By Debbie Boone, BS, CVPM

In every nook and cranny of a veterinary practice, there resides an inventory item. From paper to pens, catheters to controlled drugs, there is a lot to track. No matter the size of the practice, inventory is the second-largest expense, the easiest thing to steal, and the greatest frustration when it is not on the shelf when needed. Therefore, inventory management needs to be the responsibility of the entire team.

Without the cooperation of the group, inventory can quickly get away from us. The challenge in practice is, unlike a human pharmacy, almost everyone has a hand in the pie. So, without team investment in precision, the team itself could destroy inventory accuracy. You cannot use or sell something you do not have.

Team work

Often, hospitals will designate an inventory manager. Typically, this position is responsible for inventory ordering, meeting with sales reps, receiving supplies, stock rotation, and cycle counts. As a good checks and balances measure, a different person should enter items into stock upon arrival while checking them against packing slips and orders; the bookkeeper or manager should pay the invoices, matching them against the statement. Having three people involved reduces opportunities for embezzlement.

The most important component of team involvement is safety training. The staff handles a mixture of drugs when treating patients or counting medications to dispense, so training on hazards is imperative. Many medications should not be handled barehanded, as they can cause human health issues. Hormone therapies, chemotherapeutics, and controlled substances should be handled with caution. Either the inventory manager or the OSHA compliance manager should train all staff members to be cautious of risky inventory items.

Make sure all new team members are educated, and the entire group is monitoring each other and holding themselves accountable for each other's safety. Never prioritize speed over caution! I have seen too many techs "cowboy up" when rushing to count medications, using their hands instead of pill counters and spatulas. You may not be harmed by counting one product this way, but over the days and years you are exposing your body to many chemicals and a potentially dangerous cocktail.

Cycle counts are needed to maintain accurate quantities. Having the inventory manager perform all the product counts in a practice is an inefficient use of their time. The inventory manager should assign certain product categories to specific team members. For example, having the CSRs responsible for products like shampoos, flea preventives, and prescription heartworm medications makes sense as they are frequently sold at the front desk.

Giving responsibility for these products to the people who sell them allows them "ownership" of maintaining supplies and also insight into the consequences when inaccurate invoicing causes problems with their cycle count. The same divide and conquer rule can be used for other inventory categories. Teams feel empowered when they are given responsibility and ownership of tasks. It is wise to switch up the categories every few months as again, this is a deterrent to theft.

Health and safety first

Practices have many expensive pieces of equipment and without transparency about cost and care the staff tends to become lax about protecting them. Clippers being dropped comes to mind. We tend to fuss and make a big deal when this happens, announcing how expensive they are to everyone in the treatment room. However, rarely do we share the cost of a bottle of medication sitting on the pharmacy shelf.

Some managers, seeking to bring awareness to the price of the products in the practice have played a Price is Right-type game with the team. Once the team makes the connection between carefully handling a $400-bottle of drugs so they don't drop any down the sink and the money available to give them raises, losses and waste can be greatly reduced.

Over the years, one of the biggest causes of inventory inaccuracy was incorrect quantity or size either invoiced, charted, or picked. Getting the team to have awareness of the danger to the patient of dispensing the incorrect dose of a product in itself should be the greatest deterrent to mistakes. Alas, people are human and errors happen.

Instituting a protocol for requiring two different people to check medications before dispensing or initialing labels by the person who counted and the one who checked allows for both error awareness and accountability.

Many years ago, I was having some issues with the boarding kennel staff adding new food on top of the few kibbles left in the bottom of the storage bins. I knew they were always busy and it was done for speed. So, in order to instruct them, I called a quick meeting. I just asked if they were aware that old or rancid food could cause animals to have diarrhea. Then I explained by not scrubbing the bins before adding new food, chances were increased the animals they were caring for would have diarrhea. Then I simply asked, "Whose job is it to clean diarrhea in the kennels?"

After this, I had no issues with them cleaning the bins. They didn't want to make animals sick and they really did not want to clean up runny poo. Often we simply order staff members to perform certain duties—like stock rotation—without shining a light on why we are asking.  People want to do good work, but they need to know the purpose of the work and to feel invested in that purpose.

Careful with those supplies!

Overlooked by many in the inventory equation are hospital supplies such as white goods, needles, syringes, etc., because they are comparatively cheap. When staff members are not on board with helping control inventory, they will grab a large handful of 4x4s not thinking of the wasted money when they are not used, but yet contaminated, or they burn through catheters insisting on hitting a vein instead of handing it over to a tech who is having a better day. The patient is caused pain for no reason, and money is wasted on catheters.

There should be no shame in failure in our practices. Everyone has an off day, and all of us make mistakes. When we create an atmosphere of perfectionism that causes fear of failure, we create a workplace filled with stress and people who avoid risk. With no risk there is no growth. Make it okay to make a mistake and learn from it. No name, blame, and shame.

Your team will then willingly stretch their wings to learn new skills to grow them personally, professionally, and benefit the hospital.

Make sure your team is invested in quality control. When visiting hospitals, I have unfortunately seen vaccines sitting out on counters all day, refrigerated drugs left out by the last person who used them, and expensive lab test supplies not unpacked immediately upon delivery. Every person who touches stock should be concerned about when medications and other heat-sensitive supplies are left out.

Again, the team should be empowered to call each other out—kindly—on infractions because of their concern for the patients in their care. Even veterinarians (often the worst offenders) should be held accountable by each other and by the team.

Maintain control

Finally, all controlled drugs should be truly controlled! Our employees are our most precious commodity, and keeping them safe is paramount. Lax protocols on controlled drugs and euthanasia solutions makes access all too easy.

For drug seekers and even those contemplating suicide, having barriers to access can prove a deterrent in a time of crisis. Practices should be drug-testing employees upon hire, and on a random and routine basis. I once had the opportunity to ask the chief of police of my hometown, "What makes people steal from their place of work?" His answer was, "easy opportunity" and "self-justification that they deserve it."

When no one is watching it is too easy for the marginally honest to take advantage—or the suicidal. According to Harvard Health Publishing—the newsletter of the Harvard Medical School, "Although some people who commit suicide have an identifiable mental health problem, like depression or addiction, others don't. Some talk about wanting or planning to kill themselves or give other hints, others don't. The decision to commit suicide might be made just minutes or hours before that act."

So, if lethal inventory items are too easily accessible a decision made in minutes could easily lead to the loss of a valued team member and true heartbreak for the rest of the staff.

As Nicole Clausen, inventory guru and owner of Veterinary Care Logistics said, "Managing inventory is a team effort! One of the key goals of inventory management is to have what we need on hand to care for our patients to the best of our ability. ... Involving the entire team (whether that means looking out for refrigerated items, putting reorder tags in the bin, or logging controlled substances properly) can help the inventory system and processes be more efficient and, ultimately, provide the best care for our patients and clients."

Get your team excited about their role in inventory control and then share the additional profit with them in raises. They will be more engaged and better compensated, which reduces turnover and makes life better for everyone working in the practice.

Debbie Boone, BS, CVPM, Fear Free Certified, has worked in the veterinary profession for more than 35 years. She has experience in the management of small animal, mixed animal, specialty, and emergency practices. Her business, 2 Manage Vets Consulting, helps practices develop team communication and business skills, enhance patient care, improve profitability, and increase practice value. Boone strives to improve the lives of animals by using her expertise to improve workplace culture and the well-being of veterinary professionals. She lives in North Myrtle Beach, S.C., where she spends her off-time in her garden, at the beach, or on the boat.