AAHA - The League of Champions

In 1933, the United States was reeling. It was the fourth year of the Great Depression. Unemployment stood at 25%. A new and untested president had recently moved into the White House. It was a turbulent and uncertain time.

But amazingly, during America's darkest hours, seven leaders of the veterinary profession came together to form one of the country's greatest organizations: the American Animal Hospital Association (AAHA). It was and remains the only institution that accredits companion veterinary hospitals in the U.S. and Canada. It was built on the premise that pets deserve nothing less than the very best veterinary care.

Fast-forward to 2018. In 85 years, the country has changed in ways that were unimaginable in 1933. But AAHA has endured. Thrived. And today it is the most esteemed veterinary association in the country.

As Dr. Heather Loenser, AAHA’s Senior Veterinary Officer, put it recently, “Veterinary medicine is always evolving and improving. And AAHA has to remain flexible, ready to challenge previous protocols and upgrade them to the latest recommendations."

It is that flexibility that has maintained AAHA as the standard of veterinary excellence in a rapidly-changing world.

The best doctor in the world is the veterinarian. He can't ask his patients what is the matter--he's got to just know.” 

AAHA Accreditation is a Very Big Deal 

We know this because human hospitals have their own accreditation standards. For example, if a human hospital is not accredited by a CMS-approved program, they can't offer Medicare. Being AAHA accredited is not about prestige. Yes, that comes with it. Being accredited is actually about operating at a higher level. And when it comes to health, that's the only level to play on. The process of accreditation is challenging and rigorous. It is also voluntary and not guaranteed. When a veterinary facility steps up to become accredited, it means they are making a proclamation they are committed to excellence.

This doesn’t mean non-accredited veterinary practices are bad. No. It does mean they've not been measured by AAHA's roughly 900 accreditation standards. Some veterinary practices think good enough is good enough. And that's fine. But as AAHA's President-elect, Dr. Darren Taul says, "It also raises the question of how much more successful would they be if they truly reached for their full potential by obtaining accreditation."

As in any profession, some want to take their skillset to the next level. They want to be champions. AAHA can take them there. Since 1933, AAHA has charted a course to accreditation for approximately 3,700 practices. Dr. Bo Williamson, owner of the Tennessee Avenue Hospital in Cincinnati, Ohio, the oldest continuously accredited American Animal Hospital Association hospital in the world says, "Accreditation is a way to force yourself to be the best you can be. Owners and employees of accredited hospitals constantly look to make things better."

Currently, only 12 to 15 percent of animal hospitals are accredited. AAHA wants more practices to make the journey to accreditation. They invite you to take the accreditation challenge and go at your own pace. This allows prospective practices to know exactly what lies in front of them. 

AAHA is considered, as their motto states, 'a standard for veterinary excellence.' It works to ensure excellence in companion animal veterinary care through accreditation, guidelines development, and education." 

- Dr. Jane Sykes, Chief Veterinary Medical Officer, UC Davis Veterinary Medical Teaching Hospital.

At its core, accreditation has two functions. First, it recognizes and objectively certifies great veterinary practices. This is valuable to pet parents as they search for the best possible care for their nonhuman family members. Second, it helps good veterinary hospitals become great ones by coaching their personnel and helping practices live up to their potential. Many practices are poised to take the step from good to great, but need the counsel and guidance that AAHA provides to fully realize their latent qualities.

High Standards and Real Results

Those standards have very real life-and-death effects on animals and their human companions. Lori Seubert, an experienced cat rescuer from Toledo, Ohio is one of the many people who view AAHA accreditation as essential in choosing a veterinary facility. She recalls her capture of a rascally kitten who frequented a parking lot near a Rally’s restaurant and had evaded capture for almost two months. 

Several weeks after she was finally trapped, Rally Sally began to pant and breathe rapidly. Ms. Seubert took her to Sylvania Veterinary Hospital, an AAHA-accredited facility, where Dr. Bob Esplin diagnosed her with community-acquired pneumonia. He prescribed a multiple-day stay in an oxygen chamber and other life-saving therapies. It was a grave situation, but Rally Sally made a full recovery and was later adopted by a wonderful couple. "I’ve gone to several different vets in my area seeking affordable medical care for the rescue cats I’ve fostered," said Ms. Seubert, "but I knew this kitten was very sick and needed the best care possible. I took her to Sylvania Veterinary Hospital because I knew that she'd have the best chance at survival in a place that was accredited by the AAHA.”

Veterinarians appreciate the recognition that AAHA confers--and actually thrive on being held to AAHA's exacting standards. Dr. Laurie Hess is the principal vet and founder of the Veterinary Center for Birds & Exotics in Bedford Hills, New York. "AAHA accreditation is important to me and my staff," she says. "We operate the only accredited avian and exotic animal hospital in the State of New York. That means that we're held to the highest standards in terms of the medical and surgical care that we provide to all the birds and exotic pets that we treat. We work hard to maintain this accreditation so that bird and exotic pet owners can rest assured that their pets are receiving the most up-to-date, highest quality care available. We take AAHA accreditation very seriously and are very proud to be among a select few hospitals awarded this recognition.”

Stacy Hamilton, a vet tech and practice manager at Loving Family Animal Hospital in Aurora, Colorado, AAHA’s 2017 Practice of the Year, has seen what accreditation means to her clients. “It tells them how much we really care about practicing high-quality medicine,” she remarked, “because we’re holding ourselves to the highest standard of care possible. Our clients know we will always provide them with the best options for their loved ones. As awareness in the community has grown about what AAHA is and does, many clients have come to realize that this is an optional accreditation that few hospitals hold. That really sets us apart.”

What Do Pet Parents Think About Accreditation? - Great Question

Trone Brand Energy did a study on just that back in 2016. The study found that pet owners are overwhelmingly attracted to animal hospitals that have the AAHA accreditation.

Some of the survey highlights are below: 

85% of pet owners would choose an AAHA-accredited hospital over a non-accredited one;

58% are willing to pay more to use an accredited facility (although veterinary health insurance is now within reach for most people); and

63% would drive farther to get treatment at an accredited practice.

The full study is available here.

We're always eager to add more veterinarians and staff members to our AAHA community whether they work in a single doctor practice with a small staff or with a team of dozens of specialists and credential technicians."

- Dr. Heather Loenser

The Path to Accreditation

Accreditation involves being measured against over 900 standards of veterinary care across 18 categories. Fifty are mandatory, and then a certain number of additional points must be accumulated across the 18 categories.

Here's how the process works:

1. A practice calls the accreditation team at 800-252-2242 or emails them at practice.accreditation@aaha.org.
   
2. The practice spends three months corresponding with AAHA's accreditation team in preparation for evaluation day.
   
3. On evaluation day, a consultant visits and conducts the accreditation evaluation on-site.
   
4. The AAHA Practice Consultant will make another on-site visit two years after the initial visit.  
   

Being accredited by AAHA doesn’t mean that a veterinary practice is accredited for all time. Instead, accreditation is a continuing process. Accredited practices are re-evaluated every three years. That way, AAHA can continuously guide animal hospitals through the changes in veterinary practice and technology to ensure they can deliver state-of-the-art services.

The process is collaborative and provides feedback and improvement concepts and ideas. It allows an organization to benchmark against best practices. And as a premier organization, it allows us to be part of the formulation of those best practices and pushes the industry as a whole to higher and higher standards.”

Why do some animal hospitals choose to walk this path? Dr. Mike Cavanaugh, the CEO of AAHA, believes that the journey to accreditation effects a significant change in the morale and cohesion of a veterinary facility’s personnel. According to Dr. Cavanaugh, accreditation “means they care enough to be their very best on behalf of their patients, their clients and their staff. I often hear about the wonderful outcome of a hospital team working together to achieve accreditation and the bonding and team-building that results when they successfully achieve their shared goal of accreditation.”

The current president of AAHA, Dr. Mark McConnell agrees and notes that there are other benefits to accreditation as well. “Some choose to become AAHA-accredited because they want the structure and assistance in running a practice. Others want the best for their patients and AAHA provides resources for the practice team to deliver the best medicine. Some want a recruitment tool to attract skilled and dedicated employees who want to practice with high standards.”

Standards and Guidelines

AAHA has over 900 standards for accreditation of care. Those standards range from pain management and anesthesia, to medical records and surgery. The standards are the backbone of this organizations and are closely adhered to by over 3,700 practices.

Each standard is exhaustively researched and documented by a committee of experts in the field. The level of detail comes close to being granular, with specifications for what drugs a veterinary hospital must stock at all times, how different rooms in the facility are to be cleaned and disinfected, how clients are to be communicated with, how the practice should be run in an ecologically sound manner, what purpose-dedicated rooms the facility must have, and so on.

The standards that AAHA facilities must adhere to are grouped into 18 categories:

 It really demonstrates to the pet parent that this practice takes their role as an animal health care provider very seriously and they look to meet or exceed the best practices that have been developed overtime. It’s very much a ‘seal’ of approval and not easy to attain."

In contrast to AAHA’s standards, which are mandatory for all accredited facilities, AAHA guidelines are akin to a set of best practices that veterinary practitioners may consider in light of their own experience and in the context of the needs of the individual patient, the available resources, and the limitations unique to the practice setting. Some of its key guidelines cover diabetes management, dental care, canine and feline oncology, and end-of-life care.

To Vaccinate or Not to Vaccinate?

That is the question... and to this day the debate remains heated. AAHA has developed guidelines that can serve as a conversation starter. For example, although it is well known that rabies is fatal and inoculation is required by law in all 50 states, other vaccines can be recommended or not recommended on a case by case basis. Things to take into consideration are the dog’s lifestyle, age, and health. Location is also important as some cities are more prone to certain diseases than others.

The core, or recommended, vaccines for all dogs are:

1. Rabies
   
2. The combined vaccine of distemper, adenovirus, parvovirus, and +/- parainfluenza.
   

In 2017, AAHA created the Lifestyle-Based Vaccine Calculator. It's been accessed 45,000 times by professionals and canine caretakers.

The Human-Animal Bond

Another facet of AAHA’s work involves research into the human-animal bond and the question of how it affects human health and well-being. In 2015, AAHA formally became a member of the steering committee of the Human Animal Bond Research Initiative (HABRI). With AAHA’s assistance, HABRI’s research focuses on how the relationship between animals and people can be a beneficial factor in human health outcomes.

According to the American Veterinary Association (AVMA), the Human-Animal Bond is defined as "a mutually beneficial and dynamic relationship between people and animals that is influenced by behaviors that are essential to the health and well-being of both."

As Dr. Cavanaugh put it, “The practice teams at our AAHA-accredited hospitals celebrate the value of the human-animal bond each and every day. Ask any of them and they can rattle off a number of reasons why pets are good for their people. HABRI’s research is putting scientific evidence behind what many of us have been saying for years related to how animals affect a person’s well-being. With HABRI’s help, we’ll be able to say these things with strong evidence behind us and no longer have to make a leap of faith regarding what we know to be true.”

Among other things, HABRI is studying how companion animals contribute to psychological well-being in older adults, how interactions with animals may reduce children’s stress levels, how service dogs affect the mental health of war veterans with PTSD, and the long-term effects of pet dogs on children with autism.

The Future of AAHA

Dr. Cavanaugh believes that in the coming years, AAHA will continue to focus on its core function: accreditation. The organization is looking at modernizing the processes of collecting and analyzing member-generated data. Additionally, the way AAHA runs its on-site visits is being reimagined.

AAHA also hopes to focus on developing healthy workplace cultures. Practice members experience all kinds of emotions in the course of serving patients with all kinds of ailments. While all practitioners feel depressed at times, coming into a positive work environment makes a big difference.

That kind of forward thinking has characterized AAHA since its inception. Though its goal has remained constant for 85 years, the ways of achieving excellence are constantly changing.

Co-Author Jim Trumm, Senior Editor