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

Zoned Operations Evaluation

Introduction

In most practices, leaders rarely achieve consistently excellent results entirely on their own. Such results are usually achieved by leaders working with their caring staff, as teams. "Working as a team" doesn't simply mean holding an occasional meeting. It means collaborating day-in, day-out, whenever pooling of resources or coordinating effort is called for.

If your zone team is not collaborating effectively, this exercise can help you discover the reasons and to think of ways to achieve the kind of collaboration that makes for excellence.

Instructions

Think of a zone team you'd like to evaluate. As a point of reference, you may want to list the members of the zone, or actually diagram the entire practice staff in zones, with the staff members' names. This way, you'll be able to focus on your zone, as you complete the evaluations.

What You're Evaluating

You're evaluating the way your zone team operates in the practice flow. You're examining its dynamics, the patterns of interaction among its zone members that help account for the fact that they do, or don't, work together productively, and how they interact between zones.

Each item on the questionnaire is followed by four statements describing Q1, Q2, Q3, or Q4 zone operations. Respond to each item by allotting ten points among the four alternatives. Allocate the points in the way you feel best describes your zone team. For example:

Q1

-

10

or

Q1

-

2

or

Q1

-

1

Q2

-

0

Q2

-

2

Q2

-

7

Q3

-

0

Q2

-

0

Q3

-

1

Q4

-

0

Q4

-

6

Q4

-

1

Or any other combination you consider appropriate. The only ground rule is that a total of ten points must be allotted to each item.

Here's the procedure:

1.  Read the item and all four alternatives before allotting any points. Caution: Each "Q" statement is purposely worded to reflect extremes. It's okay to assign points to a statement, even though it is not an exact fit. The statements are simply guidelines to help you identify how your zone team operates. Reminder: The total must be ten.

2.  Write an explanation after each alternative to which you allotted points.

3.  Proceed to the next item. Follow the same process.

Below is a completed example. Study it before doing your evaluations. Remember: You're evaluating your zone team as it functions in the daily practice flow and mission focus.

My Evaluation

Item 1: Coordination Within Our Team

6

Q1 We're not too concerned with coordination. Everyone in the zone has a job to do and does it. Sure, we expect backup if we need it, but we hope other people stay out of our way, so we get on with the job. If someone's reluctant to help, we tell the coordinator, who then applies pressure.

Explanation: We mostly do the things each of us wants to do, even when we should work together. For example, the ERD reminders almost fell through, because we were all doing our own thing instead of coordinating our efforts on the new program.

1

Q2 We all have our own jobs to do, so we don't interact much. We prefer to leave one another alone. We "coordinate" when we must, but that's as far as it goes.

Explanation: There are times when we just ignore each other.

0

Q3 To us, "coordination" is another word for "getting along". We all get along fine. We stay in close touch with one another, because that's the best way to maintain good relations. Achieving zone goals through coordination is secondary.

Explanation:

3

Q4 We often touch base with one another to exchange the information and assistance that will help us do the best job. To us, "coordination" means making the pieces on our team "fit together", so it functions as it should. W e willingly collaborate to achieve optimum results for the zone and everyone on it.

Explanation: Sometimes we all really pitch in and work together to get something done, especially if it's important. A good example - development and introduction of the Giardia SNAP test promotion for traveling pets.

In the previous example, the Q1 alternative was considered most descriptive of the zone's operation, so six out of ten points were assigned to it, while one point was assigned to Q2, and three points to Q4. No appreciable amount of Q3 was noted on the zone, so no points were assigned to it. Explanatory examples follow all alternatives to which points have been assigned. Now, evaluate each of the following items and write your explanation whenever you allot points. Remember, the descriptions reflect extremes and are intended as guidelines to help you identify the ways in which your zone operates.

My Evaluation

Item 1: Coordination Within Our Team

 

Q1 We're not too concerned with coordination. Everyone in the zone has a job to do and does it. Sure, we expect backup if we need it, but we hope other people stay out of our way, so we get on with the job. If someone's reluctant to help, we tell the coordinator, who then applies the pressure.

Explanation:

 

Q2 We all have our own jobs to do, so we don't interact much. We prefer to leave one another alone. We "coordinate" when we must, but that's as far as it goes.

Explanation:

 

Q3 To us, "coordination" is another word for "getting along." We all get along fine. We stay in close touch with one another, because that's the best way to maintain good relations. Achieving zone goals through coordination is secondary.

Explanation:

 

Q4 We often touch base with one another to exchange the information and assistance that will help us to do the best job. To us, "coordination" means making the pieces on our team "fit together", so it functions as it should. We willingly collaborate to achieve optimum results for the zone and everyone on it.

Explanation:

My Evaluation

Item 2: Coordination Within Our Team

 

Q1 There's a lot of straight talk between people in our zone. We all bluntly say what we think. But much of what we say is self-serving, designed to bolster our own positions. Many of us are too close-minded to change our views. We don't pay much attention to or explore one another's ideas. Because we stick to our own ideas, we spend lots of time arguing.

Explanation:

 

Q2 There isn't much productive communication in our zone. We don't talk or listen much. Most of us are afraid to express our real opinions. When we do speak, we say what's expected, not what we really think. As a result, most of us don't say much.

Explanation:

 

Q3 We do plenty of communicating, but it's not very productive. There's a lot of good-natured conversation that doesn't really matter. Even when the practice needs are discussed, we usually stick to topics everyone can agree on. "Touchy" subjects are usually skirted or made light of.

Explanation:

My Evaluation

Item 3: How Conflict and Disagreement Are Managed on Our Team

 

Q1 We encourage and often express disagreement within our zone. This leads to arguments in which we all stick to our own views, without exploring anyone else's. Little mutual understanding results. The final decision is usually the one advocated by whoever dominates the argument, or the one imposed by the doctor. In either case, the rest of us seldom feel committed to it.

Explanation:

 

Q2 We rarely express disagreement. We submerge our differences, because we want to avoid conflicts that might prove disruptive. If disagreements do surface, we all back down quickly, so nothing much gets resolved.

Explanation:

 

Q3 We rarely express disagreement, because we don't want to hurt anyone's feelings. We make a show of amiability and accord, which probably hides a lot of suppressed doubts. If disagreements do arise, we treat them lightly; we appease or compromise, but seldom resolve anything. We settle on "popular" solutions everyone can live with.

Explanation:

 

Q4 We express our differences freely because we consider them springboards to creativity. We confront and explore disagreements until we understand all sides. Then, we develop alternate solutions and select the best. We don't always agree unanimously, but we generally understand the solution and feel committed to it.

Explanation:

My Evaluation

Item 4: Meetings with Members of Our Team Our Team

 

Q1 Most of our meetings are sermons, lectures, or presentations by the doctor or coordinator. Not much is heard from the rest of the team. When we do participate, we usually get embroiled in arguments, push our own views, without listening to others, make snide remarks, and in general, use the meeting to advance our private agendas.

Explanation:

 

Q2 Our meetings are usually boring, lack -luster, and unfocused. We rarely share information or seriously probe and analyze problems. When we do discuss problems, we slide from point to point, without reaching solid conclusions. Thus, most of our meetings are superficial or pointless.

Explanation:

 

Q3 Our meetings are usually long-winded, relaxed, and friendly. We jump from point to point; our discussions have little purpose, and less direction. We sometimes exchange information, but we keep it light and undoubting. When problems do come up, we have difficulty being candid about them, probably because we're so eager to stay on good terms with one another.

Explanation:

 

Q4 We meet when there's a clear-cut reason to do so. Each meeting has a well-defined format. It's either a formal presentation, an information-sharing meeting, or a problem-solving meeting. Agendas are distributed in advance, so we come prepared. The meetings are lively, yet business-like. We feel free to question and to speak out. There's plenty of debate, but it focuses on issues, not personalities. The meetings move in one direction and conclude with action plans that everyone understands and feels committed to.

Explanation:

My Evaluation

Item 5: Organization and Control on Our Team

 

Q1 The way we're organized, the coordinator calls the shots and makes the decisions, dealing with us mostly one-to-one. Our zone's role is to forward information to the doctor. The team is tightly structured. The doctor, who stressed hierarchy and top-down procedure, is quick to voice displeasure if anyone "steps out of line". The boss exerts control through rigid, sometimes suppressive, supervision. We're given very little autonomy.

Explanation:

 

Q2 The way we're set up, we don't interact much with one another. We seldom meet as a group. Even one-to-one meetings with the doctors are infrequent. We go by the book, making sure we conform to established policies and procedures. The coordinator exerts little personal control, insisting on strict adherence to established rules and practice paradigms.

Explanation:

 

Q3 We're organized in a loose, informal way, so as to foster harmony and rapport. The coordinator is "one of the gang". Goodwill and high morale take precedence over systems and procedures. The doctors exert very lax control, letting us do what we think best, as long as we don't create tension or controversy.

Explanation:

 

Q4 We're organized to encourage mutual interaction. We meet as a group and frequently one-to-one with the coordinator or doctor. The coordinator guides the zone team to make sure it reaches and implements timely, workable decisions. Our structure emphasizes collaboration, accessibility, and responsibility. This generates real understanding of and commitment to, the task at hand, which results in a high degree of self-control.

Explanation:

My Evaluation

Item 6: Decision Making/Problem Solving on Our Team

 

Q1 In our zone, the coordinator makes most of the decisions. Sometimes we're asked to gather data. Sometimes there's lots of noisy discussion. But, either way, the coordinator generally ends up making the decision. When things go wrong, we argue about who's at fault, jump to conclusions, and cast blame rather than systematically analyze the problem.

Explanation:

 

Q2 Generally we put off major decisions as long as we can. W e suffer from "analysis paralysis", which leads to much vacillation, but little action. When forced to decide, we usually do some superficial staff work that fails to engage the real issue. Then we procrastinate. When we finally decide, we go along with what's worked in the past, or we go "by the book." When things go wrong, we can say the problem was unavoidable, or was someone else's fault. We protect ourselves, rather than responsibly and systematically analyze the problem.

Explanation:

 

Q3 Usually the coordinator fully involves us in decisions. We hold superficial discussion, focus on positives, steer clear of negatives, and settle on the easy alternative. We base our decision on what's likely to be popular, or on a majority vote. When things go wrong, we appease, compromise, and apologize. We work hard to restore harmony, rather than systematically analyze the problem.

Explanation:

 

Q4 The coordinator involves us in decisions in which we should be involved. Our ideas are listened to with respect, evaluated with care, and when appropriate, followed. When needed, we do systematic staff work to gather data; then we meet to discuss our alternatives. The final decision may be the doctor's, but utilizes our ideas and our research. When things go wrong, we react calmly and methodically. To preclude rash action, we involve the appropriate people in systematically analyzing the problem, searching for cause, not blame.

Explanation:

My Evaluation

Item 7: Goal Setting and Planning on Our Team

 

Q1 The doctor generally sets our goals and hands them to us. We have little to say about them. When we are asked to set goals, the doctor usually changes them, so we end up with what the boss wanted in the first place. Sometimes we get to do some planning, but usually the doctor does it and tells us to follow through. As a result, we don't always fully understand our goals and plans or feel committed to them.

Explanation:

 

Q2 In our zone, goals may or may not be set, and we may or may not be involved. There's no clear-cut practice. When goals are set, they're either vague or they go "by the book", and call on us to maintain the status quo, rather than try something new. They're rarely accompanied by plans. When they are, we're not always told about them. The few plans that are disclosed are loaded with detail, "leaving no stone unturned".

Explanation:

 

Q3 In our zone, goals may or may not be set. When they are, we're usually involved. Our goals tend to be undemanding enough for everyone to reach. Many of them lack specificity. They're seldom accompanied by detailed plans. If planning is done, it's pretty loose, so nobody feels pressured, and group morale isn't diminished.

Explanation:

 

Q4 In our zone, goals are set on an ongoing basis, with all of us participating whenever appropriate. The coordinator, however, accepts only those that are challenging and realistic. The result is sound goals we understand and feel committed to. We're also fully involved in devising the accompanying plans, so we understand and appreciate what must be done to meet the goals.

Explanation:

My Evaluation

Item 8: Coordination with Other Teams and Units Within and Outside Our Organization

 

Q1 We rarely volunteer help to other zones, but we do make use of them for our own purposes. Our relationships with them are mainly exploitative. We take what we need, but don't reciprocate any more than we must, unless we have an opportunistic reason for doing so. Our interactions with members of other zones are usually very self-serving, which leads to strained and sometimes stormy relationships.

Explanation:

 

Q2 In dealing with other zones, we do whatever's "proper" or customary. There's a perfunctory quality to these relationships. We do what's expected, but nothing more. Our interactions with these other zone teams are rarely dynamic or productive.

Explanation:

 

Q3 Our interaction with other zones is usually warm, outgoing, and cooperative, especially with those practice members who reciprocate. We don't think of them as "others" but as people on the same side as we are. Instead of establishing mere "business" relationships with the other zones, we try to establish friendly, sociable relationships

Explanation:

 

Q4 We see our relationships with others as a two-way street: We help them attain their goals, and we expect them to help us attain ours. The key is reciprocity. We want good working relationships, because, in the long run, such relationships will be good for all of us. Besides, if we keep these interactions open, candid, and collaborative, we can learn much from them. Working with other units is a good way to broaden our own perspectives.

Explanation:

My Evaluation

Item 9: Critique and Feedback on Our Team

 

Q1 In our zone, critique and feedback are seldom productive and may be destructive. When it comes from the doctor, it's usually harsh, blaming, and one-sided. Feedback to the coordinator by direct reports is rare, and usually says only what they think the doctor wants to hear. Critique and feedback among other members of the zone are also harsh and often self-serving.

Explanation:

 

Q2 There are almost no critique and feedback in our zone. Rarely, the coordinator does provide perfunctory feedback, which is either vague or superficial. The rest of us almost never give the coordinator feedback. If we try, it falls on deaf ears. Critique and feedback among other members of the zone just don't happen.

Explanation:

 

Q3 We get frequent critique and feedback, almost always positive. When the coordinator gives feedback, it's highly complimentary. Everything's "great". Critique of the coordinator from direct reports or critique among peers also stresses positives and plays down negatives. In fact, critique in our zone is usually intended to make people feel good. Improving performance is secondary.

Explanation:

 

Q4 Our zone operations benefit from regular, open, and constructive critique and feedback. When they come from the coordinator, they realistically cover both positives and negatives, and they keep the recipient fully involved. The coordinator solicits critique from the rest of us, heeds it, and acts on it. Critique and feedback among the rest of us to each other, or to the coordinator, are open, direct, and productive. We all learn things that help us do a better job.

Explanation:

Zone Operations Comparison Against Other Teams

By recording your point allocation below, you'll get a bird's-eye view of your overall evaluation. We have collected statistics on how other teams have evaluated their zone operations, so that you may contrast your zone team with a statistical average. This average is not meant to be an ideal, but is merely a point of reference.

Average
Coordinator
Team

Q1

Q2

Q3

Q4

Total

Your Zone

Q1

Q2

Q3

Q4

Total

1. Coordination within zone

3.6

2.3

1.0

3.3

10

1. Coordination within zone

 

 

 

 

10

2. Income/cost awareness

3.2

1.0

1.2

5.0

10

2. Income/ cost awareness

 

 

 

 

10

3. Communications

3.2

2.0

1.2

3.6

10

3. Communications

 

 

 

 

10

4. Conflict and disagreement

3.5

1.2

1.0

3.7

10

4. Conflict and disagreement

 

 

 

 

10

5. Meetings

2.8

2.0

1.3

4.0

10

5. Meetings

 

 

 

 

10

6. Organization/ control

2.7

1.8

1.1

4.4

10

6. Organization/ control

 

 

 

 

10

7. Decision-making/problem-solving

3.1

1.7

1.0

4.5

10

7. Decision-making/problem solving

 

 

 

 

10

8. Goal setting and planning

2.7

1.8

1.1

4.4

10

8. Goal setting and planning

 

 

 

 

10

9. Coordination With Other Zones and Coordination Within Our Practice Flow

3.0

1.8

1.2

4.0

10

9. Coordination With Other Zones and Coordination Within Our Practice Flow

 

 

 

 

10

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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