Appendix B
The Practice Success Prescription: Team-Based Veterinary Healthcare Delivery by Drs. Leak. Morris Humphries
Thomas E. Catanzaro, DVM, MHA, FACHE, DACHE

Strategies for Managing Expectations

Job Descriptions

Always rewrite the job description before each hire action. Use the hiring team, as discussed in Building the Successful Veterinary Practice: Innovation & Creativity, to rewrite the description of the new qualities being solicited. Savvy leaders have each person write a detailed description of everything done in that person's job. That is, what the person really does, not the official job description, and then combine it into single duty, site work expectations, and standards of performance. Move to negotiate within the hospital zone team the recognitions for competency and/or responsible areas of accountability for that zone of the practice. Behavior rewarded will be behavior repeated.

Duty Zone Descriptions

These start with the "attributes" a candidate must exhibit during the interview, as reflected in the interview checklists in the appendices of Building the Successful Veterinary Practice: Innovation & Creativity. These are the "hire for attitude" tools we have developed. The important part is the "hiring team", which becomes the candidate's "training team" during the ninety-day orientation and training program. (See the four phase checklists on the CD included with the VCI® Signature Series Monograph Staff Training & Orientation.)

The zone coordinator will allocate the duties and outcome accountabilities based on people's strengths, then divide the balance equitably. (See the VCI® Signature Series Monograph Zoned Systems and Schedules for Multi-doctor Practices for details on coordinators and zones.)

Hire for attitude, and the candidates can usually be trained. Hire for resume skills, and if the candidate has a bad attitude, the candidate will never have a team fit!

Score Keepers

There are the people in the practice who make judgments about the performance of others' control of the cookie jar. Make sure they have your permission to do this. Performance planning limits the "control freaks" from exerting stagnant forces on the change process, as described in Chapter 6 of Building the Successful Veterinary Practice: Programs & Procedures, plus related forms are in the appendices. The score keepers' observations and reports (demands) resulting higher priorities in those areas that they judge. If you can't measure it, you can't manage it. But if you measure the wrong thing, you will likely be managing the wrong thing.

Key Result Areas (KRAs)

These are items essential for getting the job done. Often they are calls placed on you by score keepers, such as clients, spouse, kids, or a staff member, and those calls are about things important to them, not necessarily to you. Details on the process are in the VCI® Signature Series Monograph Staff Performance Planning & Goal Setting, with a CD for personalizing the sample forms. These KRAs are given highest priority and need to set the standards of performance, the value of the results of your efforts.

Pre-emptive Reporting

Send your score keepers periodic reports of your progress to ensure they are aware of your achievements. Tell clients about the continuing education you attended to gain better awareness with dentals, imaging, "Over-Forty Program" diagnostic surveillance, or maybe even sharing with your boss the successes with a client or difficult case. Do this and you control the criteria for those inevitable judgments that occur when we aren't looking.

Time Study

Have staff members keep a detailed record of how they individually spend their time at the practice, such as in ten or fifteen-minute intervals, for one to two weeks. This should be a time chart, with the horizontal lines for the dates and the vertical lines for the routine functions, including telephone, meetings, visitors, clients, patient care, vaccinations, staff discussions, kennel, mopping, animal restraint, coffee, eating, inventory, etc. When you collect this data, the low priority versus high priority balance of "projects" will surprise you. Be ready to renegotiate the time leverage within your practice for key people, as well as for the support staff.

Isolate Demand Sources

For each demand that is seen, identify who makes the demand and why. In many practices, scheduling adjustments have been made for poor performers. Schedules are driven by staff member demands, rather than client, patient, or facility needs. After that person leaves employment, the overstaffing has continued. Be prepared to communicate your concerns about an inappropriate demand mix, and be aware that there are some very skillful demanders who ask too much of the practice, of a veterinary healthcare provider, or of a staff member.

Pruning

Non-productive and diseased branches sap the energy and resources from the rest of the tree, and non-productive and problematic demands will sap them from the practice. As with pruning, cut away more demands than you think you should. The good things will recover. Cut everything that is growing in the wrong direction, as they will break first with any strain. Careful pruning of unwanted demands can quickly make the practice stronger, healthier, and more productive for the staff, the providers, and the clients.

Three Rs of Pressure Responses

All the answers for handling pressures can be stated by one of three responses:

1.  You can receive pressure. Accept it, work with it.

2.  You can reject pressure. Eliminate or prevent it.

3.  You can revise pressure. Reduce it and modify its negative impact(s).

As pressure is identified in your environment, check to see which of the three strategies is most appropriate for you at that time.

Dessert

It is a little known management fact about operational pressure that "stressed" spelled backward is "desserts." This is not just a coincidence. It offers personal relief for many people. Life is short, so when things are stressing you, it is okay to indulge yourself. Eat dessert first.

Speaker Information
(click the speaker's name to view other papers and abstracts submitted by this speaker)

Thomas E. Catanzaro, DVM, MHA, FACHE, DACHE
Diplomate, American College of Healthcare Executives


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