International Benchmarking: AAALAC International Accreditation Kathryn Bayne, MS, PhD, DVM, DACLAM, CAAB Senior Director & Director of Pacific Rim Activities

Benchmarking (also "best practice benchmarking" or "process benchmarking") is a process used in management … in which organizations evaluate various aspects of their processes in relation to best practice, usually within their own sector. This then allows organizations to develop plans on how to adopt such best practice, usually with the aim of increasing some aspect of performance. Benchmarking may be a one-off event, but is often treated as a continuous process in which organizations continually seek to challenge their practices. Wikipedia

Benchmarking to Ensure a Quality Program  The public’s expectations for science are high  Public demands for best practices  Research costs with animals is increasingly a significant financial consideration for institutions  Clients want assurances of sound data and defensible animal welfare  Animal rights groups want to stop animal use

What Are The Risks of Not Benchmarking?  Public relations problems  Increased cost/loss of innovation  Erosion of public and community trust

Potential Objectives of Benchmarking  Improving organizational performance  Setting standards for performance monitoring  Ensuring appropriate management controls

Key Elements to Benchmark  Organizational structure  Operating procedures  Oversight (management) considerations

Successfully Using Benchmarking  Select a benchmarking system that can be used to guide performance  Ensure the data resulting from the benchmarking process can be meaningfully translated into action  Translate benchmarking into methodologies and techniques that create best practice.

AAALAC International site visit teams are in a unique position to benchmark animal care and use programs Average of 212 institutions visited each year for the last 6 years

Standards used:  National legislation, policy  Guide for the Care and Use of Laboratory Animals (NRC 1996)  AAALAC International’s Reference Resources  Institutional guidelines, policies

Methods to Ensure Quality Accreditation Assessments  Composition of the site visit team  Tailored to the institution  Limit to the number of times a Council member may take out a particular ad hoc Consultant  Maintains diversity of opinion  Colleagues who share the same experiences you do in your animal care and use programs

Methods to Ensure Quality Accreditation Assessments  Review of the Site Visit Report (including the post site visit communication from the institution)  Pre-meeting electronic review and comment/discussion  Council meeting deliberations

Methods to Ensure Quality Accreditation Assessments  Review of the letter to the institution  Post Council meeting review by Council Officers  Post Council meeting review by Senior Director

Over 750 Accredited Units in 29 Countries

Examples of Program Improvement Achieved Through Benchmarking by an Accreditation Process  Enhancing the level of veterinary care provided to animals  Ensuring a sound system of review of animal use proposals and of the animal program  Enhancing worker safety  Providing enrichment to animals  Reference to the 3Rs

Adequate Veterinary Care  Number of years of training  Does this matter?  Experience  With the species  With the procedures (surgery, gavage, etc.)  Continuing education  Staying current  Responsibility and authority

Example: Two Systems  2 or 4 years post- highschool  No to limited experience outside of the workplace  Limited authority in the program  Euthanize vs. treat  Well-credentialed  Often have experience outside primary place of employment  Role on the AEC  Good program authority

Example: For AAALAC  Appropriate training and experience required  Good medical records, preventive medicine program, surveillance program, etc.  Engaged role in the AEC  Reviewing protocols, assisting with choice of drugs, ensuring appropriate housing, etc.  Viewed as a partner in the research enterprise  Offers guidance to facilitate research and ensure animal welfare

Veterinary Care Program Resources  FELASA  Guidelines for the Veterinary Care of Laboratory Animals  ACLAM  Report of the American College of Laboratory Animal Medicine on Adequate Veterinary Care in Research, Testing and Teaching

Assessing Institutional Attention to Pain and Distress?  Questions in AAALAC’s Program Description  Review of select protocol forms  Look at the animals and their medical records  Review AEC processes  Program review  Approval of pilot studies  Guidelines, institutional policies

AAALAC International Program Description  How and by whom are levels of pain and distress assessed and categorized  AEC guidelines for avoiding unnecessary pain or distress  Agents used for each species  How veterinarian provides input to choice and use of drugs

AAALAC International Program Description (con’t)  How use of anesthetics and analgesics is monitored  Training and experience of personnel performing anesthesia  Methods of euthanasia for each species  Training and experience of personnel performing euthanasia

Protocol Review Elements  Consideration of analgesics  suitability of agent  dose  Consideration of adapting animals to restraint  Consideration of humane endpoints; clearly defined experimental endpoint

Commendations  Consideration of alternatives to painful procedures  Methods for postoperative care  Multi-species environmental enrichment program  Training programs ...etc.

Concerns Addressed Following AAALAC Site Visit  Searches for alternatives to painful or distressful procedures  Re-reviewing protocols involving painful procedures  Intensifying consideration of analgesic use during protocol review

Concerns Addressed Following AAALAC Site Visit  Improving consistency in the categorization of studies vis-à-vis pain and distress (e.g., FCA)  Instituting procedures for assessing pain in the postoperative period  Intensifying review of humane endpoints during protocol review

Concerns Addressed Following AAALAC Site Visit  Emphasizing prevention of pain and distress during protocol review as well as during the AEC’s facilities inspection and program review

Specific Examples  Murine ascites production  Guidelines for tail snip procedures  Use of postoperative analgesics in rodents  Prompt reporting of animal health problems (injury, disease, experimental outcome)

Benchmarking Through the AAALAC International Accreditation Process  Science-based standards  Flexibility of performance standards  Sensitivity to legal, cultural issues  Cross fertilization through site visits  Highlighting of best practices  Continuous quality assessment process

In Summary….  Accreditation by AAALAC International is a valuable and integral component of any quality assessment benchmarking program  Requires an extensive internal review  Provides a comprehensive external review  Highlights areas of excellence  Details a path for ongoing improvements

For more information…. AAALAC International Pacific Rim Office Makana Aloha Place Waikoloa, HI phone fax