Move Forward by Going Back
Creating a culture of preventive care, or improving one, starts with the entire veterinary team. Invite everybody’s thoughts on client education before you draw up protocols.
The COVID-19 pandemic catalyzed veterinary practices to innovate, but it was costly in terms of educating clients about preventive care. Due to the increased demand for veterinary services, many hospitals chose to share only the information needed for that day’s visit. The result was a year’s worth of new pet owners and returning clients who didn’t hear about the value of preventive care and might not have understood how their actions today affect a companion animal’s future health.
Many veterinary hospitals provide preventive-care services but don’t explain the importance to clients. The disconnect happens when a failed understanding occurs between pet owners and the clinic team about the meaning of preventive care.
The quality of the recommendations varies from team member to team member depending on their beliefs around preventive care and their willingness to educate clients about proactively managing their pets’ health. Team members sometimes can’t afford comprehensive preventive care for their own pets and feel hypocritical when they counsel pet owners. This disconnect can lead to a moral conflict for employees: knowing what is best for the patient but feeling the pain and guilt of not providing the best for their pets.
Another reason preventive-care recommendations fall flat is inconsistent team training. Practice leaders should ask themselves:
- How is a client educated about pet diseases and the steps to minimize them?
- What does the education look like?
- Who is responsible for the education?
The First Step
Every hospital should have an ingrained culture of preventive care in which a core belief is the critical need for client education. Clients are the experts in their pets’ lives and want to learn to make the best medical decisions.
A focus on preventive care leads to four chief outcomes:
- Pets enjoy longer, better-quality lives.
- Empowered clients become advocates of the hospital, increasing word-of-mouth referrals.
- Veterinary teams see fewer desperately ill pets, which leads to reduced moral distress because fewer clients choose subpar care or economic-driven euthanasia.
- Providing preventive care is an ongoing mission that creates a sustainable revenue stream.
Measuring the Success
Metrics can help determine whether a hospital has a culture of preventive care. The first measures client adherence to recommendations. Here’s how:
- Take 25 to 50 random patient records and calculate the number of pets, by each service, that received recommended preventive care within the past 12 months. Evaluate services like wellness examinations, vaccinations, heartworm tests, wellness bloodwork and diagnostics that included a fecal test. If a dental treatment was recommended, did the pet receive it? Which services had the lowest adherence rates? Then ask, why aren’t clients accepting the recommendations, how are recommendations made and what needs to change to increase client acceptance?
- Hire an analytics company to summarize preventive-care services based on patient and doctor data.
- Use your practice management software system, if it’s capable, to produce adherence reports.
The second way to confirm a culture of preventive care is to listen to your team talk about preventive care with clients and each other. For example:
- Listen to front-desk conversations. How many appointments are scheduled for follow-up preventive-care services such as spays, neuters and dental treatments?
- Determine whether wellness appointments are forward-booked. Are reminders generated for pet owners who need refills of heartworm preventives and parasiticides?
- If a pet owner declines preventive-care services during an exam, the veterinarian should follow up on the client’s understanding from a well-being perspective. The statement can be as simple as: “Mrs. Smith, Sarah told me you are declining Spot’s heartworm test and preventive today. Because this is so important for Spot’s health, and for your family, too, I wanted to be sure you don’t have any questions about heartworm disease.”
How to Create the Right Culture
Often, newly imposed preventive-care programs fail because team members are resentful about hospital leaders dictating changes. This approach leads to a lack of buy-in and engagement. When teams work together to problem-solve, positive outcomes occur much faster and more effectively. Success is higher when teams are involved early in the process.
Here are three recommendations.
1. Invite Team Participation
A staff meeting is where attitudes toward preventive-care education can be explored. Hospital leaders should explain that understanding the team’s perspectives is important. Start with open-ended questions and follow up based on the responses. Team members should be encouraged to ask questions and talk about how preventive care helps pets and clients. The purpose of the exercise is to understand the barriers to creating a culture of preventive care and give each team member a voice.
“What if?” questions can encourage dialog, help a team think creatively and test boundaries. For example: “How would you feel if you were a client and preventive education was explained to you?” and “How would you feel as a pet owner if the importance of preventive care wasn’t explained and your pet contracted a preventable disease?”
2. Empower the Team
After feelings are explored, invite everyone during a facilitated discussion to suggest ways to build a culture of preventive care. This approach allows team members to recommend changes that would work for them and increase individual commitment.
Hospital leaders then should summarize and confirm the feelings. For example: “You say clients aren’t consistently educated about preventive care because of confusion. You aren’t clear about who should educate a client. Is it the technician, veterinary assistant or veterinarian? Consistent protocols about when and what clients are told don’t exist, you say, and lead to different recommendations based on the preferences of the veterinarian you are working with. Also, educating clients about preventive care takes a lot of time due to a lack of training. Finally, when clients decline recommendations, you become demotivated. Anything I missed?”
Leaders then can ask follow-up questions that empower the team to identify solutions. For example: “What steps are needed to reduce confusion about preventive-care recommendations? or “How do we want to change this?” or “What role will each of you play in making this happen?”
3. Foster Team Ownership
Feedback from the discussion will help frame a culture of preventive care. Once the team agrees on the steps, implementation goals can be set. Here’s what I suggest:
- Identify champions for each goal. Champions help align team members with the initiative. All employees are accountable for the program’s success, and their roles are clearly communicated. All team members understand how each goal aligns with their personal beliefs. In the case of preventive care, these beliefs might be to help pets live better-quality lives, to prevent avoidable illnesses and suffering, or to partner with clients to become educated advocates for a pet’s well-being.
- Make client education protocols and team training a constant and consistent focus. The protocols should outline how client education is delivered at each visit.
- Encourage employees to share best practices and discuss the difficulties encountered in educating clients about preventive care. The team can role-play effective communication and talk about how to overcome the barriers.
- Ensure the new program stays top of mind by talking about preventive care frequently. At staff meetings, share stories about how preventive-care recommendations helped a pet, its family or both. Examples might involve a pet living with small children that was diagnosed with hookworms after a recommended preventive fecal examination, or a dog that wasn’t allowed to kiss its owners but resumed the affectionate behavior after a dental treatment.
Weaving a culture of preventive care into a hospital’s daily operations becomes a vital part of client management and determines how employees view their contributions to patient health and their commitment to partnering with clients. Fewer pets will be in crisis because proactive health care results in better-managed patient care.
In the end, the veterinary team and pet owner become equal partners in the well-being of pets. Isn’t that where we want to be?
Dr. Wendy Hauser is the founder of Peak Veterinary Consulting. She writes extensively and frequently speaks about hospital culture, communications, leadership, client relations and operations. She represents the American Animal Hospital Association in the American Veterinary Medical Association’s House of Delegates.
HOW TO EDUCATE PUPPY OWNERS
Below is a sample framework for educating first-time puppy owners. In this leveraged team model, the veterinary technician or assistant provides the education, and the veterinarian answers any additional client questions. The bullet points should be outlined clearly in the protocol and not be left to a team member’s interpretation.
First Visit: 8-10 weeks old
- Talk about housebreaking, nutrition, basic behavior, household hazards, socialization, the cost of care, vaccination reactions, and tools like wellness plans and pet health insurance.
- Dispense a sample heartworm preventive.
- Forward-book the second wellness appointment.
Second Visit: 10-13 weeks old
- Ask the client about any questions arising after the first visit.
- Talk about heartworm disease and its prevention under American Heartworm Society guidelines.
- Dispense another heartworm preventive dose.
- Discuss dental care and vaccination reactions.
- Forward-book the third wellness appointment.
Third Visit: 15-16 weeks old
- Ask about any questions arising after the second visit.
- Discuss spaying or neutering, microchipping and obedience training.
- Talk about the next wellness exam, and forward-book the appointment a year out.
- Schedule the spay or neuter, or add a reminder call in the practice management information system.