Having been privileged to visit many veterinary practices, both large and small, I can say that much of the team’s stress develops because of poor quality systems, outdated tools and ancient processes. It is appropriate that we acknowledge the mental pressures of toxic behavior, ethical dilemmas and high client demand, but even those issues can be improved with better systems.
A few weeks after I had accepted a COO position in an 11-doctor hospital, I realized we had no system for good inventory management. Inventory counts were rare if ever and any “deal” was purchased regardless of need. When I found 22,000 SMZ tablets under a counter in the lab I realized a new system was needed.
One of our CSRs was a former pharmacy technician so together we got our drugs and products accurately counted, high and low order points set in the computer, and excess stock under lock and key with limited access. Now the team was not going on a scavenger hunt every time they needed to stock the pharmacy, our cash flow was much better and we actually got rid of a lot of products we didn’t need or would have expired before we could ever use them. Because we now had our computer doing its work and creating our want list, our staff was not sticking post it notes everywhere, calling our supplier every dang day to order and running out of needed tools to do their work.
Prior to this I also realized the team was being hamstrung by an outdated and clunky software. When a client looks over the counter and counts the number of keystrokes it takes to start his invoice and says “OMG! You people need to upgrade this system” you know it is time to do better by your staff. How frustrating to have a client hovering over you while you are required to tap away forever because your software sucks! I recently looked at a demo of Provet Cloud software and thought how elegant the format was and what an efficient and easy system for a team to learn and use.
Then there were the accounts receivable. Again, no set protocol so our doctors and team were stuck with trying to make payment arrangements off the cuff. With input from the team, we developed a protocol for securely holding client credit information and added payment options like CareCredit. Our receivables dropped exponentially, our clients knew what to expect when getting care for their pets and even our large animal work with trainer barns became more systemized. No more guessing games for who will pay and who won’t.
The “cookbook” for the lab was another system game changer. The practice was open 24/7 and was both GP Mixed and ER. At first, everyone worked in the lab running tests. The large animal vets even ran their own labs and Coggins submissions. Then we hired an experienced vet assistant who had worked in the lab at human hospital as our full-time lab tech and with her ideas we were able to organize the workflow. She wrote a lab manual that any tech or assistant could use to run even the most obscure tests when she was off, without having to ask anyone.
The supplies were indexed by cabinet position in the book and labeled on the shelves. Refrigerated items were also kept in specific positions in the refrigerator. Once more a good system put in place to reduce the number of movements needed by the team to get their work done.
The problem with many practices is they build systems for the way they worked when they first opened and now those same systems are still in place. My job as a consultant is often to shine light on the inefficiency of these old systems and to work with the staff to develop systems that really serve the hospital in today’s workflows.
Sometimes old habits are really bad habits. It takes someone outside the practice to see them and guide you to success.
If you are interested in getting help changing your practice habits please reach out to dboone@dboone2managevets.com
