UW/UCD Shelter Medicine Fellowship

Program

Ensuringanimalhealth:Isshelterintakealwaysthebest

waytohelp?ExploringManagedAdmission

MelissaResnick,DVM,MPH,DACVPMUW/UCDASPCAShelterMedicineFellow

ShelterVeterinarian,AnimalCareandControlTeamofPhiladelphia

BrendaDines,DVMUniversityofWisconsinMaddie'sShelterMedicineResident

Veterinarian,HumaneSocietyCalumetArea

Whatismanagedadmission?It’smanaging:• How theycomein• When theycomein• Who comesin

Canbeopenadmissionandmanagedadmission!

Whatismanagedadmission?•Willbedifferentineveryshelter

•Takesintoaccount:•Capacityforcare•Pathwayplanning

•Smallchangescanhaveabigimpact

• ACCTPhillyisanopen-admissionmunicipalshelterthatcannotturnawayananimalinneedoranownerwishingtosurrender

“ProvidershallacceptfromanycitizenoftheCityanyunwantedorstrayanimalthatisdeliveredtotheProvider“

• ~21,000dogsandcatsenteredtheshelterin2016• 5thlargestcityintheUS• Servesacommunityof1.5millionpeople• 1/4ofpopulationlivesbelowthepovertylevel

“

“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”

Howmuchofourannualintakeissurrenderedpets?

Average, 2012-2016

DOGS

Almost half! 3,557 dogs in 2016

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!

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

• 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”

“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”

Reasonfor Surrender: 3. Moving/landlordissues

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

1.Straycatsarereturnedtofield

•Communitycatsarealtered,vaccinated,andreturnedtofield•Drasticallyreducedthenumberofcatsadmitted•Drasticreductionsineuthanasiaofcats

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

2.PetsforLifeReturntoOwnerprogram•Petssurrenderedforreasonsrelatedtobeingintactcanreceivesterilizationsurgeryassurrenderintervention•Petsadmittedasstraysandreclaimedbyownerscanreceivefreesterilizationsurgery,vaccines,andmicrochip•Otherservices

3.PetFoodPantry

4.Discontinuedpickupserviceforunwantedpets

• BeganAugust2016• Decreasedfrom3-5pick-upsperdayto3-5perweek• Reservedforemergencysituations

5.Empoweredanimalcontrolofficerstoreturnanimalsidentifiablestraypetdirectly

toowners

• BeganAugust2016•Savesstafftimeandresources•Savesshelterspace

Intake diversion!

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

Veterinary care costs are similar regardless of size

Surrendereddogs,2016

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?

There had been no mention of ‘surrendered pets’ on our website…yet the public knew we admitted them!

Provided links to low-cost clinics

Intake diversion: Links to re-homing

7.Streamlinedpaperworktomoreefficientlyidentifypathwaysatintake

•Improveddatacollection•Surrenderforadoptionversusforsurrenderforhealth

A 15 minute investment at intake saves hours of time for veterinary and life-saving staff later

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

Created an owner surrender form that can be entered directly into Petpoint and captures more info

Collectedhealthspecificinformation

CreatedaQualityofLifeassessmentforowners

This has improved welfare of surrendered pets where euthanasia is best for pet

Improved documentation of ‘ownerintendedeuthanasia’

CreatedaQualityofLifeassessmentforowners

We added more info on website, including QOL assessment formPartnershipwithcharitythat

providesprivateeuthanasia

How long have you had the dog? 11 years

Reason for surrender: ‘Back legs giving way’

‘Surrendered for adoption’

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

8. Improvedpetsurrenderarea

Crowded lobby where customer service staff spoke to pet owners through glass windows

Unused hallway turned into semi-private owner surrender area

9.Reducedsurrenderhoursandofferedsurrenderappointments

•Onlyshortenedby3hours•Fewpeoplecallpriortocominginbutforthosewhodo…canofferappointment•Offerappointmentsforpeoplewhocomeoutsideofsurrenderhours(Googlecalendar)•Alternativetowaiting-haveaguaranteedtime•Exceptionscanalwaysbemadeforemergencysituations!

Reducing surrender hours allowed us to think about flow of traffic in lobby

Better staff scheduling

WOW!!

10.Strengthenedrelationshipwithdirecttransferpartners

• Rescueson-site4daysaweek• Encouragedownerstosurrenderonthosedays• Collectinfofromowneraboutpet

Intake diversion!

Even if pet not admitted to their shelter, surrender info is useful to us

“We’resogladwe’vecontinuedtohelppetsfindhomes.Andhelppeople.Wewanttobethereeveryday!”-PAWSstaffmember

“Insteadofassessingpetswhomaybescaredinacagewecanseehowtheyreallyare…withtheirownersbeforetheyevenstepfootintheshelter”-PAWSstaffmember

Spreading the word to the community with flyers

SometimesittakesanHVACrenovationtoseetheresultsofmanagedintake

• InFeb2017alargeHVACrenovationhalvedkennelspacefortwomonths

• Rescuepartnersandothershelterspulledmorelarge-breeddogs• Thepublicgotthemessagethattherewaslessspaceandsurrendereddogswereatincreasedeuthanasiarisk

• PSPCAandPAWSsetupintakediversionbyscreeningdogswhocouldbeadmitteddirectlytotheirshelter

Whathappenedwhendogintakewentdown?• Wesawlesssurrendereddogsoverall• Despitefewerdogsavailableforadoption,therewerethesamenumberofdogadopted

• Euthanasiawentdown!• Abilitytocarefordogsinourcarewentup!Moretimeforlife-savingtofindnewhomesorrescuesandforvetstafftoaddressmedicalissues

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

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!

AlittlebitabouttheshelterIworkat…HumaneSocietyCalumetArea

•Limitedadmissionwithmultiplemunicipalcontracts•Averageannualintakeof~2000•ContractwithGary,Indianaof2013thatalteredintake#’ssignificantly•Hasnumerousotherentitiesincludingaresaleshoppe,low-costclinic&wildlifecenter•H3N2outbreakMarch2016•Presentassupportstaffpriortobeingvet

Whydoanimalsendupinourshelter?• Ownercannotcarefor

• Healthoftheowner• Costofthepet

• LifestyleChanges• Stray• BehavioralIssues

• Aggression• Destructive

• LegalHolds

WhatisManagedAdmissioninmyshelter?• Wellit’salotofthings

• Wewilldiscussprior,presentandfuturecomponents• Itisaneverendingassessmentofwhatwecandobetter• Sometimesitistrialanderror• Itisanunderstandingthatalthoughmanagedadmissionisaprogramwithinitself,therearemanyotherprogramsthatwhenusedtogetherhelpourlifesavingefforts• Openadoptions• PetsforLife

ManagedAdmissionatHumaneSocietyCalumetArea

1. Returntofieldprogramforferal/under-socializedcats1. Modifiedtobedonemoreefficiently

2. FoodPantry3. Low-CostClinic

1. Recentlymoreaccess4. PetsforLifeProgram5. Changesincontractualobligations6. Scheduledappointmentsforintakes7. Utilizingadifferentfosteraspect8. Waitlist9. IntakeDiversion&Alternatives10. Assessingandtransferringfromothersheltersattheirfacilities11. Diversifyingpopulation12. Fast-Tracking

DestinationPost-Card

1. ShelterBy-PassService2. SurrenderDiversionPage

1. Resourcesformedical,behavioral,etc3. Greatercollaborationfromsurroundinganimalwelfareorganizations4. Behaviorcounseling

ConcernsforManagedAdmissions?• Wearenotaresourceforthecommunity

• Wherewilltheanimalsgo?• Displeased“relinquishers”• Notenoughtimetohandlethisprogram• Individualswillnotshowupforappointments• Contractualagreements

MitigatingThoseConcerns• WeareNOTsayingyoudonotadmitanimals

• However,youadmitanimalsasyourcapacityallows• Thebiggerquestiontoaskishowcanweprovideresourcestoalltheanimalsifweareoverwhelmed?

Whataboutemergencies&obligations?• Thegoalistonevercompletely“fill”

• Weworkwithintheunderstandingofcapacityofcare• Justbecausethereisacagedoesnotmeanitisfilled• Wemayneedopencagesforemergentsituations

• Evictions• Returns• “Dumped”Animals• HoardingCases• AnimalControlContracts

ChangesinContractualObligations

•StatedearlierwehadaoutbreakofH3N2•Hadtofigureouthowtodivertintakestobestserveanimalsinfectedandtonotnewlyinfectotheranimals•Ourcontracthadwordingtoallowustodeferintakes(Greatjob!)•Oncethecontracttimelineswereupwedidnotceasetohelp

•Insteadwehelpedwithinourmeansofhelping•Wetraveledtotheshelterandstrategicallytookdogsthatwouldmovequicklytobestservethelargeabundanceofdogs

•Fasttracking•Diversifyingpopulation

WhatifItoldyouwecouldsavemorelives?Don’tbelieveme?

I’llshowyou!

ScheduleUse

SomeoftheChanges!BeforeAfter

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

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

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

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

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

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

SomeoftheProblemsWeFace• Westillhavekinks

• Animalsarestilldumpedonoccasion• Westillhavesomecontractualobligations• Behaviorisfluid&theanimaldoesnotexcelinshelterenvironment• Underlyingmedicalconditionsarenotobserveduntillater

• OutsideIssues• Somesourcesfeelweshouldstilltakeanythingandeverything

• However,mostofthesesourcesaredenyingintakeoftheanimalthatdayaswell• Westilltransferinmanyanimalsfromthesesources

• Thisishowwecanhelpthemostanimals

Whatelsehaschangedbesidesmanagedintake?• Portalizedcages• Greaterrescueinvolvement&outreach• Removedbreedlabels• Medicalprotocols• Openadoptions

Questions?