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Trust the process

Reducing fear and stress in patients might require changing the workplace culture. Once you have the team’s attention and buy-in, your clients will take notice.

Trust the process
Make sure everyone in the practice can score fear, anxiety and stress levels and make detailed notes about how the patient prefers to be handled and the treats it likes.

It’s a busy Monday morning at your practice, full of appointments and a few walk-ins spilling over from the weekend. And then, in the midst of controlled chaos, an anxious German shepherd is scheduled for a 20-minute appointment to “check hips.” A few years ago, just writing those words would have sent my shoulders hunching and brow furling as to how I possibly could manage such a case on time and with acceptable radiographs while keeping in mind the emotional health and well-being of my patient, client and team.

I hear similar concerns from colleagues across the country. One champion in the practice wants to improve the workflow and case management, while protecting everybody’s emotional health, but no one else is on board. This can lead to burnout, compassion fatigue and destruction of the work culture.

Using well-tested strategies to create buy-in, rethink the workflow and provide appropriate education, we can manage cases like this. Most importantly, you will lessen the stress on everyone by keeping the patient’s physical and emotional health in the forefront and by avoiding being a trigger for an anxious patient.

Here are three ways to do all that.

1. The Why Matters

When the most successful leaders are asked why team members follow, the answer almost always starts with the power of why. People don’t like to be led blindly or follow a cause without having the knowledge behind it. This is incredibly applicable here, too.

Asking team members to blindly change their handling techniques and approaches to diagnostics, and even learn a new “language” about emotional health, can be daunting, overwhelming and scary. You need all team members to understand the incredible benefits that come from changing ideology and how doing so will empower them to be accountable for their actions and personal growth.

Reinforce during team meetings that this new way of thinking and practicing takes time. Acknowledge that certain team members are resistant to change. Validate their concerns and educate. A better experience for the pets whose care is entrusted to you and your team is the most important goal for all who chose veterinary medicine as a profession.

Secondly, discuss the daily stresses and challenges your team faces at work. Anxious animals, impatient clients and drained colleagues can wear on a career. Encourage team members to understand that new strategies will help remove many of these negative triggers. This will translate into better interaction with clients, who if they have good experiences will be less hesitant about making important veterinary visits and complying with our recommendations.

Just like with our team members, clients need to understand:

  • Why the physical exam has changed.
  • Why a patient’s anxiety might cause us to postpone a procedure until we can provide a more relaxed experience.
  • Why the hospital has invested in removing anxiety triggers for the benefit of the pet and its family.

Utilize your website, social media avenues and in-hospital marketing to reinforce the communication.

2. Plan Appropriately

Once team members know why a certain handling technique or sedation protocol is preferred, implementation is the next discussion. Tell your team that implementation takes time, and patience is key to achieving your goals.

Trying to instantly implement new hospital strategies without associated training and management buy-in is a sure track to failure, burnout, and losing credibility and interest. Get buy-in first from people on your staff who are good leaders, who show initiative and who have a good relationship with the staff. They are your champions and the secret to achieving practice-wide buy-in. They can lead the charge within their work groups, giving them a sense of ownership.

Once you have these people in place, you can start expanding the buy-in process. We have found that once people see the differences, everyone wants to take part.

Every clinic, big or small, has a lot of moving parts. To begin implementing a protocol or plan, take a relatively simple piece of the process for improving the emotional health of patients and start to train, implement and assess.

For example, consider introducing high-reward treats to physical exams. Have your client service representatives ask pet owners by phone which treats a patient likes, and record the answer in the medical record or add the product to the lobby treat menu. Have veterinary assistants assemble treat coolers to be brought into the exam rooms for appropriate and frequent handouts.

Associate veterinarians can explain to clients how high-reward treats trigger an endorphin release and positive associations. Giving treats can encourage client participation in the exam and a team approach that builds trust and compliance.

Once all team members know their roles and responsibilities, and how each piece of the strategy is essential, document everything in a one-page protocol. After two to four weeks, reassess what has been done well and what can be modified. Once everyone is comfortable with the process, start tackling larger protocols like handling, sedation and scheduling.

3. Assess Your Workflow

The other key to success is making sure you creatively look at how you schedule your day. This certainly sounds easier said than done.

Our industry has become accustomed to controlled chaos — the back-to-back appointments and managing multiple patients throughout the workday. When I talk to colleagues about improving emotional health in the practice, the most common barrier I hear about is time. That is, the time needed to do a different type of physical exam, the time our clients will feel has been lost if we pause, postpone and regroup, the time our technicians feel they don’t have to use alternative handling strategies, and the time crunch our associate veterinarians feel due to a multitude of factors.

This is where thinking out of the box is so important. Rethink your practice’s standards for responding to different presenting signs. Be specific in training CSRs to schedule certain appointment time frames depending on the initial concern. Leverage your technical staff for appointments that can be handled without the associate veterinarian. Have your CSR team communicate to the client ahead of time the importance of previsit pharmaceuticals or pheromones as well as the need for specific treatment plans that reduce anxiety.

Consider drop-off appointments or having an associate’s time be blocked off for procedural appointments. Don’t hesitate to sedate a patient, and don’t be afraid to pause and postpone. Prioritize what is needed to complete an exam and diagnostics rather than what a client might electively want — such as ordering bloodwork over a nail trim.

Finally, make sure everyone in the practice can score fear, anxiety and stress levels and make detailed notes about how the patient prefers to be handled and the treats it likes. Knowing this can lessen triggers at the next visit.

What is the benefit of all this time, effort, training and assessment? I cannot stress enough how I have seen the changes transform a work environment. Our patients are clearly receiving better medicine, we are getting better diagnostics, and we achieve so much more within each exam than we were previously. Our clients are more relaxed and appreciative when they see their dog or cat less anxious and fearful, which leads to more compliance with diagnostics and recommended therapies.

These clients are more likely to return for recommended wellness checks, again allowing us to practice better medicine. Their happiness leads to more referrals and positive reviews. Increased revenue has far outpaced any costs associated with the changes I described.

Workplace satisfaction is the lifeblood of any veterinary practice. A positive work culture improves the emotional health for our patients, clients and entire team.

Fearless columnist Dr. Natalie Marks is co-owner of Blum Animal Hospital in Chicago. She is Fear Free certified.

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