Sandy Walsh
RVT, CVPM
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.
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A positive surgery outcome is important for patient care and equally important for client care. How do we achieve a positive experience for both? Through teamwide communication and consistent processes.
Every employee who has contact with the client or the patient should have a clear understanding of what is involved from first touch to last. Surgery and anesthesia top the list of procedures that cause the greatest concern for clients and thus require our best effort in communication, both inside and outside of the surgery suite.
Whether it is a routine spay, a dental or a major procedure, we owe it to our clients to provide them with as much information as possible throughout the process.
Before the Procedure
Communicating the treatment plan is the first step in making sure the client understands the recommendations and why the procedure or treatment is so important. Explain how the procedure will improve the pet’s condition or quality of life.
Remember to:
- Communicate all options so the client can make an informed decision.
- Avoid vet speak. Use terms the client will understand.
- Explain the “what” and the “why,” and encourage questions.
- Outline and explain your pre-anesthetic diagnostics, anesthetic monitoring protocols, pain-control protocols, hospitalization and nursing care standards.
- Explain charges and obtain client approval before scheduling the procedure.
- Perform pre-procedure diagnostics or bloodwork while the client and patient are present in order to save time and avoid another visit.
- Confirm the procedure date a day or two in advance and give pre-admission instructions.
- Prepare for the drop-off. Have the chart ready and any forms printed and ready to sign.
- Have someone on the surgery team admit the pet and address any last-minute client questions or concerns.
- Obtain current contact information.
- Have the receptionist schedule the discharge appointment.
During the Procedure
Alert the client during the procedure if anything changes. Immediate contact is necessary if complications arise or additional services are needed. This is particularly important during dental procedures when extractions are necessary. Obtain authorization before proceeding, and document the conversation.
Keep in mind that clients will never know what went on beneath the incision or within the mouth. They will focus on what they see when they pick up their pet. How the pet looks and feels is critical.
So, do this:
- Take care when shaving the patient. Hair regrowth can take weeks or months, so make sure the shave is straight, symmetrical and not excessive. This applies to surgical shaves as well as shaves for catheters, pain-control patches and monitoring devices.
- Follow the highest standard of care with respect to anesthetic induction and monitoring.
- Use a patient warming device during the procedure.
- Give pain control as needed. Comfort should be a priority.
- Clean the incision or mouth.
- Provide a complimentary nail trim.
- Contact the client to report how the procedure went and how the pet is doing.
- Keep the patient warm, comfortable and observed throughout recovery.
After the Procedure
Now that the procedure is completed and the patient is recovering from anesthesia, take these next steps:
- Post charges to the client’s account in advance of the scheduled discharge time.
- Prepare medications and prescriptions that will be sent home with the patient.
- Dispense pain-control medications if warranted. There is no reason for a pet to feel pain or discomfort after any surgical procedure.
- Prepare detailed postoperative instructions, including what the client should expect during the first few days. Clients will not remember everything you tell them, so written instructions are necessary. They should include instructions about incision and bandage care, activity restrictions, feeding, medication and treatments.
- If an e-collar is needed, don’t make it an optional item. Include it in the price of the procedure. Size the collar appropriately and show to the client how to put it on.
- Bandage and cast wraps should be clean, uniform and wrinkle-free.
- Clean the patient again. No blood, urine, feces or surgical scrub. Brush the patient.
- Settle the bill and provide post-op instructions and information before you bring the pet to the client. You want the owner’s full attention.
- Schedule follow-up appointments. Post-op exams should be included in the price of the procedure.
- Demonstrate how to administer all dispensed medications. This is particularly important with eye and feline medications. Most clients will not admit that they do not know how to medicate the pet.
- Help the client to the car, if necessary. The pet owner will appreciate the effort, and you can make sure the pet is safely in the vehicle.
In the Days to Come
Finally, make a notation in the callback system and contact the client each of the next three days to check on the pet. Ask:
- Is the client able to give the medications as directed?
- Is the pet eating and drinking?
- How does the incision look?
- Is the patient tolerating the e-collar?
- Does the client have any questions or concerns? Make sure any post-op issues are addressed immediately and are documented in the file.
Providing exceptional customer service goes hand in hand with exceptional medical care. It involves the whole team every step of the way. We need to remember that most clients cannot differentiate the medicine from practice to practice. They can, however, differentiate customer service and value.
Follow the steps above and you will be able to provide a surgery experience for your patients and clients that sets your veterinary practice apart from others in your market area.