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A Retrospective/Prospective Evaluation of KUMC’s Post- Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

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Page 1: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

A Retrospective/Prospective Evaluation of KUMC’s Post-

Approval Monitoring Program

Michael D. Taylor, PhDOffice of Animal Welfare

Page 2: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

External Assessment of KUMC’s Animal Care and Use

Program

• “The KUMC animal care and use program has a history of professional, humane, and successful animal care and use that was punctuated by a period of serious programmatic concerns several years ago.”

• “During the 2014 visit, the Consultant observed several important programmatic changes that have strengthened the program’s integrity & defense against allegations of mismanagement and overzealous regulators.”

Consultant Report 2014

Page 3: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

External Assessment of KUMC’s Animal Care and Use

Program

• “The Consultant commends the institutions for successes since the past review.”

• “The Consultant believes that focused directional refinement is now necessary for continued programmatic maturation.”

Consultant Report 2014

Page 4: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

External Assessment of KUMC’s Post-Approval Monitoring Program

• “The evidence of work and positive impact upon the program by the Post Approval Monitor was remarkable.”

• “The (PAM) program’s success may become its undoing without a focused strategic plan for continued development.”

Consultant Report 2014

Page 5: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

KUMC’s PAM: Shifting Gears

“Identify and correct problems”

“Identify and recognize compliance”

Page 6: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

Back to the Beginning

• “…all who care for, use, or produce animals for research, testing, or teaching must assume responsibility for their well-being.”

• “The goal of the Guide is to promote the humane care and use of laboratory animals by providing information that will enhance animal well-being, the quality of research, and the advancement of scientific knowledge that is relevant to both humans and animals.”

Guide for the Care and Use of Laboratory Animals8th Edition

Page 7: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

Regulatory Obligations

• “The use of laboratory animals is governed by an interrelated, dynamic system of regulations, policies, guidelines, and procedures.”

• “Taken together, the practical effect of these laws, regulations and policies is to establish a system of self-regulation and regulatory oversight that binds researchers and institutions using animals.” Guide for the Care and

Use of Laboratory Animals8th Edition

Page 8: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

What is PAM?

• “Continuing IACUC oversight of animal activities is required by federal laws, regulations, and policies.”

• “Post-approval monitoring (PAM) is considered here in the broadest sense, consisting of all types of protocol monitoring after the IACUC’s initial protocol approval.”

Guide for the Care and Use of Laboratory Animals8th Edition

Page 9: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

10/1

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Average Rate of Compliant ACUP PAM Reviews

“If you’re not keeping score, you’re just practicing.”

Vince Lombardi, Green Bay Packers 1959-1968

Page 10: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

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f(x) = − 0.125144731519871 x² + 5.43942979573264 x + 10.3661401557285R² = 0.651280854964165

Average Rate of Compliant ACUP PAM Reviews

You Don’t Know Where You’re Going Until You Know Where You’ve Been

Page 11: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

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f(x) = − 0.125144731519871 x² + 5.43942979573264 x + 10.3661401557285R² = 0.651280854964165

Predicted Rate of Compliant ACUP PAM Reviews

“Those who cannot remember the past are condemned to repeat it.”

George Santayana, Reason in Common Sense, 1905-1906

Page 12: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

10/1

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75.0

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95.0

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Average Rate of Compliant ACUP PAM Reviews

“Fanaticism consists in redoubling your efforts when you have forgotten your aim.”

George Santayana, Reason in Common Sense, 1905-1906

Page 13: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

“…the only thing we have to fear is…fear itself…”

Franklin D. Roosevelt; Inaugural Address; March 4, 1933

• “The IACUC has not conducted an appropriate review of animal activities for protocol XXXX-XXXX to ensure that the investigators are following the protocols as approved.” (Repeat NCIs, USDA Inspection Report 9/4/12)

• “…the program was beginning to experience a plateau in the overall activities and believes it is time to re-assess and re-adjust…” (Consultant Report 2013)

Page 14: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

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65.0

75.0

85.0

95.0

105.0

Average Rate of Compliant ACUP PAM Reviews

Redoubled EffortHow did PAM change?

Page 15: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

You Find What You Are Looking For

Focus on Intensive Review of Laboratory Animal Care and Use Records

Advantage: A very effective approach to identifying and correcting protocol drift.

Page 16: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

You Find What You Are Looking For

Focus on Intensive Review of Laboratory Animal Care and Use Records

Disadvantages:

• Labor-intensive (identification/correction monopolizes time, inefficient)

• Isolation (office-based PAM)

• Potential for co-dependency and resentment (micromanagement)

Page 17: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

Taking Aim

• “The goal of the Guide is to promote the humane care and use of laboratory animals by providing information that will enhance animal well-being, the quality of research, and the advancement of scientific knowledge that is relevant to both humans and animals.”Guide for the Care and

Use of Laboratory Animals8th Edition

Page 18: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

Taking Aim• “The level of formality and intensity of PAM

should be tailored to institutional size and complexity, an in all cases should support a culture of care focusing on the animals’ well-being.”

• “Regardless of the methods used or who conducts and coordinates the monitoring, PAM programs are more likely to succeed when the institution encourages an educational partnership with investigators.”

Guide for the Care and Use of Laboratory Animals8th Edition

Page 19: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

Taking Aim

“Reactive, Fear-Based PAM”

“Proactive, Confidence-Base PAM”

Page 20: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

New Directions

• Shift the focus of PAM away from documentation analysis to observation of approved procedures.

• Collect categorical data from observations to define training activities.

• Recognize success.

• Implement KUMC’s Animal Research Coordinator (ARC) Certification Program.

Page 21: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

New Directions• Shift the focus of PAM away from

documentation analysis to observation of approved procedures.

• Pre-observation Interview: “What has occurred with the animal(s) prior to and will occur following the procedure?”

• PAM Procedures Observation: “Is the procedure, as performed, consistent with the written protocol, institutional SOPs and Policies, and The Guide?”

Page 22: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

New Directions• Collect categorical data from observations

to define training activities.

Month

Personnel Management

Program Oversight

Housing and Management

Procurement and Transport

Preventative Medicine

Clinical Care and Management

Surgery

Pain and Distress

Anesthesia and Analgesia

Euthanasia

Timely Response

Commendations

Total PAM ACUPs Reviewed

Commendation Rate

6/14 1 2 5 0 2 1 2 2 0 2 0 2 6 33%

7/14                            

8/14                            

9/14                            

10/14                            

11/14                            

Total 1 2 5 0 2 1 2 2 0 2 0 2 6 33%

PAM Report to IACUC; June 2014

Page 23: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

New Directions

• Recognize success.

Commendations June 2014

PI Department Activity Reviewed ACUP Date

Fariba Behbod Pathology; Reproductive Health

Staple Removal 2013-2175

6/23/14

Adam Krieg Clinical Sciences; Reproductive Health

Animal Identification; Genotype Biopsy

2013-2155

6/30/14

PAM Report to IACUC; June 2014

Page 24: A Retrospective/Prospective Evaluation of KUMC’s Post-Approval Monitoring Program Michael D. Taylor, PhD Office of Animal Welfare

“Whatever we expect with confidence

becomes our own self-fulfilling prophecy.”

Brian Tracy