(Re)Defining Continuity of CareNov 9 2023
Continuity of care can feel like a trendy buzzword. It’s one of those phrases that gets tossed around in both the VetMed and human medical worlds, and a casual Google search will net you dozens of definitions. They’ll generally focus around the need for an ongoing relationship between patient and caregiver and leave it at that. Continuity of care is the gold standard for medicine, and more and more pet owners are demanding this level of focused treatment. They want access to care that extends beyond their yearly wellness checks and a team that’s there for them during 2 a.m. emergencies. Here’s the key tension: meeting that client demand requires a concerted effort across your entire clinic, and most veterinary hospitals aren’t prepared to provide the necessary support. The goal of this article is to lay out the major elements of the relationship between your practice and your patients and see how you can use each interaction to build out a meaningful, long term connection. What is Continuity of Care? There’s only so much that we can do at the point of care. When we perform a surgery, we’re addressing an immediate need, but the healing process is full of both pitfalls and opportunities related to the patient’s health. Continuity of care means a consistent relationship between the pet, the owner, and the clinic throughout the life of the animal. I think of continuity of care in terms of five pillars: Consistent communication Excellent customer service Owner compliance Access to medical advice Follow through Here’s what these pillars look like in practice (and how to implement them). 1. Consistent Communication From new client intake to end of life care, it’s vital that we’re able to communicate with our clients consistently and effectively. That starts with an excellent staff that’s able to provide great service to both patients and clients. When hiring, we need to prioritize both a person’s skill set and their emotional intelligence. For a lot of clinics, automating elements of this process is a key way to build it into their operations. You can use tools for automated appointment reminders, create paper handouts with your recommendations for day-to-day concerns, and use a chat tool to cut back the amount of time that actually needs to be spent on the phone. Of course, all of this falls apart if your clinic is hard to reach. Long hold times, missed calls, and limited channels for communication all turn this into a hassle for both your hospital and your clients. Clinics that struggle with communication will struggle with providing the kind of consistency that’s key to continuity of care. Look for opportunities to cut back the number of calls that your staff needs to deal with day-to-day. 2. Excellent customer service It might not be instantly apparent how customer service ties into continuity of care. Fundamentally, though, it’s about the ways that we approach the emotional side of practicing medicine. When we help clients to feel heard, understood, and cared for, we’re establishing the kind of relationship they can lean on. When we have the forethought to anticipate a pet owner’s needs, we’re making it easier to seek care. We’re also opening space for the smaller questions and concerns that are a huge part of the journey of owning a pet. This starts with hiring and continues with training over time. It helps to have a clear sense of how you want clients to feel when they enter your clinic, and build that emotional experience into the ways that you navigate calls and follow ups. In my clinic, I like to follow up after every visit to make sure the pet did not have any complications (yes, even with vaccine appointments), making sure preventives were given and that the pet ingested them without a fuss. It is a lot of communication and it does take a substantial team effort, but we can easily alter therapies and even lend emotional support to owners after traumatic experiences. It lets them know we are here and that we care. Essentially, strong relationships are the foundation of continuity of care. It’s about building a meaningful level of trust between the client and the clinic, which is vital when it comes to discussions of care. 3. Owner Compliance Continuity of care is rooted in the ability of caregivers to work alongside owners. That means following up to make sure that the medical therapy provided is having a favorable response, and making alterations if it isn’t. It also means working to bring owners onboard with clinical recommendations, even when they’re not initially convinced. How do we ensure owner compliance? Education is always the starting point. We need to communicate clearly, and provide resources wherever possible. If our hard work and recommendations are ignored the moment a patient gets home, then the care provided will be incomplete. If I’m struggling to get aligned with a pet owner, I tend to use analogies that the owner can easily understand. I discuss the disease process in a way that makes sense to them and then discuss care options. I let them know what is available and that they have choices. I do not know their financial health, so remembering that if an owner cannot afford therapy, it’s ok I support them emotionally and we try alternatives so they can afford therapy and the pet receives care. 4. Accessibility of Care Can a pet owner reach your practice in their time of need? Pet health doesn’t follow a 9-5 schedule, and owners are hesitant when they can’t tell if they need to make an expensive trip to the ER. That can result in visits to Dr. Google, unnecessary trips to the ER, or putting off necessary treatment due to uncertainty. I’m not recommending that you spend your entire life on-call, though. Instead, look for a partner that can provide support to your clients when you’re not there. Whether or not you personally see late night emergencies, providing a support system after hours for your clients means that they have the information they need to make an informed decision about their pet. It’s about maintaining the care for the pet within the walls of your hospital, even when you’re not around. If you’re not able to provide this support and your clients have other options, they’re likely to go with the clinic that can support them in their scariest moments. The opposite is true as well, though- I’ve had many clients specifically reach out to thank me for the support they received after hours, which drives long-term loyalty to my clinic. 5. Follow through This is the culmination of your efforts when it comes to continuity of care. Here’s what I mean by follow through: Ensuring that recommendations are being followed Ensuring that medical therapy is favorable Answering questions about therapy Scheduling follow up exams These steps are inherently time-consuming. For clinics that are already feeling overwhelmed, it can be hard to plan for this additional level of support. There are two things to keep in mind here. First, if you’ve built up strong processes for the other four pillars, following through is a natural outgrowth of those structures. Second, if you’re taking steps to automate certain processes and using virtual tools to streamline others, following through doesn’t need to be a hassle. Simple follow up exams can be conducted via video call, rather than taking up an exam room. Basic email sequences can communicate reminders post-surgery. In my clinic, I like to send text reminders. It can be automated and the responses are downloaded into the medical record. One last thing to remember: help is available. The biggest thing holding clinics back from providing true continuity of care is the misapprehension that they need to do everything alone. GuardianVets is the leading partner for clinics that believe a better standard of care is possible. If you’re ready to streamline your operations and drive a new level of connection with your clients, you can sign up for a consultation below.
Utilizing Virtual Teams To Provide Quality ServiceApr 24 2023
Tech-enabled services are growing and changing rapidly in the veterinary industry! From the days of printing and mailing reminders to email and text capability, companies offering tech-enabled services found ways to integrate with our PIMS to send out reminders with a click of a button. We then moved to individualized apps for appointment requests, appointment reminders, and prescription requests or refills. Then, we arrived at a point where we could give clients access to their medical records and see test results from home while the doctor reviewed them over the phone. Now, here we are in 2023 moving towards the capability of telemedicine for follow-up appointments and hospice care. I remember a time early in my career when I was undergoing training to be a receptionist — it was a Saturday morning — we were only open for 5 hours, but the schedule was packed. At the clinic, we offered boarding services, and we also took walk-ins and work-ins. The phones were ringing off the hook. I had multiple clients in front of me with a gauntlet of needs: “I need a refill on Heartgard” “I am here to pick up my pet's medicine" “I am here to pick up my pet” “I am dropping my pet off for boarding” “I have arrived for my pet's appointment” “I am ready to check out” “I don’t have an appointment but my dog's nail is ripped and it’s bleeding” “I need to schedule a recheck appointment” Addressing a client's needs is overwhelming when you are new, let alone a seasoned staff member! The instruction from my trainer (which I remember almost 20 years later) was, “Do not make eye contact with a client until you are ready to help them." So I would keep my head down so they knew I was busy until I finished my task. The thought process was if you look at someone, then they think you are not busy, you are ready to help them and this will get you off track. Some see multitasking is an important skill, but it leaves vets burnt out and does not allow for QUALITY customer service and patient care. Allowing your team to be able to focus on customers and patients that are IN your hospital seems like a dream! Before I discovered GuardianVets I had no idea that this level of service was available for a small practice. I managed a small animal hospital for 6 years and would have loved the ability to have a “call center” to field calls for scheduling and refills. Another huge benefit that GuardianVets offers is Triage Services. That’s right! Triage Services. Take the burden of phone calls off your team so that your in-house staff can focus on patient care and customer service. GuardianVets uses technology to provide a remote team as an extension of your in-house veterinary support staff. I made a career move to GuardianVets when I needed a better work-life balance as a new mother. After I was trained and started working, I immediately saw the impact we were making on the hospitals we worked with. As someone who has worked in general practice as well as emergency medicine, I can empathize with the client and patient experience in both scenarios. Most importantly, I see how beneficial our services are to the entire veterinary teams in practice! There are many different ways that hospitals can utilize virtual teams to tailor services to each practice’s needs. Our practice solution can meet any level of demand; we work with small animal, large animal, exotics, specialty, and emergency hospitals. Options include, but will not be limited to: VCSR (virtual client service representative) Triage after hours Triage and Overflow during hours As a triage technician, I take pride in the fact that GuardianVets requires our technicians to be credentialed. When I take a call for a practice my number one goal is to properly triage the patient. If the patient needs immediate care I am able to facilitate that according to the hospital’s specific protocols. When a hospital is closed, our virtual team is there to answer incoming client calls. They never get a voicemail! If the doctor is on-call, I can see the hours they are available and which patients and emergencies they are able to see. If the pet does not fall into these guidelines or if there is not a doctor on-call, I can refer your patient to the preferred emergency hospital or urgent care. If the pet is stable and does not need to be seen right away, I am able to offer reassurance and a professional recommendation to the client. If the hospital allows it, I can schedule an appointment right then and there. If the pet has ingested a potential poison I can refer them to the appropriate hotline and also provide emergency options when warranted. Virtual teams are also a huge asset to emergency hospitals. Before working in an emergency hospital, I never realized that wait times could get over 4 hours. It never crossed my mind. Then I realized that wait times can get to 8-12 hours, especially during nights and weekends. On top of caring for critical emergencies as an in-person emergency technician, I also had the task of letting the owners of stable patients know the wait times. This is a huge stressor. If you get to a point where your emergency room is at capacity, you still need to triage the patient and interact with the client to make sure you are making the best recommendation. In practice, sending a client to another emergency hospital can be one of the hardest tasks. It also takes away from your time with hospitalized pets and owners of UNSTABLE patients. As a triage technician, I am so happy that I can help emergency teams with this burden. The patients get triaged properly, and I can alert them of possible wait times, exam costs, and payment options. If the hospital is at capacity, I refer them out accordingly. THIS IS A BIG DEAL! It allows teams in the hospital to prioritize patient care while still providing exceptional customer service. You get to focus on why you got into veterinary medicine. QUALITY! With virtual teams, your practice can unlock limitless capacity to meet any demand and provide quality customer service through and through.
Battling The Burnout BluesMar 17 2023
Imagine this scenario: Dr. Sarah is a successful veterinarian at a general practice in a small town. She has been working for years and is well-loved by her patients and their owners. But lately she had been feeling burned out from the long hours of her job, especially her overnight shifts. One night Dr. Sarah was called at 1am for a patient that had been having diarrhea for the past two days. The pet was stable, active and still had a good appetite. Dr. Sarah advised a bland diet and scheduled the pet to be seen the next morning. The next day Dr. Sarah was exhausted from lack of sleep and was very fatigued during her appointments. Have you ever felt like Dr. Sarah? By the time she realized how overworked she had become, she was knee deep in stress! A survey of burnout among veterinary practitioners in the United States was published in the January 2021 issue of JAVMA. This study surveyed over 2,200 veterinary practitioners in the US to assess the prevalence and risk factors associated with burnout in the profession. The study found that over 50% of respondents reported experiencing high levels of emotional exhaustion, depersonalization, and reduced personal accomplishment, indicating burnout. Risk factors included working longer hours, lower job satisfaction, and higher levels of debt. The field is both fulfilling and demanding. During long work hours, veterinarians frequently deal with emotional situations, such as euthanizing animals, and delivering bad news to pet owners. These experiences can take a toll on a veterinarian's emotional well-being. Over time, the emotional burden of caring for sick or injured animals can cause veterinarians to experience compassion fatigue. Burnout and compassion fatigue leave behind some noticeable traces. The AVMA wrote that bottled-up emotions, sadness and apathy, and the inability to get pleasure from activities that previously were enjoyable are all symptoms of compassion fatigue. (Source: “Work and compassion fatigue”.) Some veterinarians may feel overwhelmed by the demands of their job, such as managing a busy caseload, managing high call volume, and training new staff. It's important for veterinarians to recognize the signs of burnout and seek help when needed, such as taking time off, seeking counseling, or changing their work environment. How can tech-enabled services help Veterinarians mitigate feelings of burnout? These kinds of services can offer various ways to help veterinarians diminish feelings of burnout. Here are a few examples: Practice management software: Remember the days of the spiral notebook for scheduling appointments? Those hand-written appointment and prescription refill reminder notices? Or those vintage triplicate invoice books for billing out clients? Practice Management Software revolutionized the way practices handled appointments, reminders, and billing, while it also centralized and digitized medical records. “A survey of veterinary practices found that practices that adopted practice management software reported a 25% reduction in time spent on administrative tasks and a 30% increase in client satisfaction" (Source: "Streamlining veterinary practice operations with practice management software" by T. S. Mahan and S. J. Bartlett, Journal of the American Veterinary Medical Association, 2017) Tech-enabled' isn't scary at all! These virtual tools and services have already benefited veterinary practices. Telemedicine: Telemedicine services allow veterinarians to provide remote consultations, which can help reduce the workload associated with in-person appointments. Telemedicine can also make veterinary care more accessible to pet owners, which can help alleviate stress for veterinarians who feel overwhelmed by demand. After-hours triage and virtual front desk services can help veterinarians solve burnout in several ways. Reducing workload is one of the main benefits tech-enabled services provide Veterinarians. After-hours triage services can help reduce the workload on veterinarians by taking calls from pet owners outside of normal business hours. This can free up veterinarians to focus on other tasks, such as patient care, and reduce the likelihood of burnout. Other ways these virtual tools can benefit vets include: Improved work-life balance: By outsourcing after-hours triage and front desk services, veterinarians can spend more time with their families and pursue hobbies or interests outside of work, which can help reduce stress and prevent burnout. "A survey of veterinary practices found that practices offering after-hours triage services reported a 27% reduction in on-call time for veterinarians and a 34% reduction in on-call time for veterinary technicians. Additionally, practices offering after-hours triage reported higher staff morale and reduced staff turnover" (Source: "Effect of after-hours emergency telephone triage on veterinary practitioners' workloads and quality of life" by S. M. Rhind, et al., Journal of the American Veterinary Medical Association, 2018). Enhanced patient care: After-hours triage services can provide pet owners with immediate support when their pet is experiencing a medical emergency. By providing prompt and efficient care, these services can help improve patient outcomes and reduce stress for veterinarians who may feel overwhelmed by a high volume of emergency calls. Improved client communication: Virtual front desk services can help improve client communication by acting as a virtual extension of your veterinary team. This can reduce the number of phone calls and emails that veterinarians receive, freeing up their time and reducing stress. Cost-effective: Outsourcing after-hours triage and virtual front desk services can be cost-effective by deploying remote support staff for a fraction of the cost of employing and training new people. Not only that, remaining in-clinic CSRs and CVTs are freed up for patient care and handling in-person tasks with more focus. By reducing the workload on veterinarians, practices can improve their efficiency and productivity, which can help increase revenue and profitability. Overall, tech-enabled services can offer valuable tools and resources to help veterinarians manage their workload, improve patient care, and prioritize their own well-being. By leveraging these services, veterinarians can mitigate feelings of burnout and maintain a healthy work environment. We have paid close attention to the symptoms of this problem and have the perfect solution for it. GuardianVets’ Virtual Services can meet any level of demand for your practice! Our triage team will sort non-urgent calls appropriately so you can focus on what you love: enhancing pet health and not feeling the stress! Want to know more? Take the next step and reach out to us at email@example.com if you have any questions, or fill out the Get Started form on our website to book your consultation!
Is Your Practice Bottlenecked?Aug 17 2022
The word bottleneck is pretty straight forward, the narrowing end of a bottle. In that space, things get much more crowded, tend to collide, and slow down. Bottlenecked is a term we use to describe something or someone that has been slowed down by an obstruction, hindrance in performance, or even lack of support. If you were a machine, and you weren’t working to your utmost ability, or something was slowing you down, you’d be bottlenecked. Surprisingly, that term can be used in the Veterinary space as well. I know what you’re thinking, how? And what are you talking about? We're moving at speeds that we can’t keep up with! Well what if you could keep up with those speeds, and generate much more revenue, if it weren’t for being bottlenecked. Have you ever sat down and really put thoughts onto paper to calculate the amount of money your practice is losing monthly, by being understaffed, burnt out, overwhelmed? Your team will inherently slow down, or in other words, become bottlenecked. That causes the practice to lose out on valuable money, and time. Not to mention the pets that would be able to be seen, and happy clients when you tell them you have appointments open that week to see their fur baby. The numbers are pretty astonishing, and shed light to the need for help in this ever growing industry. Let’s put some numbers together, to visualize what I mean. If your practice was running at optimal level, I mean full steam ahead, clients in and out in a timely manner, how many appointments an hour do you think you’ll be able to see? The answer typically is 4. But your practice is not running at optimal level and you’re only able to see 3 an hour. This is due to being understaffed, having to pull technicians off of the Doctor and help out the front desk staff. This slows the Doctor down, which doesn’t allow them to see as many appointments as they would an hour, in turn causing a loss in revenue and time spent with clients and their pets. If the Doctor doesn’t have their ideal support staff, they are not running optimally. Back to the numbers, how much is your transaction size? For this calculation's sake, let’s say $250. That's $250 an hour you are losing right there. Let's take it a step further. You’re working 8 hours a day, let’s say, 22 days a month. Pull your phone out and punch those numbers in, $250 multiplied by 8, multiplied by 22. That is $44,000 you are missing out on a MONTH, just by being understaffed and losing out on one appointment an hour. Imagine you’re doing even less than that? Or imagine you have multiple Doctors with minimal support? Bottlenecked practice vs. Practice operating Ideally vs. Practice with no support There is help out there for practices like this, it can come in the form of a partner, or by DIY (hiring yourself). In the next blog post, I’d like to discuss the differences between the DIY approach and using a partner like GuardianVets. If you would like to learn more about GuardianVets as a partner, we would love to set up a meeting with you and your practice. Contact email: firstname.lastname@example.org
Pet SafetyAug 17 2021
Amber Mader | RVT Tips and tricks for keeping your pet safe during high temperatures: When it's hot don't leave your pet in the car! Even if the temperature outside is only 70 degrees, the inside of your car maybe as much as 20 degrees hotter. On a day that is 85 degrees, it only takes 10 minutes for the inside of your car to reach 102 degrees. Within just 30 minutes, the car's interior can reach from 85 degrees to 120 degrees. Know the symptoms of heat exhaustion: Excessive panting Drooling Vomiting and diarrhea Weakness Increased heart rate and respiratory rate Elevated body temperature **It is important to make sure your pets have plenty of fresh water and access to a fan, air condition or shade during high temperatures. Facts: In 2018-2019 almost 78 pets passed away due to heat exhaustion from being in a hot car. Pets can only survive 2-3 days without water. Dogs are unable to sweat so instead they pant to help cool themselves down.
The Pandemic’s Impact on Veterinary Medicine’s Most Sacred ResponsibilityAug 16 2021
Dr. Holly Sawyer, DVM During the most heinous rotation of my senior year in veterinary school, my horse developed laminitis in all four hooves. It is an acutely painful condition with an extremely poor prognosis. Emmy was 32, beloved beyond words, and I agonized over the decision before me. Four sleepless nights later, I chose to end her suffering. Truly, I was not certain I would be okay without her. Little did I comprehend, Emmy, who had taught me so much during her life, would mold me into the veterinarian I became the day she died. Euthanasia became hallowed ground for me. While most of my colleagues treat these appointments as jarringly sad interludes in an otherwise busy day of saving or improving lives, I view them as the highest purpose of my training and the most significant act I could ever perform for the family. Why? Because euthanasia would only ever happen once in the animal’s lifetime, and nothing intensifies the preciousness of the human-animal bond like imminent separation. I was present during the worst days of my clients’ lives—and humbled to have seen so many at their very best. For me, this realization occurred before the term “human-animal bond” officially entered the veterinary vernacular, before hospice gained popularity, and well before COVID turned this most sacred responsibility of the veterinary profession into a minefield of client anxiety and unmet expectations. I am out of private practice now—partly due to my refusal to erect a barrier between myself and the raw grief of clients—but in my current position with a veterinary triage provider, I still witness the chaos reigning in our profession over this very issue. Whether euthanasia results from financial constraint, grave prognosis, or the tender knowledge the joy has gone out of an animal’s life, clients asking for this service are typically driven by one overriding emotion and, thus, have one supreme need the veterinary team must address. Euthanasia, distilled Illness and death slam all of us with the realization we do not have full control over life (we never did, of course, but this is a topic for philosophy class). Lack of control breeds fear: fear of what to expect with the euthanasia itself. Fear the pet will be scared, will suffer, or will struggle. Fear of taking a pet’s life away too early (or too late). Fear of not knowing how we will cope with the loss of this animal. Fear of not knowing if mornings or evenings will be worse. A young boy’s fear over how he will grieve his first and best friend. An elderly widow’s fear she might not survive the loss of her constant companion. Fear is the emotion behind every thought and the engine driving every client’s euthanasia experience. When the veterinary team meets a client’s fear with compassion, effective communication, and predictable action, the pet owner’s emotion transforms into gratitude. If any of these components are missing, if the complex dance of describing the euthanasia process, responding to the client’s body language, modifying tone and posture, and showing affection for the animal at the center of the visit falls apart, client fear easily escalates to fury. Why? Because in a tangible or intangible way, the client feels abandoned—and this is the single and absolute unforgivable sin of our profession. COVID’s unintended consequences Curbside care converted face-to-face heart-to-hearts into constrained phone conversations, which could easily degrade into a listing of facts delivered with thinly veiled impatience. This hardly happens on purpose, but each day’s flood of patient cases dictates less time on each pet. Compassion suffers at the hands of expediency. Without compassion, rapport evaporates, trust crumbles, and communication falters. Additionally, in most cases, clients could not be present during the euthanasia itself due to social distancing. This introduces a level of unpredictability in this emotional procedure, heretofore unimagined by most pet parents. Veterinary professionals do their best to slow down and treat euthanasia with the kindness and respect it deserves, whether the client is with the pet or not; all the client sees, however, is a crammed parking lot, a wait time defying logic, and a clinic too busy to answer exhaustive questions. Many pet parents feel their final and greatest responsibility is to be with their four-legged friend to the very end, to pour out the kind of love only they can give when the pet needs it most. Curbside care wrenched the inviolable duty away from them. As mask mandates subside and clinics return to more normal workflows, our profession is still grappling with unmanageable patient loads. To mitigate burnout, many practitioners who were once on-call for afterhours care now refer all clients to emergency clinics. In some cases, the nearest emergency facility is three hours away, and we all know the wait times for emergency care have skyrocketed. Clients calling in the middle of the night expecting their veterinarian to be available are stunned to find themselves sent to a distant stranger instead. During regular business hours, same-day euthanasia requests are either worked in at the cost of staff sanity or are scheduled out to a different, hopefully less busy, day. We all know this is not always the case. Clients told they must delay euthanasia wonder how to trust a practice, which, to their thinking, is making their pet suffer needlessly. Mobile veterinarians are now answering nonstop calls from new clients requesting same-day euthanasia, while dealing with limited staff support and impractical driving distances. The way forward The veterinary profession’s ability to end suffering humanely and peacefully is at the heart of what makes us different from every other medical profession. It is a heavy and delicate responsibility, which can determine if the heart of veterinary medicine is noble or tarnished. As we emerge from the strictures of the pandemic, let us own that client trust in our profession has decreased. Meet this challenge by renewing your commitment to compassion. Put yourself in the client’s shoes. Even a brief glimpse of life through their eyes can reset your emotional temperature. Effectively communicate any changes in your after-hours services to pet owners through social media, pet portal announcements, invoice notes, hold time messaging, and, most importantly, in-person interactions. Go out of your way to acknowledge client fear and explain what to expect throughout the euthanasia process. Never let a client feel abandoned. Your extra effort will not only rebuild client trust, but enhance team satisfaction, magnify the human-animal bond, and restore the beating heart of this most honorable profession. Holly Sawyer, DVM, Human-Animal Bond certified, is a 1999 graduate of UC Davis School of Veterinary Medicine. After 19 years in private practice, she became a regional director for GuardianVets, a veterinary communication company that helps practices streamline access to patient care, strengthen client bonding, and alleviate professional burnout through live, 24-hour triage service, call overflow support, and user-friendly telemedicine access. https://www.veterinarypracticenews.com/the-pandemics-impact-on-veterinary-medicines-most-sacred-responsibility/