducted in a step‐by‐step manner. This might include instruction for the pet owner to wear a facemask (if indicated), access they may or may not have to the facility, whether they are allowed to accompany their pet for its veterinary visit, communication options with the veterinary team, and what is being done to ensure their safety. Even long after a pandemic has passed, some clients will likely have developed habits around hand washing, physical distancing, and the use of hand sanitizers, and everything possible should be done so they can feel comfortable seeking veterinary care for their pets.

      In the immediate aftermath of a pandemic, there is also a great opportunity to introduce topics that might not have garnered much attention previously, such as One Health (see 2.19 One Health). This initiative that links the health of animals, humans, and the environment is a great way to highlight the interrelatedness of such concerns, and the need for clients to appreciate the “big picture” of caring for our pets, ourselves, and our planet.

      1.6.4 Changing Practice Protocols

Veterinary staff are typically well educated and dedicated to animal health, but at the same time they want to protect themselves and their families from transmissible diseases, and their concern is legitimate. For the foreseeable future, we should expect that they will appreciate ongoing instruction on practice safety protocols, patient flow, and access to appropriate personal protective equipment (PPE). Because veterinary teams work collectively, there should be protocols in place for monitoring the health of individual staff members, having policies for isolation and quarantine, and supporting unambiguous and generous policies about which situations should prompt team members to leave the premises to preserve the health of others. It is also important to be aware of the additional stress experienced by staff and how that can take an immeasurable toll on productivity, commitment, and teamwork. Most veterinary hospitals have a relatively small contingent of team members, so without careful and considerate policies, staff could wrongly interpret that their physical and mental health is not a major concern of the hospital, which would be a very unfortunate conclusion.

      While they were always appropriate, protocols for personal hygiene were not always followed in periods prior to pandemics, but are definitely critical afterwards. There should be hand washing between each patient visit and adequate time allowed not only for sanitization of the examination rooms, but also for more thorough disinfection. This includes not only surfaces used for pets, but also those that might have contact from owners as well. This will add time to appointments which might eventually need to be recouped through increased fees.

      Veterinary staff are extremely valuable and their health is an important concern, so there should be ongoing dialogue about what steps the hospital is taking to keep everyone safe. Whenever possible, such protocols should be institutionalized as standards of care (see 9.4 Standards of Care) and staff should be counseled and coached as to what they should be doing to keep themselves and each other safe. It is important to consider even minor risks and work collectively to address concerns. When staff appreciate that their ongoing health is a major priority, and when it is reinforced by other team members, they can be confident that things are being done to mitigate their risks for getting sick. It is important to realize that fear is likely to persist long after a pandemic, so relaxing standards should only be contemplated after robust team discussions and the best available evidence.

      1.6.5 Expectations for Telehealth

      An increasing number of our clients have become quite familiar with teleconferencing in their daily lives. This comfort has extended to dealing with their physicians, and telehealth consulting with veterinary teams should be presumed to become a routine matter and perhaps even a preference for many clients (see 2.5 – Virtual Care (Telehealth)). The interaction can be synchronous (real‐time) or asynchronous (respond following review) but the expectation of clients will likely be that there are many times when dealing with pet care virtually is preferred. It is not just a matter of personal safety, but many clients have found this to be convenient as well.

      We should anticipate that many clients will be receptive to the practice of telehealth, and this is also a great way for pets to be triaged before exposing them to our facilities and hospital teams. Some conditions will be more amenable to virtual care than others, and clear guidelines should exist as to what can be attempted through this platform, and what should prompt a recommendation for the animal to be seen in the hospital.

      Remote monitoring is also available for our patients, and a variety of clinical attributes can now be measured at home. This includes collars that can measure activity, heart rate, respiratory rate, and some aspects of body temperature, but other devices such as glucometers can also be used. This can be very helpful for hospice patients, postsurgical patients, and those with a need for routine monitoring.

      Many clients are familiar with a variety of options for virtual connection, but hospitals should be comfortable with the privacy protections for any type of telehealth attempted, and it is best if the hospital designates only a few programs with which they are comfortable in this regard, and at which teams can gain proficiency. Because telehealth is likely to become a routine part of veterinary practice going forward, one of the most important things for veterinary teams to have in place are the criteria for telehealth visits, the structure of those visits, and the fees associated with telehealth consults. Telehealth need not be a money‐losing proposition for the practice and can be as or more profitable than other types of services if instituted correctly.

      1.6.6 Economic Insecurity

      The impact of the pandemic was not felt equally across populations, as is often the case with economic shocks. Many clients had interruptions in their ability to work and earn money, some may have had to deal with personal tragedies, and the uncertainty of what might come next often influences spending decisions for many years. Thus, it is reasonable to expect that clients might be hesitant when it comes to large expenditures for their pets, typically for several years or until they no longer feel vulnerable. Others may prefer to postpone procedures that are not considered essential and immediate until they feel more financially secure.

      Following any economic shock, such consumer attitudes are inevitable, and veterinary practices should anticipate this and plan their client messaging accordingly. There should be unequivocal communication about what services should be prioritized and which can be delayed, not to scare clients but to help them make informed decisions for the care of their pets. It may also be advisable to consider credit terms for procedures that might be preapproved by the hospital, as well as payment plans that allow clients to do the work recommended but spread payment out over a longer interval (see 10.17