Using the Whole Clinic Team to Deliver Cost-Effective Care
World Small Animal Veterinary Association Congress Proceedings, 2018
Mark Moran, BSc, MBA
Vets in Business Limited, Ashcott, Bridgwater, Somerset, UK

Identifying the Opportunities

The key to providing cost effective healthcare is to ensure that a clinic’s principle asset, our veterinary surgeons, are being used productively and supported appropriately. In many clinics experience has shown that veterinary surgeons can spend over half of their time carrying out tasks and duties that could be performed by less qualified, and hence expensive, members of the team.

There are many reasons why this situation occurs, however, the most common reason I am given is that it is just the way we do things here! So how can you tell if your clinic is using the whole clinic team effectively? The simplest way I have found is to ask them. This can be achieved by using a simple survey, and/or using individual confidential interviews. Often using an independent person for this task encourages staff to be more open and honest about their feelings, so long as they are made to feel secure that their comments will be treated in confidence.

Key facts to establish include:

  • How well do the staff understand the aims, objectives and values of their clinic?
  • Who do staff go to when they have an issue to resolve?
  • Do staff feel that all of their skills are fully utilised?
  • Are staff being developed in way that is consistent with the clinic’s goals?
  • What do staff most enjoy about working at the clinic?
  • What do they least like, and would change tomorrow if they could?

The Barriers to Good Team-Working

The biggest barriers to effective team-working are firstly that staff are unsure as to exactly what their role allows them to do, and secondly, that they do not know either what to say, or have the confidence to say it even when they do.

Often both of these situations have arisen because of the action of either the owners or veterinary surgeons when there have been issues arising out of staff doing or saying “the wrong thing” in the past. Without support and encouragement staff will not take “risks” and so absolve themselves from the situation.

The key steps to breaking down these barriers are to ensure all staff roles have been clarified, to provide support and encouragement to staff to develop and use new skills, and to develop best practice protocols and procedures that can be used to train all staff, provide a reference point when required, and to ensure consistency of service.

Protocols and Procedures

Protocols and procedures are important because they ensure we provide a consistent message, and provide the means to delivering a consistent service regardless of which members of staff are involved.

The process of creating or updating a protocol should involve as large a group as practicable so as to draw upon the collective knowledge and experience of the team. We also know that veterinary surgeons can hold strong views, and it is important to reach a consensus if we are to develop protocols that have the support of the whole clinic team. Involving staff in the process is an effective way of locking them into the outcome.

Of course, even for the most common preventative treatments, there are many options, and choosing the right one will require us to understand the patient’s circumstances. As such, protocols need to identify the key questions that staff has to ask to establish the lifestyle and risk factors that will be used to determine the most appropriate solution for that pet. Used correctly, good protocols should ensure that whichever member of staff asks the questions, based on the same answers the resulting recommendation will be the same.

Once developed, effective protocols allow us to share best practice across the whole clinic team, and provide the training documentation for new team members.

Key preventative healthcare protocols include: vaccination policy (based on local risks), parasite control policy (based on local risk), and neutering policy (by species and breed).

Engaging Staff

The most effective way to engage staff is to define areas of responsibility, either collectively or individually, and to involve them in improving performance in these areas. This provides lots of opportunities to draw on their experiences, to allow them to “own” solutions, to support each other, and for us to praise. Two activities that lend themselves to this approach are running clubs or clinics, and managing and following up on reminders or recalls.

Clubs and clinics are an excellent tool to encourage staff to engage in a team approach because just the act of creating them reinforces the importance attached to working together. They also allow the more experienced members of staff to make better use of existing skills and to pass on their experience to more junior team members. Popular clubs and clinics include puppy and kitten socialisation and advice, weight control, senior pet clubs, and those for behaviour issues.

Developing and maintaining the clinic’s systems for reminders and recalls is an excellent way to engage less clinical staff such as receptionists and administrators. These staff have often joined a clinic specifically because of their affinity to animals, and so following up on reminders or recalls is an effective way for them to make a positive contribution to the health of our patients.

Your Action Plan

Developing a team approach is about much more than just saying it is something we intend to do. If your clinic has not historically used staff in this way, then the level of cultural change required can be considerable. You will need to demonstrate your good intentions in practice before long-serving staff begin to feel comfortable with the new process and fully engage. You will need to plan carefully, and take small steps. What the first step will look like is very much dependent on where you are now, which is why you should always start with a review.


Speaker Information
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Mark Moran, BSc, MBA
Vets in Business Limited
Ashcott, Bridgwater, Somerset, UK

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