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

Staff Meetings

Staff meetings serve a purpose, but that purpose is not always in the best interest of the staff or the practice. The healthcare industry has always operated on a committee form of reference, the basic thought being that the more minds brought into play on a subject, the better chance for an optimum outcome. So it should be with the practice staff meetings.

The most effective staff meeting is a time to exchange ideas on a problem or a new venture. Or it could be used to evaluate an existing program that has not become the profit center desired. In any case, it should not be a time for "the boss to talk".

But staff meetings do not produce profit, people do. And people cannot be productive while sitting in staff meetings. So what is the solution? It has been observed that a weekly in-house staff newsletter provides most of the information that the traditional staff meeting did, yet does not require the commitment of productive practice hours. A staff member with a home computer can be paid $5 to $10 per issue to produce the newsletter. Each section of the hospital provides input to the editor by close of business on Friday. An obituary column is added for those patients that died during the week, so all staff are aware of grieving clients or therapeutic misadventures. The "medical record cause of death" is listed in the terms told to the client, so embarrassing situations do not occur, when staff are shopping in town and meet a client whose pet has crossed over the Rainbow Bridge. This is also the medium that the boss gets to use to provide practice direction and philosophy, and solidify mission focus and core values on a recurring basis.

The practice manager, or the coordinator of coordinators, who brings the staff together to "listen", only asks for problems. The staff should already be trained to understand and know their duties within the hospital, and in most all cases know their jobs better than the manager. We don't need a staff meeting to discuss the common facts. The staff meeting is a quality time for the exchange of information, the getting, as well as giving, of meaningful data. Try this format for ninety days:

 Assign a non-supervisory member of the staff to facilitate (chair) the staff meeting. This position will rotate among all staff members from meeting to meeting.

 When a staff meeting is to be held, require full attendance, even if it means paying overtime. It is an expectation of employment.

 Have an agenda that is published and posted at least three days before the meeting, maybe even in the weekly staff newsletter. This way, other additions or discussions outside the meeting will lead to more productive idea exchanges inside the meeting. All staff additions to the agenda must be submitted twenty-four hours before the scheduled meeting.

 If the agenda reflects an issue that has family impact, such as benefit plans, it allows the staff member to discuss the concerns at home before the meeting, thereby allowing spouse questions to be asked.

 It also is good for reducing the frustrations of staff members, who try to respond to further inquires at home.

 A revised agenda will be done by the meeting facilitator before the meeting, with sufficient copies for all practice participants.

 The meeting must start on time, at the place announced, and stay to the schedule, especially for those not on shift. Do not drop back and repeat items for late arrivals, they must get the information from other sources outside the meeting.

 New topics will not be brought to the staff meeting except to be scheduled for the next agenda. This prevents surprises and off-the-cuff responses that might be inappropriate to team efforts.

Staff Relations

In the biblical sense, don't have any. That simple personal policy will greatly enhance working relationships. The bond that forms within a medical lifesaving environment is strong, but should not be mistaken for personal feelings of attachment.

The network of staff interrelationships is a web usually too complex to predict, since values and skills are complicated by bias and duties. The logical approach is to delegate authority and responsibility to the lowest level possible to control a functional area. If your style is to hold people responsible for their actions, then allow them the honor of having control of those duties within the established practice parameters. Let the lower level supervisors/coordinators rate the people beneath them. With rating comes control.

The veterinary practice staff is a family, which means the supervisor needs to be aware of home difficulties, financial challenges, or other stress factors affecting any employee.

 Flexible work hours are often an easy solution to many challenges, but the usual standard structure learned by most practitioners did not include this employee benefit. If the difficulty is monetary, the rules change.

 Internal controls will become more important to remove temptation from the employee.

 It may be possible to increase an employee's hours, but more likely, it will be of greater assistance to set them up with a financial counselor, who is skilled in assisting the financially overwhelmed family.

 The rules are similar with drug and alcohol problems. Seek local expertise to assist the employee.

When the peaceful hum of the practice is disrupted by an angry or frustrated employee, action is needed quickly. I find it very comfortable to bring the dissatisfied employee into my office and tell the person I detect unhappiness. Please remember, praise in public, but counsel in private.

If we cannot resolve the issue, the next step is to give the individual the rest of the week off with pay. This is usually best done on Wednesdays or Thursdays, to assess the employee's position, and look for alternate employment that would make the person happier. If the person comes back on Monday with a smile, the person gets that next chance, with no ill feelings. On the other hand, many come back just to tell us they found another job, which saves us benefit monies. Either way, we do what is best for the employee and practice.

Recognition Programs

Research from the American College of Healthcare Executives has shown that healthcare workers in the United States are primarily motivated by recognition factors, money being only one way, and salary alone is about five down the list. In Europe, the feeling of belonging to a quality healthcare team is the number one motivator. My perception of the average veterinary practice today is that the paraprofessional staff can be reached with either motivator, but using both is best.

Recognitions are provided in two basic formats: carrots to be dangled or surprises. The types of recognition rewards," incentives" is a misnomer, vary greatly from a caring thank you or a pat on the back, to a day off with pay, to money in the pay envelope. Incentives that are repeated on a regular basis, become expected, and, thereby, no longer become a recognition factor or motivator. An innovative manager will mix and match all the variations to maximize impact, while keeping overhead controlled.

Bonus monies based on gross have generally caused fiscal hardships in the long run, while "productivity pay" based on changes in net has produced greater practice liquidity. The term "bonus" sounds like a gift. In veterinary practice, the staff earns every penny they get, so "productivity"," performance", or "recognition" pay much better describe why the boss is saying "thank you" with money. Productivity or performance pay, not incentives, should be based on specific factors over which the employee has control. The money should come from excess production, levels of income over the budgeted expectation, or excess savings, as money left is because a specific expense was well controlled by the staff. It is easy for a practice manager, or the coordinator of coordinators, to share twenty percent of the excess gross, when the income budget target has already been made, or twenty percent of the savings under the budget goal for an expense center. The additional monies could even be called "exceptional performance pay". A few examples would be $1.00 per new client over the average for receptionists, a percent of net increase for dog food sales for the nutritional counselor, a percent of increased dental net for the nurse/technician marketing those services, etc.

Other recognitions are seen with sponsored bowling leagues, gift certificates, staff softball teams, picnics, movie tickets, or a host of other great ideas that can be family events or after-hours relaxations. Surprise lunches or dinners can also be a great time to add to the staff bond. Regardless of the method selected, remember that the purpose is to recognize exceptional performance.

Review the text Building The Successful Veterinary Practice: Leadership Tools and the VCI® Signature Series Monograph on Human Resources for more details on staff meetings and nurturing of the staff involvement.

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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