Testing Ground

Hosting a Health Clinic

by C.A. Sharp

First published in Double Helix Network News, Summer 2011

Photo By: Bill Dakin

Photo By: Bill Dakin

Health clinics for genetic disease screening are one of the most valuable services a dog club or other motivated group can offer to purebred dog breeders.  Holding a clinic, especially one that offers multiple types of screening, makes testing convenient and economical for dog owners.  Test results are important tools for making informed breeding decisions.  Holding a clinic might seem like a daunting task, but with a little planning and organization anybody from an individual breeder to a national club can host a successful event.

Proper Prior Planning…

One of the best ways to make any event successful is to lay out a plan of action well before even the first deadlines loom.  For a small event you can start the process a few weeks ahead of time; a large one with multiple offerings might require that you get your dogs in a row four to six months out.  If you write your plan down and keep a copy, it will be there to guide you the next time you host a clinic or when you pass the responsibility on to someone else.

There should be one individual in charge of the event.  If that’s you, you may be able to handle everything for a small clinic yourself.  However, for a large multi-offering event you’re going to need a team of key volunteers.  However many people you involve, your team’s initial chore is to determine the what, where, and when for the clinic.

First things first

Everything else hinges on what you will be offering at your clinic.  Offerings may include one or more of the following:

–       X-rays for orthopedic conditions

–       Eye exams

–       BAER tests for hearing

–       Semen collection

–       DNA health screening

–       Registry DNA parentage evaluation sampling

–       DNA bank sample collection

–       Research sample collection

–       Anything else that may be useful to participants

Once you know what you plan to offer, look at possible dates and operation times.  You might want to start with two or three possible dates and whittle down the list as you identify conflicting events and verify availability of facilities and key personnel.  A major competitive event will draw a ready-made pool of participants if you can piggy-back your clinic health.  In this case, the date and time will be determined by the other event’s venue and schedule.  A small, simple clinic will require only a few hours operation, but a large one held at a national specialty or other major event might extend over several days.

Human Resources

There are a plethora of tasks to complete before, during and after any clinic.  The “personnel roster” that follows describes key volunteer positions for a large clinic.  For smaller events use the list as a guide and combine areas of responsibility to suit your needs.

Operations guru – The go-to person for all things clinic:  Puts a team together, supervises pre-event planning, and directs the clinic itself

Lab liaison – Point person for all communication with labs and research groups

Bean counter  – Handles all money matters

Paper shuffler – Performs all non-financial clerical tasks

Volunteer wrangler – Recruits and oversees warm bodies to help  on event day

Publicist – Creates and distributes all promotional items

Web Geek – Responsible for website/page, Facebook, Twitter, etc.

Supply guy/gal –  Acquires, stores, and distributes all necessary clinic supplies

Logistics wizard – Gets all clinic materiel where it needs to be when it needs to be there

The Pros – Veterinarians, animal health technicians, and any other specialists needed.

Location, location, location

Decide where to hold your clinic.  The venue needs to have adequate facilities and be conveniently located for participants.

Every event will need a check-in and waiting area which may or may not be in the same room as the exams/sample-collection.  If you plan to offer x-ray-based screening you will either need enlist the cooperation of a local veterinarian or find an examiner who has a portable unit.  If the latter, you must find a space that meets the vet’s specifications.  Eye exam require a room which can be made very dark and is big enough to hold an exam table, a small work table or desk, a chair or two, and two or three people.  If you will be collecting blood samples, you’ll need one or more exam tables with adequate work space around them plus a supply staging table and someplace to safely stow completed samples.   Cheek swab sampling can be done almost anywhere you can position a supply table and a few chairs plus one or more additional tables on to dry the swabs.

For single-day events a veterinary office works well  A vet’s office already has a waiting room, check in desk, exam rooms, adequate parking, and, if needed, x-ray facilities.  The down-side is you will probably be limited to scheduling your clinic on a Sunday or after hours.

A caution about outdoor events:  Make sure the actual collection/exam area is under cover.  (Rain, snow, sleet, and/or hail are sure to fall if it isn’t!)  Make sure any outdoor venue has or can accommodate adequate sample storage facilities to prevent sample damage or contamination from things like wind, loose dogs, and rampaging children.

Make sure you reserve your space; multi-use public facilities are in high demand and may be booked well in advance.  If you are doing a clinic during another event, make sure the event organizers are willing to have you there, know your needs, and will make adequate space available to you at the times you need it.

A final note on facilities:  Have a Plan B in case something goes awry.  Identify another nearby place which can be used in an emergency.  Depending on the situation, you may need to cancel.  If that happens, if at all possible you should have a way to notify participants ahead of time, particularly if some of them may be traveling long distances.

Necessary stuff

Put together a list of necessary supplies and equipment.  You’ll need adequate numbers of tables and chairs for staging supplies, a check-in station, waiting area, and exam/sample collection area(s.)  Many venues will provide these, but you still need a count so they provide the right number.  If you will have veterinarians or other professionals performing exams, they will probably bring their own supplies, but check to see if there is anything they expect you to provide.

If you will be collecting blood samples stock up on alcohol wipes, syringes with 20 gauge needles, and an adequate number of blood tubes.  You’ll also need coolers and cold packs.  (Hint:  Bags of frozen peas are a cheap, easily obtained, lightweight “cool pack.)  If a wash basin won’t be available, get hand sanitizer so sample collectors can clean their hands.  This is especially important for those collecting with cheek swabs because they are working in the dogs’ mouths.

For cheek swab items, be sure you obtain sufficient kits from the lab offering the test.  If the lab does not issue kits, be sure you have an adequate supply of cytology swabs on hand.  Finally, it doesn’t hurt to have a big box of dog cookies to reward the victims after their ordeal.

A suggested supply list for a large, multi-offering clinic can be found in the appendix at the end of this article.  Use it as a guide to develop your own list.

Time is of the essence

Create a timeline to make sure things get done on time.  This section lays out key tasks and when they need to be done for each of the key volunteer positions described under “Human Resources,” above.  You can combine or split tasks to suit your event. All the key volunteers should have their assignments no later than 90 days before the event.

Operations guru

90 Days out:  Obtain detailed sampling and handling instructions for each clinic item from the Lab Liaison.  Study them and prepare a notebook with all pertinent information for on-site reference during the clinic.  (Once prepared, this notebook can be retained for future clinics, though it should be reviewed at least once a year and updated as necessary.)

Pre-registration and payment can save time and effort on event day.  Decide whether you will offer this convenience and coordinate with other key volunteers to implement.  If pre-registration is offered, establish a cut-off date no later than one week prior to the event.

Determine whether your group will accept samples collected elsewhere. (Note:  It is better that you don’t.  See “Handle With Care!” below.)  Will your group be providing photocopying at the event for those who forget to bring copies of required documents.  (Hint:  Not is the better option, here, too.  You’ll have plenty to do without this.)  Provide policy statements on these two items to the Publicist and the Web Geek so attendees will have prior notification.

Throughout the pre-event period, keep in touch with and assist other key volunteers.  Trouble-shoot problems and facilitate communication between key volunteers if necessary.

If a club is hosting the clinic, discuss with the board whether or not they wish to underwrite a portion of the costs on some or all of the items.  Price underwriting encourages participation and benefits your breed.   If the club does decide to underwrite, try to make prices come to even dollar amounts – it’ll be easier to make change during the event.  Notify the Bean Counter and the Web Geek of any changes in pricing.

Serve as point-of-contact for any veterinarians or other professionals who will be offering their services at the clinic.  See that their needs are met.

One Week Out:  Visit the clinic site during this week to inspect the space.  Make plans for how you will arrange check-in and collection/exam areas with an eye to traffic flow and efficient operation.  If your supplies are being shipped to a drop-point, verify that they have arrived; have contingency plans ready if they have not.

Lab liaison

90 Days Out:  Contact all research groups and testing labs connected to clinic offerings to provide them with clinic dates and determine current prices and whether bulk discounts are offered.  If a lab/research group provides sampling kits, order those at this time.  Advise the labs  to ship no later than a month before the event (this gives you time to trouble-shoot if necessary.)  Obtain instructions and current forms for each offering.  Give the instructions to the Operations Guru.  If clinic info will be made available on a website, obtain pdf files of the forms for the Web Geek; you can often download these from the lab or research group’s website.

From now until clinic time, field all communications with laboratories and research groups.  Consult with or advise Operations Guru or other key volunteers as necessary.

 Bean-counter

90 Days Out:  Create or update forms for recording monetary receipts.  (Hint:  If you can have a computer on-site, set up a spreadsheet so all you need to do is enter the information as it comes in.)  If PayPal® is used for pre-registration and you don’t have access to the account coordinate with whoever does so you will receive payment information in a timely manner and decide how you will handle any refunds for those who pay but later can’t attend.  Refund information needs to be provided to the Publicist and Web Geek.  Decide what types of payment will be accepted (checks, cash, and/or credit cards) and advise other key personnel.

60 Days Out:  Maintain an up-to-date record of all receipts and expenses.

1 Week Out:  Get a change fund for event.

 Paper shuffler

90 Days Out:  Set up a log to record all clinic activity.  At a minimum this should detail who presented dogs, how many, and for which offerings.  The date payment was received and payment type (cash, check, etc.) can also be helpful,  Prepare check-in sheets for each clinic item with columns for the dog’s call name, the owner’s name, payment type, and – for multi-day events – date seen.  If your group offers pre-registration, keep the clinic log current.   Coordinate with the Web Geek or other key volunteers to collect this information.

60 Days Out:  if applicable, continue logging all pre-registrations as received.  Send participants an acknowledgement notice verifying the item(s) purchased.

1 Week Out:  Post any pre-registrations to the individual item check-in sheets; doing so will save time during the event.  Make enough copies of these forms to accommodate walk-ups.

Volunteer wrangler

90 Days Out:  Work with the Operations Guru to develop a list of warm bodies needed on clinic-day including someone to direct clinic traffic, one or more runners, cheek swab samplers (one person can do it but it is much easier if there are at least two at any given time,) two-person team(s) including an AHT or other qualified individual for blood sample collection, and – if required for any other offerings – veterinarians and AHTs,  Once arrangements have been made with any veterinarian, refer him/her to the Operations Guru as the point-of-contact for anything they might need.  Make sure the Operations Guru has the names, contact information and work assignments for professional participants.  Work with the Publicist to develop recruiting announcements.

60 Days Out:  Set up a work schedule for the event and start active volunteer recruitment.  Get the contact info, including a cell phone number (useful during the event) for each volunteer.  Determine their availability and assign a work shift.  If you will be recruiting AHT’s for blood sample collection, determine whether they have any special needs and communicate those to the appropriate key volunteers.  Continue the recruiting process until a week out.

1 Week Out:  Verify with all volunteers that they know when and where they will be working and what they will be doing.

Publicist

90 Days Out:  Develop promotional and informational announcements; coordinate with other key volunteers for content.  Put together a distribution list and schedule for any and all appropriate media.  If your group cannot take credit cards at the event, make sure all your promotion includes that information.  Encourage pre-registration, if offered.

60 Days Out:  Initiate promotion of the clinic and preregistration, if applicable, continuing through the week before the event.

 Web Geek

90 Days Out:  Prepare any needed web-mounted material with input from other key volunteers and with the site’s webmaster if other than yourself.  A page should, at the very least, include date, time and location for the clinic, a listing of the clinic offerings, and a “contact us” for questions.  You may also want to include a description of each item and its price.  Have forms available for download and advise attendees to fill them out ahead of time.

If pre-registration is offered, provide an on-line payment option so you can take advantage of credit card payment.  If your site doesn’t have a formal storefront, PayPal ® buttons are easy to install if your group has or can set up an account.

If your clinic will be a large multi-offering event, you might also want to provide some instructions.  What paperwork must be presented?  Is there any special preparation participants must make?  Where appropriate, provide links to related web pages for research and other sampling/ testing offerings.

If Facebook will be utilized for publicizing the event, prepare and mount all necessary information there.

60 Days Out:  Website and/or Facebook info goes live.  Once they are up, monitor Facebook for comments and  oversee the “contact us” e-mail.  Answer questions or direct them to the appropriate key volunteer.  Assist Publicist as needed with Facebook and Twitter.

One Week Out:  If applicable, disable pre-pay option ASAP after the pre-registration deadline.

 Supply guy/gal

60 Days Out:  If your group does not already have one, develop a supplies list with input from other key volunteers.  (See Appendix for a suggested list.)  Coordinate with other key volunteers to determine any special supply needs.  Inventory left-over supplies from prior clinics and acquire anything needed.

30 Days Out:  If kits have not been received, notify the Lab Liaison for follow-up to make sure you have them on time.  Arrange with Logistics Wizard to get all supplies delivered to the site.

One Week Out:  Get all supplies to the Logistics Wizard.

 Logistics wizard

90 Days Out:  Check with the Supply Guy/gal to determine what needs to be shipped to the clinic site.  Get specific post-event sample shipping instructions for each lab/research group from the Lab Liaison.  Check with the Bean Counter and Paper Shuffler to determine which post-clinic sample shipments must include a check.  Make a check-off list to assure everything that needs to be shipped to one place gets included in a single package and sent to or from the clinic at the proper time.

60 Days Out:  If needed, arrange for an incoming “drop point” on or near the event site.  Identify shippers convenient to the clinic site for post-event shipping needs.  Verify that they provide overnight service and that they will accept biological samples.

1 Week Out:  Make sure everything gets delivered to the event site in a timely manner.

 The Pros 

Veterinarians and other professionals connected to specific clinic items will generally run their own show.  They should be directed to the Operations Guru for anything they might need.  AHTs or others who will be drawing blood should communicate their needs to the Volunteer Wrangler.

Handle With Care!

If your clinic includes cheek swab or blood sample collection there are a few important things to keep in mind.  Every laboratory and research group will have its own specific requirements but here are some general guidelines.

Laboratories appreciate receiving properly collected and handled samples.  Improper handling can render a sample useless.  You must take the utmost care in collecting, storing, and shipping your samples.  Not only does this ensure happy clinic customers, it helps you maintain a good working relationship with the labs and research groups.

Ensuring sample quality is the reason you should not accept samples gathered elsewhere and brought to you at the event.  If you don’t collect a sample, you don’t know what dog was actually sampled or whether the sample was collected and packaged correctly.  Nor can you rely upon people’s assurances that they have the proper sampling kit.  Labs can be picky about getting samples collected with another lab’s kit.  If the customer paid for the test and the lab rejects the sample, you may be the one stuck in the middle.

Blood samples

Blood must be kept chilled between collection and shipping.  Because temperature maintenance can be critical and qualified blood-drawers are in limited supply, if you plan a multi-day event it might be best to hold the blood draw on a single day.    Try to make use of a refrigerator for overnight storage and do not allow the blood to freeze.  Blood needs to be shipped in a container that can be kept cold.  Small, insulated beverage coolers are cheap and work well.  If you cannot find cold packs, use bags of frozen peas.  Pack any accompanying paperwork in a zip-lock bag so it won’t get wet.

Cheek swab samples

Before sampling each dog, verify that it hasn’t had food, water, or exposure to other dogs or toys for at least one hour prior to swabbing.  This prevents cross-contamination with another dog’s DNA.  If someone brings a young puppy, make sure it isn’t still nursing.  Ideally, these questions should be asked at the check-in table.

Collect swab samples one dog at a time.  Samplers should wash or sanitize their hands between dogs.  Swabs will need to be air-dried before packaging; select a place where multiple swabs can be laid out without touching.  The drying area must be safe from jostling by people or dogs.  If your event is outdoors, protect the swabs from wind.  Make sure the paperwork does not get separated from the associated swabs.  If swabs are to be shipped back in their individual sleeves, fasten the flap on the tube loosely with a piece of tape.  WARNING:  If you seal swab sleeves tightly, moisture trapped inside can spoil the sample.

When the swabs are dry, package them and related paperwork as per the instructions of the lab to which they will be sent.  Prior to shipping, store completed swab/form sets in a box kept safe from traffic and moisture.   Have a separate box for each lab’s completed samples and forms.

If the clinic is held in humid conditions it may be necessary to spread out completed swab envelopes indoors for a few hours to get them as dry as possible.  DO NOT ship swabs in plastic containers or bubble-wrap envelopes as these trap moisture.

Clinic Day!                                                                  

The Operations Guru and anyone else who will be helping with set up should arrive before the event (at least two hours for a blood draw, one for other items) to make sure all tables, chairs, supplies, etc. are in place.  If at all possible, set up the day before.  All other key volunteers who will be working the event should arrive no later than a half hour before opening.  Day-of-event volunteers who have been assigned work shifts should arrive 15 minutes before their scheduled time so they can receive instruction and for a smooth transition between shifts.

The Lab Liaison, Publicist, Logistics Wizard, and Web Geek do not need to be present during the clinic unless they have other duties at that time.

Supply guy/gal

Collect supplies from the drop point, if shipped.  Deliver them to the clinic site at least an hour before opening.  Open supply containers and distribute all items to the appropriate work areas before the clinic opens.  If the clinic will run multiple days and the set-up is not in a secure (i.e. indoors, locked) area, pack up and remove all supplies at the end of each day and bring them back at least one hour before start time the next morning.  If something is running low or somebody needs something, go get it.  At the end of the event, pack up all leftovers.  Coordinate with the Logistics Wizard for transport to the place they will be stored.

Operations guru

Supervise and direct all clinic volunteers and assist in sampling dogs.  Oversee sample handling, labeling, and short-term storage (prior to shipping).  Once the clinic opens, make sure all samples are handled properly to avoid contamination.  Verify sample labeling for accuracy and compliance with lab requirements.  Oversee proper air drying of all cheek swab samples and refrigeration of blood samples.

For multi-day clinics, at the end of each day assist the Paper Shuffler to check all samples collected against the clinic log and check-in sheets.  Secure all samples overnight in a place where no unauthorized person will have access to them and where there is no possibility of contamination.   Verify that the Bean Counter has balanced the day’s receipts against the clinic log.

When the clinic is over, assist the Paper Shuffler and Bean Counter with a final over-all inventory of samples and an audit of at-event receipts and expenses.

Paper Shuffler

Oversee all on-site paperwork, including verifying that forms submitted are properly and legibly filled out.  Run the check-in table.  Verify any payment required with the Bean Counter.  If the dog will have a cheek swab test, verify that it has had no exposure to foreign DNA.  (See “Handle With Care!” above.”)  Assist Bean Counter with daily audit of receipts and expenses.

Bean Counter:

Maintain control of the cash fund and all monies received during event.  Record receipts for walk-ups.  If the event is multi-day, secure the money box overnight.  With the assistance of the Paper Shuffler, audit receipts and expenses daily.

If you do not have check writing authority for the host group, provide the responsible party with a list of any checks (payee and amount) needed to go with sample shipments.  if appropriate, prepare and make the end-of-event deposit and give the receipts record to the appropriate individual.  If you are doing a large multi-day clinic and you receive considerable cash it may be prudent to make a few interim deposits or convert the cash to cashiers checks.

Volunteer wrangler

Make sure all scheduled volunteers remember their shifts.  Fill in for no-shows.  Dragoon extra help if needed.

The job’s not over…

…until the paperwork, among other things, is finished.

Logistics wizard

Shipping samples to labs and research groups is job one:  All samples should be shipped as soon as possible after the close of the clinic.  Make sure checks for the labs are included in any shipments that require them.  Provide the Lab Liaison with tracking numbers for all shipments.

Blood samples need to be cushioned when packed to prevent breakage.  Place any accompanying paperwork in a zip-lock bag or other waterproof container.  Samples should be shipped as soon as possible via overnight service.  DO NOT ship blood on a Friday.  If you do, someone, somewhere will leave the container sitting on a loading dock in bad weather until Monday.  If you cannot ship the same day as the clinic or the morning after, make sure blood is properly stored and chilled until the earliest possible shipping opportunity.

Cheek swabs are less problematic but should reach the lab in a maximum of 3 shipping days.  Ship them at the earliest opportunity after the close of the clinic.

Bean Counter

Your top priority is to make sure the Logistics Wizard gets any checks that need to be included in the sample shipments.  Provide the club treasurer or other appropriate party with copies of all clinic financial records and a listing of any checks written including check number, date, payee, and amount.  After the event, redeposit the cash fund.  Turn expense receipts and a record of all income and expense over to the host organizations treasurer or other responsible party.

Lab Liaison

Follow up with the labs/research groups to make sure all samples arrived in good order.  (Don’t depend on the shipping company’s on-line tracking information, alone.)  Trouble-shoot any problems.  Being on top of shipping issues helps you build a good relationship with the labs.

 Volunteer Wrangler

Send thank-you notes to all volunteers and professionals who took part in the clinic.  If applicable, make sure the club newsletter editor and webmaster receive a list of volunteers so they can be thanked in those media.

Publicist

Send out a “thank you” message to clinic participants and announce clinic totals.  If the host organization is a club, send copies of the announcement to the newsletter editor and webmaster

Operations Guru

Verify that all key volunteers with after-event duties follow through.  Call a “post mortem” meeting a week or so after the clinic to discuss the event.  Make note of things that worked and things that didn’t for future reference.  Serve refreshments and celebrate a job well done!

If your club or group hasn’t done a clinic in the past, consider putting one on.  This article tells you the things most folks have to learn by trial and error.  (The author has tried – and occasionally erred – at numerous clinics.)   Putting on a clinic, particularly a big one, is a lot of work.  However, the effort is well worth it.

Clinics are a tremendous benefit to the dogs, their owners, and your breed as a whole.  If you’ve already done a clinic, plan more and keep up the good work!

Appendix:  Supplies list

This is a basic clinic supply list.  Add or delete items as needed to suit the specifics of your event.

  • Copies of forms for all clinic offerings
  • Brochures or other hand-outs about clinic offerings
  • Cytology swabs, if not provided by lab(s) (for cheek swab items)
  • Clipboards, one for each clinic item
  • #10 (business size) white envelopes for packaging individual swab sample sets
  • Disposable tablecloths
  • Pens (for people to fill out forms)
  • Cash box (for change fund)
  • Note pads
  • Paper clips
  • Scotch tape
  • Packing Tape
  • Stapler and staples
  • Small boxes/baskets for small supply items
  • Boxes for completed swab kits
  • Anti-bacterial hand wash or wipes
  • Suitable shipping containers for blood tubes
  • Sufficient 6ml EDTA (or other, as required) blood tubes (for blood sample items)(recommend you have at least 100 – research groups generally do not supply these)
  • Cold packs  (or bags of frozen peas)
  • Suitable shipping boxes for cheek swab samples
  • Tables and chairs, if not provided
  • Dog cookies