Client Communication Research Articles

Federated Learning-based neural networks for airline passenger satisfaction prediction

Preserving user data privacy is paramount for airlines. However, achieving highly accurate predictions of passenger satisfaction while safeguarding the privacy of individual companys data remains a considerable challenge. To achieve this objective, we utilized a privacy-preserving machine learning technique known as Federated Learning (FL). FL allows model training on decentralized devices while ensuring data security and privacy. The FL process comprises client training processes, communication rounds, and weight aggregation. We simulate FL principles using multiple processes to enable distributed learning. Clients preprocess data and train local models, ensuring data privacy. Communication rounds involve clients downloading the global model, local training, and transmitting updates to a central server. Weight aggregation methods like Federated Averaging merge these updates, preserving data privacy. Additionally, we leverage Artificial Neural Networks (ANNs) as foundational techniques. ANNs consist of input, hidden, and output layers, with weight adjustments based on real value differences to achieve accuracy. Our approach combines FL with ANNs to demonstrate FLs potential in privacy-preserving predictive analytics. We use the Airline Passenger Satisfaction dataset for modeling and evaluate the impact of neural network depth and submodel quantity on prediction accuracy. Our experimental results reveal that neither the depth of neural networks nor the number of submodels significantly affects prediction accuracy. FL emerges as a promising approach to balance data privacy and prediction accuracy effectively.

In-house three-dimensional printing for surgical planning: learning curve from a case series of temporomandibular joint and related disorders.

Three-dimensional (3D) printed models can improve the understanding of the structural anatomic changes in cases of temporomandibular joint ankylosis and pseudoankylosis leading to closed jaw locking. Their use in pre-surgical planning and intraoperative guidance has been reported, contributing to the predictability and success of these surgery procedures, which can be quite complex, especially in small animal patients. The use and production of 3D tools and models remain challenging and are so far limited to institutions with high (economical and human) resources. This study aims to propose simplified workflows using open-source software to facilitate an in-house 3D printing process. To illustrate this, three cases of temporomandibular joint ankylosis and one of pseudoankylosis were reviewed, where in-house 3D printed models were used for client communication and surgical management. The 3D models were segmented from computed tomography and printed via stereolithography. They were used to support discussion with clients (n = 4), to allow surgeons to pre-surgical plan and practice (n = 4) and for intraoperative guidance during surgery (n = 2). Surgical cutting guides were produced in one case to improve precision and define more accurately osteotomy lines. It is essential to consider the initial time and financial investment required for establishing an in-house 3D printing production, particularly when there is a need to produce biocompatible tools, such as surgical cutting guides. However, efficient and streamlined workflows encourage the integration of this technology, by accelerating the printing process and reducing the steep learning curves, while open-source software enhances accessibility to these resources.

Readability of postoperative discharge instructions is associated with complication rate in companion animals undergoing sterilisation.

Readability of client communications is a commonly overlooked topic in veterinary medical education. In human medicine, it has been advised that the readability of patient materials should be at USA schooling sixth-grade level or below. We hypothesised that student written discharge instructions would be of an inappropriate readability level, and discharges scored with higher reading grade levels would be associated with more complications. The cohort comprised 149 dogs and cats presenting for sterilisation. The readability of discharge instructions was assessed using the Flesch Reading Ease (FRE) and Flesch-Kincaid Grade Level (FKGL) formulas. Records were examined for evidence of postoperative complications. The mean FRE score of the discharge instructions was 61.97, with 30.87% being classified as 'difficult' or 'fairly difficult', 60.4% as 'standard' and 8.72% as 'fairly easy'. The mean FKGL was 8.64, with 98% being above reading level 6. Overall, there was an association between FKGL and complication occurrence (p = 0.005). Stratification by species demonstrated FRE and FKGL to be associated with complication occurrence in dogs (FRE score, p = 0.038; FKGL, p = 0.002), but not cats (FRE score, p = 0.964; FKGL, p = 0.679). Due to the retrospective nature of the study, there were difficulties associated with extracting relevant complication information from the medical records. Only 2% of owner-directed discharge instructions were written at readability levels aligning with the recommendations set forth in the human guidelines.

A Unique Spectrum of Care Tool Provides a Self-Regulated Learning Opportunity and Facilitates Client Communication.

Providing only the most state-of-the-art, intensive, and expensive level of treatment available does not meet the needs of every pet owner and pet. To overcome this barrier, veterinarians are working to provide spectrum of care (SOC) options to pet owners. This teaching tip describes the creation of a Spectrum of Care Options Presentation and Explanation (SCOPE), a tool which can serve a variety of educational purposes and improve delivery of care across the spectrum of care. The SCOPE considers andragogy, evidence-based medicine and pet owner preferences related to communication as well as the cost of care. Using a SCOPE during oncology consultations led by an intern on an oncology service rotation demonstrated the utility of the SCOPE to identify evidence-based SOC options for pets with cancer, serve as a self-regulated learning experience for the participating intern and elicit pet owner, and pet contextual issues impacting the care plan. The SCOPE can used to promote the implementation of SOC in veterinary medicine. The SCOPE has flexibility and may be adapted for use in disciplines other than oncology and with a variety of learners such as veterinary students or in early career mentoring programs.

ERegMat – a digital registry for improved quality of antenatal care: a cluster-randomized trial in a rural area in Bangladesh

IntroductionLongitudinal client tracking systems with digital health interventions are recommended for implementation in resource-limited settings but lack evidence of benefits, harms, and implementation. In the eRegMat cluster-randomized controlled trial, we aimed to assess the effectiveness of an eRegistry versus an unshared digital client record.MethodsFifty-nine primary health care facilities in Matlab, Bangladesh were randomized with a 1:1 allocation ratio to receive an eRegistry (intervention, 30 health facilities) with decision support, feedback dashboards and targeted client communication, or an unshared digital client record without digital health interventions (control, 29 health facilities). We assessed timely antenatal care attendance, quality of care, and health outcomes. Outcome data were captured in the eRegistry, or unshared digital client record used by health workers, and through a postpartum household survey. We estimated adjusted relative risks (ARRs) following the intention-to-treat principle and adjusted for cluster randomization.ResultsFrom October 2018 to June 2020, 3023 pregnant women were enrolled in the intervention and 2746 in the control groups through community and facility registrations. Intervention and control groups did not differ for the primary outcomes: timely attendance at eligible antenatal care visits (42.5% vs. 40.3%, ARR 0.96, 95% CI 0.89–1.05, p-value 0.4) and hypertension screening and management (95.1% vs. 94.7%, ARR 1.00, 95% CI 0.96–1.03, p-value 0.8). The secondary outcome of perinatal mortality and severe perinatal morbidities was lower in the intervention (14.6%) compared to the control group (15%) (ARR 0.74, 95% CI 0.58–0.96, p-value 0.02), with the change mostly attributed to morbidity outcomes.ConclusionDue to technical and implementation challenges we were unable to estimate the effect of the intervention with sufficient precision. Challenges included delays in rollout of the digital health interventions and outcome data collection, existence of parallel documentation systems on paper and digital and the COVID-19 pandemic. Given these methodological constraints, we are unable to draw definitive interpretations of trial results.Trial registrationISRCTN Registry ISRCTN69491836; https://www.isrctn.com/ISRCTN69491836. Date of registration 06.12.2018.

Enhancement, Not Elimination: AI’s Impact on Jobs in the Indirect Tax Domain

The article explores the transformative potential of artificial intelligence (AI) in the indirect tax domain in response to Stephen J. Andriole’s article “The Big Miss: AI Will Replace Just About Everything and its view that AI will lead to widespread job displacement. We argue that AI will not broadly eliminate jobs in indirect tax but rather empower tax professionals by automating repetitive tasks, enhancing data analysis, and facilitating compliance. AI-powered tools will enable tax professionals to focus on higher-value activities, such as strategic planning, risk management, and client communication. The future of AI in indirect tax is promising, with advancements in machine learning and generative AI expected to enhance its capabilities further. Organizations that embrace AI and invest in reskilling their workforce will be well-positioned to transform and thrive in the indirect tax domain. AI will enhance, not eliminate, jobs in indirect tax.

Mapping the Role of Digital Health Interventions to Enhance Effective Coverage of Antenatal Care: A Scoping Review.

Antenatal care (ANC) is a core component of maternal health services. However, only half of the pregnant women in LMICs obtain WHO recommended minimum of four antenatal contacts. In addition, ANC 4+ is a commonly used indicator in monitoring ANC utilization. However, contact coverage alone provides no indications of service quality. In recent years, digital health interventions bring opportunities to provide quality maternal health care. Yet, there are few reviews on how digital health interventions contribute to improving effective coverage of antenatal care. A rigorous review that examines the role of digital health interventions in improving effective coverage of antenatal care is needed to examine how digital health solutions were rapidly deployed to support quality antenatal care service delivery. This review aimed to map evidence on the role of digital health solutions on quality of antenatal care service to enhance effective ANC coverage. A scoping review approach was used and four Databases (PubMed, Cochrane Library, Scopus and Embase) as well as search engines like Advanced Google Search and Google Scholar were searched from September 1 to 8, 2022. Thematic content analysis was used to present the findings. A total of 1701 articles were searched. A total of 27 full-text studies were included in the final analysis. The most reported use of digital health was for client education and behavior change communication. Most studies showed that digital health interventions have proven effective in improving antenatal care. However, most of the studies did not address to assess the quality of ANC services. In this review, we found out that digital health solutions targeted at pregnant women can improve antenatal care services. There is body of evidence showing the effectiveness of digital health interventions on a range of maternal health outcomes. Few pieces of literature exist on the use of digital health interventions on the quality of antenatal care services. There is a need for more trial and program evaluation studies that examine the role of digital health interventions on the quality of ANC.

Exploring Diverse Methods of Reverse Engineering MQTT Client Interfaces

The fast evolution of Industry 4.0 and smart manufacturing has led to an increased reliance on MQTT (Message Queuing Telemetry Transport) as a lightweight messaging protocol for efficient machine-to-machine communication. Despite MQTT being well-suited as a standard protocol for the Industrial Internet of Things and the increasing provision of MQTT interfaces by manufacturers for their production machines, the presence of poorly documented, non-machine-readable APIs poses challenges. Consequently, integrating these devices into an existing production environment requires significant effort and is prone to errors.In this paper, we explore diverse methods for extracting valuable information from running MQTT clients, enabling the reconstruction of their communication interfaces with the associated endpoints. This information can then be transformed into a standardized machine-readable format. The AsyncAPI Initiative has defined such an industry standard for defining asynchronous APIs, which includes MQTT. These AsyncAPI Specifications can be used to make a subsequent implementation of programs that interact with these interfaces more fast and reliable.The presented approaches focus on extracting interface information by analyzing network traffic and MQTT messages. We concentrate on observing the behavior of MQTT clients from an external perspective, deliberately disregarding the internal workings and program code of the clients themselves. Furthermore, we discuss an approach to map the data from the intercepted MQTT communication to a AsyncAPI Specification.Through our research, we aim to provide insights into the various techniques that can be employed to reverse engineer MQTT client interfaces effectively. By leveraging these approaches, it is possible to gain valuable knowledge about MQTT client communication interfaces, thus simplifying the subsequent implementation of programs that interact with these interfaces.

Integrating Augmented Reality in Architectural Design: A New Paradigm

The explores into the significant impact of augmented reality (AR) within the domain of architectural. The research being conducted examines the transformative effect of augmented reality (AR) on the practice of architectural design, including the entire process from basic conceptualization through ultimate execution. The present investigation analyzes the utilization of augmented reality (AR) as an approach to enhance visualization, increase design accuracy, and ease client communication. This study discusses the advantages of augmented reality (AR) in facilitating the production of realistic and engaging design experiences. By using AR technology, designers are able to go past the restrictions presented by standard two-dimensional drawings and realistic models. The work addresses the challenges and obstacles linked to augmented reality (AR) technology, such equipment standards and technical knowledge. This article provides a comprehensive examination of current uses of augmented reality (AR) in architecture, utilizing a combination of mathematical modeling and practical case studies. Also, it analyzes the potential of AR to reshape the next phase of architectural design.

Exploring metaverse-enabled innovation in banking: Leveraging NFTS, blockchain, and smart contracts for transformative business opportunities

Industries all throughout the world are preparing to understand the ramifications of the emerging metaverse, which is a merger of the virtual and physical worlds. Notably, the banking industry stands on the cusp of a monumental shift, with the metaverse offering unprecedented operational enhancements. While the potential transformations brought about by the metaverse are discussed in various sectors, there is a discernible gap in understanding its specific applications in banking, especially with respect to advanced technologies such as NFTs, blockchain, and smart contracts. The study adopts a comprehensive approach to bridge this knowledge gap, employing convenience non-probability sampling to engage 48 subject matter experts specializing in Metaverse-Enabled Innovation in Banking. Data was collected using both mailed and electronic questionnaires. The empirical analysis offers strong evidence supporting the pivotal role of technologies like Digital Twins, Artificial Intelligence, and Blockchain-Based Assets in the metaverse's preliminary stages. We discover a plethora of business potential for banks within the metaverse, including client communication, cross-border transactions, mortgages, digital assets, green loans, and data security.‎‎

Developing a Centralized Receipt Service to Streamline Restaurant Operations and Reduce Costs

The fast food industry, which the restaurant industry falls under, has several challenges, including receipt management. Conventional document management means are ineffective, expensive, and inconducive to the best performance of restaurants and the satisfaction of consumers. This article discusses the challenges arising from the decentralized receipt service and how they have developed and deployed the Centralised Receipt Service to solve these issues with modern technologies like Go Gin framework and AWS lambda. The service thus factors in cloud architecture to improve the receipt data storage, retrievals, management, and less paper use. It also improves customer satisfaction through digital receipts through Short Messaging Service and mobile responsive web front end. Receiving centralized services helps enhance performance by cutting operational costs, reducing paperwork, and increasing record-keeping. Besides, it helps the business reduce paper usage, positively contributing to environmental conservation. It provides a potential growing scale for all forms of businesses; restaurants can use it to address expanding customers’ demands for digital services. It also exposes future possibilities for using AI for predictive analysis and customized client communications. Therefore, by consolidating restaurant receipt management, they can enhance customer satisfaction with less spending and set the business up for success in the dynamic digital space. This study supports that this centralized method for receipt services is feasible and fundamental in today’s restaurant businesses since it comes with a package of effectiveness, sustainability, and customer appeal opportunities.

Service Quality and Customer Loyalty in Private and Public Banks

In both public and private banking institutions, the purpose of this study was to investigate the relationship between customer loyalty and various service quality parameters, including tangibility, reliability, assurance, responsiveness, and empathy. A regression analysis was carried out in order to investigate the connections that exist between these factors and the occurrence of repeat business. Based on the findings, it has been determined that tangibility, reliability, assurance, and empathy have a substantial impact on customer loyalty in both public and private banking institutions. These criteria are relevant in the banking business since they have been found to have positive connections with client loyalty. Yet, in this scenario, responsiveness did not yield a statistically meaningful impact on client loyalty. The overall regression model showed a high level of statistical significance, indicating the effectiveness of Tangibility, Reliability, Assurance, and Empathy in jointly accounting for variations in consumer loyalty. This research provides valuable insights for banks aiming to improve customer retention by focusing on specific areas of exceptional service. The findings resulted in suggestions for banks to improve service quality by investing in physical and online environments (Tangibility), maintaining reliable and error-free services (Reliability), improving client trust and communication (Assurance), and promoting empathetic interactions (Empathy).

Veterinarians are reluctant to recommend virtual consultations to a fellow veterinarian.

To explore veterinarians' use of virtual veterinarian-client-patient consultations before and during the coronavirus disease 2019 (COVID-19) pandemic and examine veterinarians' attitudes toward virtual consultations. 135 companion animal veterinarians in Canada, the US, and Europe. An anonymous online survey was distributed to gather participating veterinarians' use of information and communication technologies and their perception of virtual consultations' effect on patient care, client communication, and their own well-being. Willingness to recommend virtual consultations was evaluated using the Net Promoter Score. Multivariable logistic regression explored factors associated with willingness to recommend virtual consultations. Percentage of participating veterinarians using the telephone and videoconferencing increased significantly (P < .001) from before (83.6% and 3.0%, respectively) to during the COVID-19 pandemic (97.0% and 22.4%, respectively). Participants were significantly less confident (P < .001) about their ability to reach a diagnosis using a virtual consultation as compared to a hands-on patient examination. Participants perceived client communication to be more challenging during virtual as compared to face-to-face consultations, particularly for building rapport and expressing empathy. Participants were extremely unwilling to recommend virtual consultations (Net Promoter Score = -41.4) with 21.6% (24/111) promoters and 63.1% (70/111) detractors. Confidence doing a virtual patient examination and comfort using videoconferencing technology were both positively associated (P < .05) with willingness to recommend virtual consultations. Veterinary practices and organizations interested in encouraging virtual veterinarian-client-patient consultations likely need to prioritize veterinarians' acceptance as an initial focus. The veterinary profession would benefit from further research and education to inform virtual veterinary care.

Development of a three-dimensional computer model of the equine heart using a polyurethane casting technique and in vivo contrast-enhanced computed tomography

Introduction/objectivesInsight into the three-dimensional (3D) anatomy of the equine heart is essential in veterinary education and to develop minimally invasive intracardiac procedures. The aim was to create a 3D computer model simulating the in vivo anatomy of the adult equine heart. AnimalsTen horses and five ponies. Materials and methodsTen horses, euthanized for non-cardiovascular reasons, were used for in situ cardiac casting with polyurethane foam and subsequent computed tomography (CT) of the excised heart. In five anaesthetized ponies, a contrast-enhanced electrocardiogram-gated CT protocol was optimized to image the entire heart. Dedicated image processing software was used to create 3D models of all CT scans derived from both methods. Resulting models were compared regarding relative proportions, detail and ease of segmentation. ResultsThe casting protocol produced high detail, but compliant structures such as the pulmonary trunk were disproportionally expanded by the foam. Optimization of the contrast-enhanced CT protocol, especially adding a delayed phase for visualization of the cardiac veins, resulted in sufficiently detailed CT images to create an anatomically correct 3D model of the pony heart. Rescaling was needed to obtain a horse-sized model. ConclusionsThree-dimensional computer models based on contrast-enhanced CT images appeared superior to those based on casted hearts to represent the in vivo situation and are preferred to obtain an anatomically correct heart model useful for education, client communication and research purposes. Scaling was, however, necessary to obtain an approximation of an adult horse heart as cardiac CT imaging is restricted by thoracic size.

Building a Client Resource and Communication Platform for Community-Based Organizations to Address Health and Social Needs: Co-Design Study.

Connecting individuals to existing community resources is critical to addressing social needs and improving population health. While there is much ongoing informatics work embedding social needs screening and referrals into health care systems and their electronic health records, there has been less focus on the digital ecosystem and needs of community-based organizations (CBOs) providing or connecting individuals to these resources. We used human-centered design to develop a digital platform for CBOs, focused on identification of health and social resources and communication with their clients. Centered in the Develop phase of the design process, we conducted in-depth interviews in 2 phases with community-based organizational leadership and staff to create and iterate on the platform. We elicited and mapped participant feedback to theory-informed domains from the Technology Acceptance Model, such as Usefulness and Ease of Use, to build the final product and summarized all major design decisions as the platform development proceeded. Overall, we completed 22 interviews with 18 community-based organizational leadership and staff in 2 consecutive Develop phases. After coding of the interview transcripts, there were 4 major themes related to usability, relevance, and external factors impacting use. Specifically, CBOs expressed an interest in a customer relationship management software to manage their client interactions and communications, and they needed specific additional features to address the scope of their everyday work, namely (1) digital and SMS text messaging communication with clients and (2) easy ways to identify relevant community resources based on diverse client needs and various program eligibility criteria. Finally, clear implementation needs emerged, such as digital training and support for staff using new platforms. The final platform, titled "Mapping to Enhance the Vitality of Engaged Neighborhoods (MAVEN)," was completed in the Salesforce environment in 2022, and it included features and functions directly mapped to the design process. Engaging community organizations in user-centered design of a health and social resource platform was essential to tapping into their deep expertise in serving local communities and neighborhoods. Design methods informed by behavioral theory can be similarly employed in other informatics research. Moving forward, much more work will be necessary to support the implementation of platforms specific to CBOs' needs, especially given the resources, training, and customization needed in these settings.

THE IMPORTANCE OF DIGITAL MARKETING IN COMPANIES AS A VITAL TOOL

Digital marketing (or online marketing) are all the actions and strategies that use the internet, digital devices and online platforms to promote, sell or communicate everything related to products or services, customer service and performance monitoring. . This research focuses on analyzing the importance of it in companies as a vital tool, detailing fundamental strategies to achieve proposed goals.The methodology used in the research is Quantitative, data collection was carried out through a survey with semi-open questions.The results indicate that Digital Marketing is extremely important for companies, as well as being a useful tool for them, but the familiarity of the respondents with this system is quite regular.Effective strategies such as television and radio advertising were identified to increase the customer base and improve the profitability of a company. Likewise, effective traditional marketing strategies such as social networks and influence marketing are mentioned, since social networks play a fundamental role in the digital marketing strategy within companies.As a result of the research, useful tips are proposed to implement within companies and promote digital marketing in companies. These include the use of social media and transparent client communication

Breed, smaller weight, and multiple injections are associated with increased adverse event reports within three days following canine vaccine administration.

To evaluate patient and vaccine factors associated with adverse events (AEs) recorded within 3 days of vaccine administration in a large cohort of dogs. 4,654,187 dogs vaccinated in 16,087,455 office visits in a 5-year period at 1,119 hospitals of a corporate practice. Electronic medical records of dogs vaccinated between January 1, 2016, and December 31, 2020, were searched for diagnoses of possible AEs recorded within 3 days of administration of vaccines without concurrent injectable heartworm preventative. Patient risk factors (age, sex, breed, and weight) and number and type of vaccine were extracted from records. ORs (and 95% CIs) for risk factors were estimated via multivariable logistic regression mixed models with patient as a random effect. AEs were recorded following 31,197 vaccination visits (0.19%, or 19.4/10,000 visits). Reported AE rates increased from 1 to 4 vaccines administered and among individual vaccines were greatest for rabies vaccine. AE rate was generally inversely related to body weight, with largest rates in dogs ≤ 5 kg. The largest AE rates were noted in French Bulldogs and Dachshunds (ORs > 4 compared to mixed-breed dogs). Risk factor information can be used to update vaccination protocols and client communication. Breed differences may indicate genetics as the primary risk factor for adverse vaccine reactions following vaccinations.

Requirement elicitation model for global software development vendors

AbstractRequirements elicitation is critical phase of software development that involve direct communication of clients and vendors. In global software development (GSD), importance of requirements elicitation becomes more critical due to geographical distance. The aim of this research is to design and implement requirement elicitation model (REM) where GSD organization can evaluate their organizations and can classify their level of implementation where organization lies. Systematic literature review (SLR) was conducted for the identification of critical success factors (CSFs) from a sample of 70 research articles. Furthermore, the identified CSFs are organized into five levels based on Capability Maturity Model Integration (CMMI) and Software Outsourcing Vendors' Readiness Model (SOVRM). A second SLR was conducted for identifying all possible practices for the implementation of CSFs. To validate the findings of SLR and to find more practices in the view of industrial practitioners for the identified CSFs, a questionnaire survey was conducted in the GSD organizations in which 35 experts, from different countries, contributed. For REM evaluation, we have conducted two case studies. The outcome analysis after conducting case studies confirms that our assessment framework is easier to understand, apply, and successfully critic the strengths and weaknesses of organizations during requirements elicitation in GSD.

2023 AAHA Management of Allergic Skin Diseases in Dogs and Cats Guidelines.

These guidelines present a systematic approach to diagnosis, treatment, and management of allergic skin diseases in dogs and cats. The guidelines describe detailed diagnosis and treatment plans for flea allergy, food allergy, and atopy in dogs and for flea allergy, food allergy, and feline atopic skin syndrome in cats. Management of the allergic patient entails a multimodal approach with frequent and ongoing communication with the client. Obtaining a comprehensive history is crucial for diagnosis and treatment of allergic skin diseases, and the guidelines describe key questions to ask when presented with allergic canine and feline patients. Once a detailed history is obtained, a physical examination should be performed, a minimum dermatologic database collected, and treatment for secondary infection, ectoparasites, and pruritus (where indicated) initiated. The process of diagnosing and managing allergic skin disease can be prolonged and frustrating for clients. The guidelines offer recommendations and tips for client communication and when referral to a dermatologist should be considered, to improve client satisfaction and optimize patient outcomes.

How do veterinarians mitigate liability concerns with workforce shortages?

The challenge of meeting pet healthcare demands with inadequate staff resources creates legal and ethical considerations for the veterinary profession. Inadequate staffing can result in access to care issues that impact companion animal health, public health, and the human animal bond. An overburdened work environment may also result in liability issues related to standard of care, client dissatisfaction, and subsequent complaints. The following recommendations may ameliorate the legal and ethical impacts to include: a focus on how to optimize current resources (human and technology); improve client communications and medical record-keeping strategies; promote preventive care; develop and memorialize clinical standard operating procedures; and prioritize staff well-being to prevent burn out. These recommendations should be considered good practices when functioning under optimal conditions but are even more valuable to implement effectively in an overburdened companion animal medicine environment.