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In animal shelters, it is important to have efficient systems that allow for the assessment of individual animals while affording consideration to the population itself. Indeed, shelter medicine represents a unique blend of both individual patient and population medicine. A useful system for patient evaluation is known as the “problem‐oriented approach,” which is widely accepted as the gold standard for small animal patient care and assessment.

A problem is defined as “any abnormality requiring medical or surgical management or one that interferes with quality of life” (Lorenz 1993). Thus, problems include both physical and behavioral conditions that require management or treatment and/or that affect welfare. In an animal shelter, problems are also defined as conditions that affect public health and safety (such as potentially zoonotic diseases or severe or unpredictable aggression).

The problem‐oriented approach is used to systematically identify and address an animal's problems. With this approach, the clinical reasoning process is based on four steps: (i) database collection, (ii) problem identification, (iii) plan formulation, and (iv) assessment and follow‐up. This approach enables the clinician to logically approach each patient to ensure thorough and accurate assessment so that appropriate and timely actions can be taken. A thorough, written or computerized medical record that includes all elements of the animal's assessment and care must be maintained for each patient. See the section later in this chapter on medical record keeping and data collection for more information.