but the cat intake was also much higher. With these results, the shelter heightened its adherence to its preventive protocols in the fall and winter. Similarly, surveillance data can confirm suspicions and provide evidence to change behavior and shelter protocols. A veterinarian had the clinical impression that the survival rate among fostered un‐weaned kittens could be improved by making changes to their management in foster homes; foster care providers were resistant to change. The data (see Figure 3.2) demonstrated a survival rate of only 71%. The providers were unaware of this rate, and they also found it unacceptable. The veterinarian updated protocols and made presentations to explain the basis for the changes. Over the next several years, survival rates increased to over 90%.
Figure 3.1 Incidence rate of URTD among cats by season.
Figure 3.2 Annual survival rates of un‐weaned kittens in foster care 2011–2014.
Routine monitoring and analysis of data augment the daily observations of the medical staff, adding to their understanding of the state of the health of the population. When routinely incorporated into population care, data surveillance can improve the health and welfare of shelter animals.
3.2.5 Frequency of Review, Interpretation and Communication
A key component of disease surveillance is regular data review and communication (Anderson 1982; Nelson and Williams 2007). Regular review by medical staff facilitates prompt recognition of changes in disease frequency and heightens responsiveness to these changes. This facilitates the timely achievement of disease‐related goals and enables the medical staff to inform the administration and other shelter staff of health changes in a timely manner. No less than monthly reviews of the frequency of some diseases (e.g. upper respiratory tract infections) at regular staff meetings are warranted. Monthly reviews have the added benefit of maintaining interest in disease surveillance and attention to the collection of quality data. It is powerfully motivating for staff to realize that their adherence to protocols was responsible for falling disease rates and the achievement of other goals.
The timing of some analyses can be pre‐specified, but other analyses may need to occur as the data suggests new questions. Frequency of monitoring is usually related to the incidence and severity of the disease, and whether the shelter has specific goals related to that disease. Generally speaking, high‐incidence diseases (e.g. feline URTD) will be monitored more frequently (e.g. monthly) than those of lower frequency. Disease outbreaks also trigger more frequent monitoring.
Interpretation of the results should include staff that may have insight into a particular analysis. The medical staff should obviously be involved but, in many instances, the shelter manager, kennel personnel or volunteers may also have important insights into why disease is manifesting as it is. For example, the interpretation of data relating to a rise in the mortality of fostered kittens might involve the shelter manager, veterinarian, executive leadership, foster‐care providers and others empowered to make protocol changes based on that data.
The ability to interpret and communicate findings based on the data is heavily influenced by the data presentation; the presentation can obscure or enhance the message it contains. It is beyond the scope of this chapter to make recommendations for effective data presentation, but references are provided (Knaflic 2015; Tufte 2001). A consistent recommendation in these references is to keep presentations simple and focused on the message that needs to be conveyed; it is important to avoid ostentatious presentations that obscure that message.
3.2.6 Data Quality and Administrative Buy‐In
Since disease surveillance requires the commitment of staff throughout a shelter, members of the shelter administration and management staff must believe in and support surveillance efforts. Staff training and incentives enhance the collection of quality data. When staff members understand the rationale for, and the importance of, complete and accurate collection of information, data quality rises. Resources are wasted in the collection of poor‐quality data, and analyses of that data can be misleading. Summary reports should be shared with staff on a regular basis. A review of the analyses facilitates discussions aimed at reducing disease and provides an opportunity to celebrate staff contributions to declining disease rates!
3.2.7 Recording Changes Affecting the Surveillance Program
Changes that can have an impact on disease frequency occur routinely in shelters. For example, turnover in foster‐care providers or staff, shifting shelter priorities, or changes to the economy of the community can impact the magnitude of disease rates and their interpretation. For example, in one community, the 2008 economic downturn resulted in the surrender of an increased number of animals requiring veterinary care because owners could not afford treatment. If the nature and timing of those changes are not recorded, people forget, and incorrect conclusions may be drawn from the data. One strategy for capturing these changes is a “Log of Events and Protocol Changes” that is updated as changes occur. An example of a log is provided in Table 3.2.
Table 3.2 Log of events and protocol changes for 2015.
| Date | Relevant Events |
|---|---|
| 1‐Jan | Animal control contracts from Sunny and Marlow towns discontinued. Owner surrenders will continue to be accepted. |
| 20‐Feb | A seizure of 60 dogs from Mary Smith is undertaken. The number of dogs exceeds the housing capacity of the shelter. Crates are set up and dogs are housed in staff offices. |
| 25‐Apr | Grant (~$20,000) received to increase Trap Neuter Return (TNR) efforts. |
| 30‐Apr | The shelter eliminated the part‐time veterinarian position due to financial concerns. |
| 9‐Jul | The intake policy changed. Nuisance feral cats managed by providing traps and spay‐neuter services. Animal Control officers trained to vaccinate stray animals before bringing them to the shelter. |
| 10‐Sept | Shelter eliminated two full‐time staff positions due to budget crisis; shelter is understaffed. |
| 23‐Oct | Funding restored, and two staff members rehired. |
| 15–23‐Dec | Mega adoption event. |
3.3 Length of Stay (LOS) in Shelters
The length of time animals spend in a shelter affects their likelihood of exposure to infectious agents; it also affects their stress levels (which impacts susceptibility to infection). Several studies have linked increased length of stay (LOS) with enhanced risk
