Discussion & Case Study: Reducing Shelter Length of Stay for Felines and One Shelter s Journey to Save More Feline Lives Part I Mehnaz Chumkee Aziz, DVM This presentation will focus on how your shelter can systematically evaluate every opportunity to decrease length of stay (LOS) for the animals in your care. We will focus specifically on cats; however, these population management tools can be applied to all animals in your shelter. Reduced LOS can be achieved by managing shelter intake, by implementing management practices that ensure good flow-through the sheltering system, and by promoting optimal outcomes for each animal. This presentation will highlight why monitoring LOS and animal care days is just as important as monitoring shelter intakes and outcomes as important statistics. Capacity & LOS: Length of stay is the most significant risk factor for illness in shelter animals. Studies have found that increased LOS within a shelter is correlated to increased risk of acquiring canine or feline upper respiratory disease (Dinnage et al 2009 & Edinboro et al 2004). With illness comes the need for treatment, reduced welfare, and a yet more prolonged stay. The longer an animal is confined, the greater the demand for sufficient space, interaction and environmental enrichment to prevent confinement-related stress and behavioral disorders. However, longer stays also mean more crowded shelters, reducing the availability of space and care for each animal. Ultimately, the longer the stay per animal, the higher the costs as well. Shelters are a resource-limited environment: higher costs per animal mean less available for each animal and perhaps even more importantly, less to invest in preventive programs that keep animals safe in their homes and out of the shelter to begin with. Conversely, for any given outcome, shortening the LOS to that outcome will reduce costs, lower risks for behavioral and health problems for each animal, and provide better conditions for shelter animals and people alike. Length of stay, therefore, has implications for animal welfare, animal health, sheltering costs, and ultimately a shelter s capacity to save lives. Length of stay is the duration of an animal s time in the shelter from the day of intake to the day of disposition. It is the total number of animal care days per animal. One animal care day is equivalent to one animal in the shelter system for one day. This includes one housing unit + one day s worth of care time + one day s worth of consumable supplies. One thousand animals housed for 20 days each results in 20,000 animal care days, which places a greater burden on a given staff and facility than 1,000 animals housed for 10 days (10,000 animal care days).
For a shelter caring for thousands of animals per year, even minor increases in LOS can add up to very substantial numbers of additional animal care days. Reducing the LOS even minimally can dramatically reduce crowding and improve the level of care available for each animal. Euthanasia does not need to increase, nor does the live release rate need to decrease to achieve a shorter LOS. In reality, we typically see the opposite effect - reduced crowding and illness due to shortened LOS lead to an increased number of lives saved. The table below shows how the daily shelter population will increase as LOS (number of animal care days per animal) increases even when animal intake remains constant: Daily Intake Average LOS Daily Population 5 animals 5 days 25 animals 5 animals 10 days 50 animals 5 animals 20 days 100 animals As LOS increases, the daily population increases and the shelter s capacity to provide humane care is reaching its maximum limit. This increased daily population results in a greater burden on staff, the facility, and the animals. Since the capacity of the staffing and the facility remain the same on a day-to-day basis, it is more challenging to care for 100 animals each day than it is to care for 50 animals. The above table can also be viewed in reverse, which highlights the number of animals served (daily intake) based on a given capacity: Daily Capacity Average LOS Daily Intake 100 animals 5 days 20 animals 100 animals 10 days 10 animals 100 animals 20 days 5 animals This leads to the critical question - what is a shelter s true capacity for care? Capacity to care is based on a shelter s ability to provide and uphold the five freedoms for each animal in its care. By definition, capacity is how many animals the shelter can care for at any one time. Flow is defined as how many animals the shelter can care for over time.
Both capacity and flow are limited by physical factors such as the number of housing units, but, more importantly, they are limited by additional factors such as the number of trained staff and volunteers, the number of services and programs the shelter provides, the shelter intake and live release numbers, and the average LOS. Shelter capacity should remain relatively stable, unless more housing is built or more staffing is acquired. Flow, however, can change based on the average LOS. For any given capacity, doubling the LOS reduces the number of animals served by half, as shown in the table above. By maximizing flow, a shelter can reduce its daily population. The combination of these factors dictates what a shelter s capacity to provide humane care truly is. The basic calculation that relates LOS to intake and capacity is: Daily Capacity Needed = Daily Intake x Average LOS Breaking Down LOS: There are multiple steps in the sheltering system: intake, medical and behavioral evaluations, surgery, etc. It is helpful to break down LOS into these separate components and target programs at reducing LOS in each component. Pathway Planning: Proactive population management allows for streamlined movement of animals through the sheltering system to live outcomes with the maximum efficiency. Proactive population management starts with pathway planning. This is a means of actively tracking each animal s shelter stay from the moment it enters (or even before) to the moment it leaves. The idea behind pathway planning is that each animal is on the road to an outcome from the very beginning, so each next step in the sheltering system can be anticipated, scheduled, and completed on time. Each animal admitted to the shelter has a different pathway (stray vs owner surrender vs feral). Along each pathway, there is critical flow through points that we need to get each animal through promptly and efficiently. Intake - Should they come in at all? Intake is not necessarily the optimal option for every cat, particularly community cats who have historically high euthanasia rates across the country. We will discuss the new paradigm for responding to community cats, addressing issues such as population management, welfare, and reuniting cats with owners. Intake diversion programs (also known as pet retention programs) are on the rise. This is one strategy to completely reduce an animal s shelter LOS. By providing the public with assistance so they can keep their pets in their homes, these programs uphold the human-animal bond and, concurrently, alleviate shelter intake in the community.
Pre-Intake: Strictly speaking, time an animal spends pre-intake does not count towards LOS in the shelter. And that is a good thing allowing as much preparation and care as possible to take place outside of the shelter will generally benefit both the animal and the shelter. Shelters have always informally managed pre-intake LOS in various ways, for instance by asking finders to hold off on turning in a litter of kittens until they are old enough for adoption, or asking an owner wishing to surrender an animal to wait a few days until there is room in the shelter. Recently the value of this practice has been recognized and formal programs implemented to more actively plan shelter admissions, most notably through managed intake programs. Managed intake refers to a thoughtful process whereby admission to the shelter is scheduled based on the shelter s capacity to provide care and, in some cases, assure a live outcome for each animal admitted. This can include scheduled intake, scheduled foster returns, and encouraging public finders to foster underage animals. Pre-Adoption: The next component of LOS to consider is pre-adoption. This encompasses any required holding time between admission and when an animal becomes actively available for adoption most commonly, stray holding periods or intake quarantine. Every effort should be made to minimize LOS in pre-adoption except as needed to ensure that owners have a reasonable opportunity to be reunited with lost pets. Of course, mandated holding periods must be followed; however, voluntary holds beyond legal mandates should be carefully weighed. When evaluating stray holding periods, check the median time to owner reclaim. Extending holding periods beyond a few days for unidentified animals may not result in increased reclaims and may jeopardize other options for live release, especially if this results in overcrowding of the shelter. In California, for instance, extending the stray holding period from 72 hours to 4-6 days failed to correspond with a significantly higher rate of return to owner for cats or dogs, yet resulted in substantially greater demands for housing and care. Remember that animals with ID and those that will be euthanized rather than made available for adoption or rescue can always be held longer. Because unidentified cats are rarely reclaimed, mandatory stray holds of any length tend to be detrimental. Ideally, all un-owned cats without ID will be moved through the shelter to live release (adoption, rescue, or return to location of origin) as quickly as possible. Likewise routine intake quarantines should be carefully evaluated. For shelters transferring in animals from very high risk locations/source shelters, intake quarantine may be justified to avoid animals breaking with severe illness on the adoption floor or after adoption. In that case, time to onset of disease should be carefully tracked and a quarantine period selected of the shortest length that permits the majority of cases to be caught.
Keep in mind that prolonged intake quarantines also carry risks, which outweigh benefits much of the time. True quarantine requires an all in all out system, whereby a group of animals is segregated from all other animals for the duration of quarantine. For shelters, the added challenge exists of providing sufficient enrichment and interaction during this time to maintain behavioral as well as physical health. If an all-in-all-out system cannot be maintained, quarantine will actually tend to increase risk, as cats with unknown health backgrounds are constantly added to the mix. It is rarely helpful, and often harmful, to hold animals in such a circumstance simply waiting for multiple vaccines to be given. There may still be logistical reasons for holding newly admitted animals back from adoption, such as need to complete medical or surgical procedures. This length of time should be minimized, for example by scheduling more frequent, shorter periods when these procedures are completed (4 hours of surgery every other day versus 6 hours twice a week, for example), training additional staff to perform the procedure to the extent possible, and/or making the animal available for adoption prior to completing the procedure (e.g. allowing animals to be selected for adoption prior to surgery, which is then completed before the animal is released). Often, some amount of time in pre-adoption holding is inevitable. For many shelters, it makes sense to optimize this time by allowing animals to be viewed and selected for adoption or rescue during their holding period. If animals can be selected during their stray hold, for example, shelter staff will know to prioritize surgery or any other needed processing for that animal to move quickly through the system. In many cases, this allows animals to bypass spending time in adoption entirely, saving space and resources for those animals that truly need it. This practice is known as open selection. Preventing Detours: Detours refer to time spent by an animal not actively and productively moving towards a live outcome. This includes both time spent being treated for shelter-acquired illness and time spent lost in the system, awaiting needed care and processing. These two factors tend to feed on each other when care is delayed and LOS increases, the risk for illness rises commensurately. When more animals are ill, staff time for animal care and processing is reduced, and delays tend to occur. It is easy for a vicious cycle to get started that leads to ever increasing crowding and disease. Fortunately, this can be reversed through a diligent effort to bring the population back within shelter capacity through extra attention to each step of animal movement through the system. Ultimately, the key to unwinding a cycle of bonus length of stay, or better yet preventing it in the first place, is a system of Daily Population Wellness Rounds. Unlike medical rounds, population wellness rounds take into account a holistic view of each animal in the shelter, within the context of the whole population, and ask of every individual what can we do for you today?
Whether an elderly purebred Persian needs a rescue group contacted, or a fearful cat needs a hiding box to help her cope, daily rounds ensures that each animal s needs are met and that every step is taken promptly to move the animal through the system. In order to provide this holistic perspective, population rounds should include staff empowered to make decisions and take action from a shelter management, medical, and behavioral perspective. When starting from an overcrowded ground zero, daily rounds can seem like an overwhelming task. Starting with an emphasis on moving fast track animals quickly through the system can help reduce the daily burden and allow focus on animals with more complex requirements. Sometimes it is necessary to bring extra staff on board or invest in overtime for a short while to get caught up. Sometimes it is necessary to start small and work up even weekly rounds are better than no rounds at all. Each time an animal is moved safely through the system even one day sooner than before, breathing room is created to do a little more, and then still a little more. Pretty soon an un-vicious cycle is created where animals move through the shelter more quickly, illness and stress is reduced, volunteers and adopters are happier, costs decline, and resources are freed up to focus on the life saving preventive work that is at the heart of all we do. Adoption LOS: Adoption LOS refers to time spent actively available and awaiting adoption. Not every animal will need to spend the same amount of time in the sheltering system. Some, such as injured animals and neonates, will require extended care to get to the point of adoption. Others will appeal to the tastes of a rare few adopters and may wait a long while for that right person to walk in the door. Fortunately, there are also many animals that come in the door ready to go, appeal to a broad range of adopters and have no particular barriers to adoption. Allowing these fast track animals to move through the shelter system quickly is key to providing the conditions and care that the slower track animals require to thrive. Developing a system to identify fast track versus slow track animals at, or soon after, intake can help ensure each animal moves along the appropriate pathway. Especially when resources to move animals through to adoption are limited (e.g. space in adoption areas, surgical slots for spay/neuter), fast track animals should skip to the head of the line ahead of slow track animals. This frees up congestion in pre-adoption areas and lowers the daily population, freeing staff time to provide better care for slow and fast track alike, and ultimately will tend to reduce LOS for both groups. Many activities are undertaken to reduce the amount of time animals spend waiting for adoption: special promotions, great photographs, pricing strategies, and more. All of these are important, but the single most important factor in many cases in determining the average LOS to adoption is simply the number of animals available for adoption at any given time.
As an example: Shelter A has 100 cats in its care and Shelter B has 200. Let us say each shelter decided to manage intake to coincide with live release, such that no cat will be euthanized for space or time. Now let us say each shelter adopts 10 cats per day and consequently admits 10 cats per day, staying full but not overcrowded. What will the length of stay be for Shelter A? Length of stay = daily population/outcomes per day. So for Shelter A, the average LOS will be 100 cats on site per day/10 adoptions per day = 10 days. For Shelter B it will be 20 days. Even with the same intake, the same adoption rate, the same great policies and promotions, the LOS will be twice as long at Shelter B as at Shelter A, simply by having more cats available. Of course, it is not always as simple as that. Sometimes having more animals available for adoption will lead to a greater number of adoptions. This can happen if potential adopters were put off by a lack of sufficient choices. Other times, having fewer animals for adoption can increase adoptions, if presentation improves or adopters feel less overwhelmed. Determining the exact right number of animals to have for adoption, then, is a critical decision. This number is determined by the expected number of adoptions over time and is therefore termed Adoption Driven Capacity or ADC. The basic calculation for Adoption Driven Capacity is: ADC = Average adoptions per day x target LOS to adoption It is important to note that even shelters that maintain their daily population within their given physical housing capacity may still be beyond their optimal capacity. Remember, capacity for care is based on more than just physical capacity. The concept of housing fewer animals at any one time, ideally calculated by the shelter s ADC, is based on the idea that maintaining an optimal capacity will prevent crowding and therefore mitigate stress. For cats, specifically, this will reduce stress-associated URI incidences. The final component of adoption LOS is to ensure that all of the hard work done to move animals through the system is not negated by restrictive adoption requirements. This concept is known as open adoptions. It is defined as a policy to help people adopt animals best suited to their lifestyles. The purpose of the adoption interaction is to create learning opportunities in order to equip the person with information and resources for her/his current and future use as a pet parent or guardian. Open adoption agencies generally have few or no hard and fast adoption criteria. Instead, the process uses guidelines as a checklist of things to discuss in the adoption counseling.
Conclusion: It is important to emphasize that increased euthanasia is not required to reduce LOS. The amount of euthanasia is determined by the difference between the number of animals admitted and the number of live release outcomes. Ensuring that proactive population management is in place will result in reduced LOS, increased welfare, plentiful space and good care for each animal, and eventually increase the life-saving capacity of a shelter. References: Dinnage, J.D., et al. (2009). Descriptive epidemiology of feline upper respiratory tract disease in an animal shelter. J Feline Med Surg 11: 816-825. Edinboro, C. H., et al. (2004). "A placebo-controlled trial of two intranasal vaccines to prevent tracheobronchitis (kennel cough) in dogs entering a humane shelter." Preventive Veterinary Medicine 62(2): 89-99.
Discussion & Case Study: Reducing Shelter Length of Stay for Felines and One Shelter s Journey to Save More Feline Lives Part II Dr. Cristie Kamiya In the second part of this talk, we walk you through a few of the programs and process changes that Humane Society Silicon Valley (HSSV) implemented to increase life-saving capacity and decrease length of stay. The presentation will be divided into five parts to reflect the Million Cat Challenge - five key initiatives to balance intake, humane capacity within the shelter, and live release: 1 1. Alternatives to intake: Provide positive alternatives to keep cats in the home or community when admission to a shelter is not the best choice. 2. Managed admission: Schedule intake of cats to match the shelter s ability to assure humane care and safe movement through the shelter system to an appropriate outcome for every cat. 3. Capacity for care: Match the numbers of cats cared for at any one time with the capacity required to assure the Five Freedoms of animal welfare for all cats in the shelter. 4. Removing barriers to adoption: Expand the pool of adopters by removing barriers to adoption such as cost, process, or location. 5. Return-to-field: Sterilize, vaccinate, and return healthy un-owned shelter cats to the location of origin as an alternative to euthanasia. 1. Alternatives to Intake HSSV s Medical Center has been offering High Volume High Quality Spay and Neuter Services to the public since 2009. Multiple county and privately funded programs are available for residents of Santa Clara County to participate in low or no cost spay and neuter surgeries for their pets, and community cats through trap-neuter-return (TNR). Free surgeries for community cats/tnr are available Monday through Saturday, and on 18 Sunday Community Cat Spay/Neuter clinics per year through HSSV s Medical Center. 1 Million Cat Challenge: http://www.millioncatchallenge.org/the-five-key-initiatives/
As part of this service, community cats are spayed/neutered, vaccinated for rabies and FVRCP, de-wormed, treated for external parasites, ear-tipped, and micro chipped through a privately funded grant. Monthly TNR classes are also provided to community members interested in trapping community cats. The Pet Pantry is a program to help prevent pet surrenders because of an inability to pay for pet food and keep pets in their homes. This program provides food, litter, and other supplies on a monthly basis to families in need. This program also supports community cat colony caretakers to offset some of the expenses related to feeding managed colonies. The P.U.P. (Prevent Unwanted Pregnancies) Program addresses accidental litters in the home. Through the PUP Program, families are provided free medical care for the litter of kittens and puppies in exchange for keeping the litter in their home with mom until weaned. Once weaned, the kittens and puppies are spayed/neutered and adopted through HSSV s adoption program, and the mother (and father, and other adult animals in the family if applicable) is spayed and vaccinated for free at the same time, then returned to the owner. 2. Managed Admission All owner-surrenders are by appointment only. During the initial contact, it is determined what intake procedures are due. Then, a pre-intake appointment is scheduled, during which time a medical and behavioral assessment is made, vaccines and deworming are administered, testing and minor diagnostics performed, and spay/neuter surgery is scheduled if needed. In most cases, once the pre-intake examination is performed, the official scheduled intake on a later date is straight to the adoption floor, or at the time of spay/neuter surgery. This pre-intake process eliminates the bottleneck that can sometimes occur waiting for the next step in the shelter flow. 3. Capacity for Care HSSV has made a commitment to update current shelter practices to reflect the recommended guidelines as published in the Association of Shelter Veterinarians Guidelines for Standards of Care in Animal Shelters. 2 The focus of this initiative remains on decreasing length of stay, high quality housing, behavioral enrichment, and social support for cats in care. 2 Association of Shelter Veterinarians http://www.sheltervet.org/about/shelter-standards/
The project commenced with cutting portals into every stainless steel cage in the building, and continues with creating new programs to improve the lives of cats at HSSV. The Kitten Nursery, which is an extension of the Foster Care program, provides onsite, 24-hour care for underage kittens, and queens with litters of kittens. This dedicated space protects the most vulnerable of the shelter population, and allows a safe place for kittens to thrive until old enough for adoption. 4. Removing Barriers to Adoption HSSV has a total of three off-site adoption centers in addition to the main HSSV Animal Care Center in Milpitas. These Neighborhood Adoption Centers located inside PETCO and PetSmart stores expand HSSV s reach, providing opportunities for adoption directly into the communities. Seasonal Adoption Promotions occur multiple times a year, varying from low cost to free adoptions of cats. Throughout the rest of the year, pricing on adoptable cats is variable and many times are free. Social media outlets, great photography and videography promote the adoption of HSSV pets. More difficult to adopt cats, such as those that are under-socialized or fearful, HSSV offers post-adoption services, such as free appointments with boarded veterinary behavior specialists, training scholarships, and limited medical support, etc. to ensure pet retention post-adoption. 5. Return-to-Field Stray cats, including feral or community cats that enter the shelter are assessed for adoptability. Cats that are deemed unadoptable due to behavioral or other reasons are held for their stray period, altered, vaccinated and dewormed, ear-tipped, micro chipped, and then returned to their original location. Adult stray cats that cannot be safely returned to their original location, and unsocial, older feral kittens that are not suitable for indoor life are enrolled in our Garden Cat/Working Cat Adoption Program. This program gives outdoor cats an opportunity for adoption into outdoor homes in barns, vineyards, gardens and patios.
It is acknowledged that housing outdoor cats is a challenge in a shelter environment. In response to this problem, HSSV created the Community Cat Garden, which is an outdoor facility that houses outdoor shelter cats until they are adopted. The Community Cat Garden can house up to 12 adult cats at any given time in an enclosed outdoor patio/garden setting. This environment provides a safe temporary home for the cats in the Garden Cat/Working Cat program.