Getting Technical columnist Sandy Walsh is a veterinary practice management consultant, speaker and adviser. She is an instructor for Patterson Veterinary Management University and continues to work in a small animal practice. She has over 35 years of experience in the veterinary field and brings her in-the-trenches experience directly to readers.Read Articles Written by Sandy Walsh
Efficiency is something we strive for every day in practice life. But are you doing everything you can to achieve this goal? Here are some simple, commonly overlooked ways to make a big difference in the daily workflow.
Everyone needs to be punctual — in the door, on the floor and ready to work when the shift starts. When one person is late, a negative impact can extend throughout the day. Everyone, from clients and patients to the support team, suffers.
Doctors need to be punctual as well and set the tone for the day. Being ready 30 minutes before the first appointment allows time for patient rounds, pre-surgical exams and client communication.
Establish your hospital policy. Document it, communicate it and enforce it. Set the example if you are in a leadership position.
2. Schedule Appointments
Walk-in practices typically are less efficient. They are usually high volume and operate in constant chaos. Mistakes are more prominent, resulting in lower levels of patient care and lost revenue potential. The impact can be seen on three groups:
- Employees: Higher levels of stress, burnout and turnover.
- Clients: Longer wait times, lower levels of service and bonding, and fewer client referrals.
- Patients: Rushed care, necessary services not offered, and lower compliance.
Other than emergencies, clients should be scheduled for a specific time. Build urgent-care slots into your schedule and address emergencies as needed. The transition is easy. Clients will appreciate the time set aside just for them and you can better predict your staffing and inventory needs.
3. Prepare for the Visit
With scheduled appointments, you know what to expect throughout the day. Do appointment scheduler rounds so you know who is walking in and why. Clients should receive immediate personalized acknowledgement as they arrive. Be ready for the visit by doing this:
- Pull the chart.
- Print the treatment plan.
- Print releases or information-gathering tools.
Prepare the exam room with what might be needed, such as an otoscope and vaccines.
4. Staff Appropriately
Most practices say they are frequently understaffed. This is true in many cases. Everyone is affected when there aren’t enough employees to get the work done efficiently. Clients, patients and the veterinary team will feel it. If this sounds like you, it may be time to:
- Hire appropriately. Build your team with the right employees.
- Train appropriately. Invest in your team by offering comprehensive training.
- Staff appropriately throughout the day.
The 2017 Well-Managed Practice Benchmarks Study placed the optimal staff/DVM ratio at 4.2-to-1. This figure represents all staff supporting each full-time-equivalent doctor. Have you checked your numbers? When you are chronically understaffed, visits are rushed, services are not offered, mistakes are made and your revenue potential cannot be maximized.
5. Simplify Your Wellness Plans
We all know what a dog and a cat need to stay healthy. Build your basic wellness plans around your hospital patient care models. Make them comprehensive but not overwhelming. Recommend programs that will:
- Prevent disease.
- Improve a patient’s quality of life.
- Improve a client’s peace of mind.
- Remain flexible and affordable for clients.
Train early and train often when it comes to wellness plans. The whole team needs to be onboard so that clients are not confused by mixed messages before, during or after the visit. Keep it simple.
6. Minimize Computer Entries
How many exam codes do you have? How many of them do you use daily and how many do you really need? In order to capture and clarify all possible services, we have overdone it when it comes to service codes. Pare them down and eliminate the unnecessary ones. Look for other areas of redundancy. Use your practice management software to group, bundle or link service codes for anything predictable, such as:
- Dental plans and procedures.
- Routine surgical procedures.
- Wellness plans.
- Serial X-rays.
- Serial bloodwork.
- Free doses.
- Hospital treatments.
- Wellness plans.
If you do this, training will be easier and there will be less confusion. You will experience fewer mistakes, greater fee capture, improved efficiency and happier employees.
7. Prepare for the Discharge
This is just as important as preparing for the initial visit. Schedule discharge appointments when the pet is dropped off or when a post-procedure update is given to the client. Eliminate end-of-day chaos and random discharges by:
- Posting all charges in advance.
- Preparing any medications or products.
- Preparing home care and discharge instructions.
- Preparing the patient.
Discharges should be done in an exam room whenever possible. Instructions are delivered, medication administration is demonstrated and questions are answered. When communication has happened throughout the day, a scheduled routine discharge can be done with a technician in 10 minutes.
8. Check out in the Exam Room
Workstations are becoming more common in the exam rooms, especially with the evolution of electronic medical records. Starting and completing a patient visit in the exam room has its benefits. For example:
- A decrease in the number of client and patient handoffs will personalize the visit.
- You will have the opportunity to discuss a pet’s condition and treatment options and any financial considerations in a private setting.
- Follow-up appointments can be scheduled before the client leaves the room.
- Compliance rates will improve.
- Pileups at the front desk will be reduced.
9. Leverage the Team
Who does what in your practice? Doctors produce the active income — roughly 50 percent — and the support staff produces the other 50 percent, the passive income. We can’t have one without the other, but they shouldn’t overlap. Inefficiency results when doctors are doing “non-doctor” tasks that the support team should be doing.
Think about whether everyone is doing his or her job. You have highly skilled team members, so use them and let them do the job they were hired and trained to do. The result is a higher level of employee engagement and job satisfaction. You should always have the right person doing the right thing at the right time. This is efficiency.
We can’t do it all. Most of us have too much on our plate every day, yet we continue to pile it on. We need to get over these four common excuses for doing this to ourselves:
- It’s easier to do it myself.
- It’s faster to do it myself.
- I know it will get done.
- I know it will get done right.
Delegate what can and should be done by someone else. If you have the right team in place, you will be able to share the load before you become overwhelmed. As confidence and trust develop, you will feel more comfortable delegating.
Choose wisely and look to the worthy, willing, competent and trained employees. Share your expectations and keep the lines of communication open. Your employees will feel valued and you will feel less overwhelmed.
Follow the tips above and look for other ways to improve efficiency in your practice. The patients, clients, team and bottom line will all benefit from your efforts.