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UW/UCD Shelter Medicine Fellowship
Program
Ensuringanimalhealth:Isshelterintakealwaysthebest
waytohelp?ExploringManagedAdmission
MelissaResnick,DVM,MPH,DACVPMUW/UCDASPCAShelterMedicineFellow
ShelterVeterinarian,AnimalCareandControlTeamofPhiladelphia
BrendaDines,DVMUniversityofWisconsinMaddie'sShelterMedicineResident
Veterinarian,HumaneSocietyCalumetArea
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Whatismanagedadmission?It’smanaging:• How theycomein• When theycomein• Who comesin
Canbeopenadmissionandmanagedadmission!
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Whatismanagedadmission?•Willbedifferentineveryshelter
•Takesintoaccount:•Capacityforcare•Pathwayplanning
•Smallchangescanhaveabigimpact
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• ACCTPhillyisanopen-admissionmunicipalshelterthatcannotturnawayananimalinneedoranownerwishingtosurrender
“ProvidershallacceptfromanycitizenoftheCityanyunwantedorstrayanimalthatisdeliveredtotheProvider“
• ~21,000dogsandcatsenteredtheshelterin2016• 5thlargestcityintheUS• Servesacommunityof1.5millionpeople• 1/4ofpopulationlivesbelowthepovertylevel
“
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“It can’t apply to my shelter, we’re open admission!”
“How can we offer surrender interventions when the reasons for surrender seem insurmountable?”
Howcanwe‘manage’surrenderedpetswhenwemust‘takethemall’?
“We don’t have enough time or staff in any department to even keep up now!”
My initial reaction to managed admission Staff’s reaction:
“This will never work here!”
“We’ll euthanize more surrendered pets”
“Customer service staff don’t have time or staff to collect and enter more info”
“Owners will abandon pets in lobby or say pet is a stray”
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Howmuchofourannualintakeissurrenderedpets?
Average, 2012-2016
DOGS
Almost half! 3,557 dogs in 2016
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Howmuchofourannualintakeissurrenderedpets?
CATS 4,492 surrendered cats in 2016
Only 1/3 of all cats remain in shelter
Average, 2012-2016
Stray cats are returned to field!
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WhyarepetssurrenderedtoACCTPhilly?
DOGSCATS
2012-2016 data
Top 3•1. Health of animal•2. Lifestyle changes (new baby new job, owner’s health)•3. Moving/landlord issues
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• Rangesfrombasicanimalcaretoacuteinjuries/illnesstocomplicatedchronicdiseases
• Orsimplycan’taffordeuthanasia
ReasonforSurrender:1.Healthofanimal
“He keeps getting worms”
“She is not using her litter box and not keeping the
mice away”
“Sick and blind and unable to control bowels”
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“Needs too much attention”
How long have you had the cat? “Over 10 years”“Have a new baby in home”
Reasonfor Surrender: 2. Lifestylechanges
“Twins on the way”
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Reasonfor Surrender: 3. Moving/landlordissues
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Steps taken towards managed admission
1. Returntofieldstraycats2. PetsforLifeReturntoOwnerprogram3. Foodpantry4. Discontinuedpickupserviceforunwantedpets(Fall2016)5. Empoweredanimalcontrolofficerstoreturnanimalswith
identificationdirectlytoowners(2017)6. Createda‘Surrender’pageonshelterwebsite7. Streamlinedintakeprocessandpaperwork(surrenderfor
adoptionversusforeuthanasia)8. Improvedpetsurrenderarea9. Reducedsurrenderhours10. Strengthenedrelationshipwithdirecttransferpartners(reword?)
Steps already taken
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1.Straycatsarereturnedtofield
•Communitycatsarealtered,vaccinated,andreturnedtofield•Drasticallyreducedthenumberofcatsadmitted•Drasticreductionsineuthanasiaofcats
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0
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
2011 2012 2013 2014 2015 2016 2017
Stray cats
Surrendered cats
October 2014 began collaboration with Best Friends
Catintakebyyear
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2.PetsforLifeReturntoOwnerprogram•Petssurrenderedforreasonsrelatedtobeingintactcanreceivesterilizationsurgeryassurrenderintervention•Petsadmittedasstraysandreclaimedbyownerscanreceivefreesterilizationsurgery,vaccines,andmicrochip•Otherservices
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4.Discontinuedpickupserviceforunwantedpets
• BeganAugust2016• Decreasedfrom3-5pick-upsperdayto3-5perweek• Reservedforemergencysituations
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5.Empoweredanimalcontrolofficerstoreturnanimalsidentifiablestraypetdirectly
toowners
• BeganAugust2016•Savesstafftimeandresources•Savesshelterspace
Intake diversion!
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Steps taken towards managed admission 1. Returntofieldstraycats2. PetsforLifeReturntoOwnerprogram3. Foodpantry4. Discontinuedpickupserviceforunwantedpets(Fall2016)5. Empoweredanimalcontrolofficerstoreturnanimalswithidentificationdirectlyto
owners(2017)6. Createda‘Surrender’pageonshelterwebsite7. Streamlinedintakeprocessandpaperwork(surrenderfor
adoptionversusforeuthanasia)8. Improvedpetsurrenderarea9. Reducedsurrenderhours10. Strengthenedrelationshipwithdirecttransferpartners(reword?)
What’s next?
Where can we make the biggest impact? Health of animal
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Veterinary care costs are similar regardless of size
Surrendereddogs,2016
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6.Createda‘Surrender’pageonshelterwebsite
•Providedlinkstolow-costclinicsandspay/neutersurgery•Resourcesforre-homingpets•Linkstoothersurrenderpreventiongroups•Explicitlystatepossibilitythatoutcomemaybeeuthanasia(shelteraslastresort;notfirstoption)
•Explainedshelterunabletoofferservicestoownedpetsatthistime
Will pet have a better outcome coming in the shelter or staying where they are?
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There had been no mention of ‘surrendered pets’ on our website…yet the public knew we admitted them!
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Provided links to low-cost clinics
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Intake diversion: Links to re-homing
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7.Streamlinedpaperworktomoreefficientlyidentifypathwaysatintake
•Improveddatacollection•Surrenderforadoptionversusforsurrenderforhealth
A 15 minute investment at intake saves hours of time for veterinary and life-saving staff later
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Information on owner surrender forms was often missing or not provided
Information on owner surrender forms (or written on the back) not entered into Petpoint
Owner filled out form without guidance or help from staff
Owners were leaving with valuable information about pet’s health and behavior
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Created an owner surrender form that can be entered directly into Petpoint and captures more info
Collectedhealthspecificinformation
CreatedaQualityofLifeassessmentforowners
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This has improved welfare of surrendered pets where euthanasia is best for pet
Improved documentation of ‘ownerintendedeuthanasia’
CreatedaQualityofLifeassessmentforowners
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We added more info on website, including QOL assessment formPartnershipwithcharitythat
providesprivateeuthanasia
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How long have you had the dog? 11 years
Reason for surrender: ‘Back legs giving way’
‘Surrendered for adoption’
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Why are you giving the dog up? “Old and health problems”
Moreinformationplaces pets appropriately with rescue groups or adoptive homes and improves good outcomes for pets
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8. Improvedpetsurrenderarea
Crowded lobby where customer service staff spoke to pet owners through glass windows
Unused hallway turned into semi-private owner surrender area
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9.Reducedsurrenderhoursandofferedsurrenderappointments
•Onlyshortenedby3hours•Fewpeoplecallpriortocominginbutforthosewhodo…canofferappointment•Offerappointmentsforpeoplewhocomeoutsideofsurrenderhours(Googlecalendar)•Alternativetowaiting-haveaguaranteedtime•Exceptionscanalwaysbemadeforemergencysituations!
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Reducing surrender hours allowed us to think about flow of traffic in lobby
Better staff scheduling
WOW!!
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10.Strengthenedrelationshipwithdirecttransferpartners
• Rescueson-site4daysaweek• Encouragedownerstosurrenderonthosedays• Collectinfofromowneraboutpet
Intake diversion!
Even if pet not admitted to their shelter, surrender info is useful to us
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“We’resogladwe’vecontinuedtohelppetsfindhomes.Andhelppeople.Wewanttobethereeveryday!”-PAWSstaffmember
“Insteadofassessingpetswhomaybescaredinacagewecanseehowtheyreallyare…withtheirownersbeforetheyevenstepfootintheshelter”-PAWSstaffmember
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Spreading the word to the community with flyers
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SometimesittakesanHVACrenovationtoseetheresultsofmanagedintake
• InFeb2017alargeHVACrenovationhalvedkennelspacefortwomonths
• Rescuepartnersandothershelterspulledmorelarge-breeddogs• Thepublicgotthemessagethattherewaslessspaceandsurrendereddogswereatincreasedeuthanasiarisk
• PSPCAandPAWSsetupintakediversionbyscreeningdogswhocouldbeadmitteddirectlytotheirshelter
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Whathappenedwhendogintakewentdown?• Wesawlesssurrendereddogsoverall• Despitefewerdogsavailableforadoption,therewerethesamenumberofdogadopted
• Euthanasiawentdown!• Abilitytocarefordogsinourcarewentup!Moretimeforlife-savingtofindnewhomesorrescuesandforvetstafftoaddressmedicalissues
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Nextsteps
☐Work with Pets for Life to expand resources for pet retention
☐PFL will begin customer service training in surrender prevention counseling
☐Trainvolunteerstohelpcollectinformationaboutsurrenderedpets
☐Collaboration with other organizations also working to keep pets in homes to create help desk
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Even if you feel like your shelter can’t do anything to manage admission you may actually be able to make some small changes that have a big impact!
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AlittlebitabouttheshelterIworkat…HumaneSocietyCalumetArea
•Limitedadmissionwithmultiplemunicipalcontracts•Averageannualintakeof~2000•ContractwithGary,Indianaof2013thatalteredintake#’ssignificantly•Hasnumerousotherentitiesincludingaresaleshoppe,low-costclinic&wildlifecenter•H3N2outbreakMarch2016•Presentassupportstaffpriortobeingvet
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Whydoanimalsendupinourshelter?• Ownercannotcarefor
• Healthoftheowner• Costofthepet
• LifestyleChanges• Stray• BehavioralIssues
• Aggression• Destructive
• LegalHolds
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WhatisManagedAdmissioninmyshelter?• Wellit’salotofthings
• Wewilldiscussprior,presentandfuturecomponents• Itisaneverendingassessmentofwhatwecandobetter• Sometimesitistrialanderror• Itisanunderstandingthatalthoughmanagedadmissionisaprogramwithinitself,therearemanyotherprogramsthatwhenusedtogetherhelpourlifesavingefforts• Openadoptions• PetsforLife
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ManagedAdmissionatHumaneSocietyCalumetArea
1. Returntofieldprogramforferal/under-socializedcats1. Modifiedtobedonemoreefficiently
2. FoodPantry3. Low-CostClinic
1. Recentlymoreaccess4. PetsforLifeProgram5. Changesincontractualobligations6. Scheduledappointmentsforintakes7. Utilizingadifferentfosteraspect8. Waitlist9. IntakeDiversion&Alternatives10. Assessingandtransferringfromothersheltersattheirfacilities11. Diversifyingpopulation12. Fast-Tracking
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DestinationPost-Card
1. ShelterBy-PassService2. SurrenderDiversionPage
1. Resourcesformedical,behavioral,etc3. Greatercollaborationfromsurroundinganimalwelfareorganizations4. Behaviorcounseling
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ConcernsforManagedAdmissions?• Wearenotaresourceforthecommunity
• Wherewilltheanimalsgo?• Displeased“relinquishers”• Notenoughtimetohandlethisprogram• Individualswillnotshowupforappointments• Contractualagreements
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MitigatingThoseConcerns• WeareNOTsayingyoudonotadmitanimals
• However,youadmitanimalsasyourcapacityallows• Thebiggerquestiontoaskishowcanweprovideresourcestoalltheanimalsifweareoverwhelmed?
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Whataboutemergencies&obligations?• Thegoalistonevercompletely“fill”
• Weworkwithintheunderstandingofcapacityofcare• Justbecausethereisacagedoesnotmeanitisfilled• Wemayneedopencagesforemergentsituations
• Evictions• Returns• “Dumped”Animals• HoardingCases• AnimalControlContracts
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ChangesinContractualObligations
•StatedearlierwehadaoutbreakofH3N2•Hadtofigureouthowtodivertintakestobestserveanimalsinfectedandtonotnewlyinfectotheranimals•Ourcontracthadwordingtoallowustodeferintakes(Greatjob!)•Oncethecontracttimelineswereupwedidnotceasetohelp
•Insteadwehelpedwithinourmeansofhelping•Wetraveledtotheshelterandstrategicallytookdogsthatwouldmovequicklytobestservethelargeabundanceofdogs
•Fasttracking•Diversifyingpopulation
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WhatifItoldyouwecouldsavemorelives?Don’tbelieveme?
I’llshowyou!
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SomeoftheChanges!BeforeAfter
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Ut 2014were
Owner Surrender
Return
Stray
Transfer In
Total
2012 2013 2014 2015 2016 2017
6788 89
6543
148
42 51 57 51 3971
143 142
8958 69 80
89
136
356
196
139
212
341
417
591
370
290
511
INTAKES JANUARY TO APRIL
Owner Surrender Return Stray Transfer In Total
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Died
Euthanasia
Return to Owner
Transfer Out
Adoption
Total
2012 2013 2014 2015 2016 2017
4 17 263 1 4
7 10 1533
5 0
22 27 36 3923 17
16 25
119
27 1532
300 313
367
298
252
439
349
392
563
400
296
492
OUTCOMES JANUARY TO APRILDied Euthanasia Return to Owner Transfer Out Adoption Total
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Owner Surrender
Return
Stray
Transfer In
Total
2012 2013 2014 2015 2016 2017 to Date
Intakes Overall
253 232 217 221 230 210
181 208 226 206 193103
837
1061
421 429 390
130
453 466
1492
776674
317
1724
1967
2356
16321487
760
INTAKES OVERALLOwner Surrender Return Stray Transfer In Total
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Died
Euthanasia
Return to Owner
Transfer Out
Adoption
Total
2012 2013 2014 2015 2016 2017 to date
61145 125
52 28 9
50 50 91 9111 1
63 106191
124 77 28
52 101232
11834 40
1512 1478
1750
1352 1372
611
17381880
2389
1737
1522
689
OUTCOMES OVERALLDied Euthanasia Return to Owner Transfer Out Adoption Total
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Outcomes 2012 2013 2014 2015 2016 2017toDate TrendsDied 3.5% 7.7% 5.2% 3.0% 1.8% 1.3%Euthanasia 2.9% 2.7% 3.8% 5.2% 0.7% 0.1%ReturntoOwner 3.6% 5.6% 8.0% 7.1% 5.1% 4.1%TransferOut 3.0% 5.4% 9.7% 6.8% 2.2% 5.8%Adoption 87.0% 78.6% 73.3% 77.8% 90.1% 88.7%
PercentagesOutcomesOverall
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2012 2013 2014 2015 2016 2017 to Date
Broken Down Overall Outcomes
Died Euthanasia Return to Owner Transfer Out Adoption
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Whathasmanagedadmissiondoneforlengthofstay?
•Ourlengthofstayhitanalltimelow!•Itdecreasedbyover2x!•Why?
•Animalswerenotmentallydecliningincage•Animalswerenotgettingsickasfrequently
•Animalsthatwere,weregettingaddressedmuchearlier•Whichusuallymeantlessdayssick
•Staffcouldprovideenrichment
Year 2012 2013 2014 2015 2016 2017toDateAverageLengthofStay 51.9 54.4 48.1 65.3 50 20
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SomeoftheProblemsWeFace• Westillhavekinks
• Animalsarestilldumpedonoccasion• Westillhavesomecontractualobligations• Behaviorisfluid&theanimaldoesnotexcelinshelterenvironment• Underlyingmedicalconditionsarenotobserveduntillater
• OutsideIssues• Somesourcesfeelweshouldstilltakeanythingandeverything
• However,mostofthesesourcesaredenyingintakeoftheanimalthatdayaswell• Westilltransferinmanyanimalsfromthesesources
• Thisishowwecanhelpthemostanimals
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Whatelsehaschangedbesidesmanagedintake?• Portalizedcages• Greaterrescueinvolvement&outreach• Removedbreedlabels• Medicalprotocols• Openadoptions