Allowing employees to do some record keeping and client communication from home can help maximize their time in the actual office. They will likely also appreciate spending more time with their families, even if they are technically working. If you work in retail veterinary medicine of any type, you are no doubt familiar with feeling overwhelmed by chaos. Whether we are talking about clients and coworkers, or managers and employees, the sum total of any one day’s various duties and interactions can leave us feeling whiplashed and whipsawed. As if managing our patients’ diverse medical needs was not challenging enough, the nature of veterinary work also compels each team member to perform a wide variety of overlapping tasks. The result is a schedule of various duties that can feel unstructured, even chaotic. Think about your average workday: You arrive in the morning to a flurry of activity in which everyone around you is performing their typical tasks. Overnight patient care and daily procedure intakes compete with managing messages and lab work results, all before diving into the day’s lineup of unexpected emergencies, and scheduled appointments and/or procedures. And this is just the morning. It is hard not to perceive any busy vet practice’s operations as a controlled kind of chaos. In the best case scenario, the chaos feels like a choreographed dance where everyone is in their “flow” zone. In the worst, they are all running around like decapitated chickens. (Remember the first days of pandemic protocol?) The goal, of course, is chaos minimization and ease of workflow. But getting there is not typically possible without making some fundamental changes in how we operate. Developing a structure to work for your practice is key. However, it is hard to do when everything feels so out of control. This is when throwing your hands up and going with the fowl seems so much easier! So, what is a veterinary practice to do? We found ourselves in that unenviable spot just a few months back. The chaos had reached its pandemic peak. Simple (but crucial!) things were falling between the cracks and morale was at an all-time low. We were clearly losing the war on entropy. To claw our way back to order, we knew we were going to have to make some bold structural changes. Here is how we did it: 1) We adopted a new PIMS As it turned out, telemedicine was not really something our clients were clamoring for; clearer, more effective communication was, however. With the option of email and text messaging newly linked to a more detailed medical record system, not only did our clients get their wish, we experienced a greater sense of organization overall. Few things beat back the chaos like a PIMS (process information management system), which made it easier to share cases and allowed techs to more easily keep track of to-do items and stay on top of orders. Receptionists did not like the change at first, but they soon discovered its benefits and settled in. Switching our PIMS may have seemed like a bad idea in the midst of all the COVID chaos, but the order it instilled both practice-wide and to the clients was worth the discomfort of a sweeping change in operations and recordkeeping. Plus, the inevitability of change had already become ingrained by this point in the pandemic. What was one more? 2) We altered our internal team structure This was a big “OMG, why did we never think of doing this before?” moment for us. We changed our one-tech-one-doc approach to a two-techs-one-doc-one-receptionist structure. Adding another tech per doc (whereas we previously had “floater” techs pick up the slack) worked wonders, but looping in the receptionist made all the difference. Indeed, missed charges near-disappeared, mistake rates dropped, and fewer issues fell through the cracks overall (e.g. info conveyed, callbacks completed, prescriptions prepared properly). This alone was worth the change, but the overall improvement in workflow speed and ease proved the biggest benefit. We looked and felt organized for the first time since the start of the pandemic. 3) We let clients back in This summer, we decided it was time. We let clients back in—one per patient—while maintaining curbside service as an option. This smoothed out most of the confrontational issues with clients and made client flow easier to manage. Alas, this was before the Delta variant. We thought of going back to full-on curbside, but the gains in operational ease were measured against the risk, and we decided our indoor social distancing protocol was actually pretty safe given our team’s vaccination status (our rooms are sizable, too). To be sure, this approach will not work well for every practice, but for us it was a game-changer when it came to ease of flow, diminished wait times, and client comfort overall. 4) We bought a buzzer lock for our front door Sometimes the best solutions are the simplest. Getting a lock on the front door to buzz clients in helps keep them safely at bay while we get our bearings. Plus, it keeps us from having to uncomfortably confront our clients when they cluelessly let themselves in. 5) Started working from home Hate to say it, but being able to do a lot of our recordkeeping and client communications at home made it easier to get there at a reasonable time and maintain a speedy workflow while physically in the building. File this under “PIMS improvements,” if you like, but it deserves a special mention since it was not something we had to do as part of the new system. While this structure will not work everywhere, all our docs have preferred it to writing everything up while between patients at work, which had inevitably slowed things down. Managers have since adopted this approach, too, which makes preparing estimates and reports less of an interruption to their more pressing duties during appointment hours. And they get to go home to their families. 6) Re-set client expectations Clients are typically angling to get as much from you as they possibly can. Re-setting expectations for estimates, report cards, and lab results have helped immeasurably. After all, if you lead pet owners to believe they will always be attended to immediately, they will often be disappointed. While this may seem like a no-brainer, for us it took a special effort to re-educate “spoiled” clients on the timing of communications. Talk about taking a load off. Client patience requires explanations, but you typically only have to do it once and the long-term benefits (for everyone) are worth it. Again, it must be said: These changes will not work for every practice. We all have our unique styles and personal preferences. Nevertheless, I suspect more than a few of you will consider one or more of these list items as you attempt to turn your team’s headless fowl behavior into a surprisingly un-chaotic workflow. Patty Khuly, VMD, MBA, owns a small animal practice in Miami and is a passionate blogger at drpattykhuly.com. Columnists’ opinions do not necessarily reflect those of Veterinary Practice News.
