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myEVT.com I exceptional veterinary team I May/June 2011
CASE STUDY: Natick Animal Clinic
Case S
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May/June 2011 I exceptional veterinary team I myEVT.com
| 35
Did
tact
What They linic instituted their first-gccoanre
al C
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Natick Anim ractice model emph
p
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ellness
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• Senior w
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surgery
• Preventiv
• Specialty
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o
ucati
anagemen
• Client ed
• Weight m
alth
• Dental he
How They Did It
Client and In-House
Communication
Today, Natick Animal Clinic assigns each client a
primary care veterinarian and schedules wellness and
illness visits with this doctor as frequently as possible.
Clients maintain direct contact with their veterinarians through telephone calls, voicemail, or email.
Veterinarians return nonurgent messages on their
next available shift, while the covering veterinarians
handle urgent calls for primary veterinarians on their
off-days. Email communication is maintained individually at the doctor’s discretion; this is the preferred mode of communication for several of
Natick’s doctors. Every staff member has an email
account; team members regularly email clients and
one another.
Receptionists handle call-backs regarding the schedule, appointment confirmation, and billing issues.
Natick’s receptionists are also provided with Client
Service Scripts (see page 40) that provide strategies
for dealing with everything from appointment reminders to improving compliance. They are taught
to “lead” clients to appointments with their primary
care doctor in order to reinforce the practice’s model.
“We don’t say, ‘When would you like to come in?’,”
explains Harding. “We say, ‘Dr. Mani sees appointments on Tuesdays, Wednesdays, and Saturdays.
Which one of these days is most convenient to your
schedule?’”
All-hands staff meetings are held at least quarterly,
and the hospital is an active member of the community it serves, offering military, senior, and shelter
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myEVT.com I exceptional veterinary team I May/June 2011
service discounts. Natick Animal Clinic also hosts the
“Santa Sunday” fundraiser and bake sale; proceeds
are donated each year to an animal-based charity.
Preventive Health Appointments
The clinic emphasizes preventive health measures to
optimize pet health and minimize emergency room
visits. The reception staff sends email reminders 6
weeks in advance of annual wellness appointment due
dates. If the owner does not schedule an appointment,
repeat emails are sent once a month for 3 months.
Clients are called twice—once during the month that
the annual visit is due and the month after it is due.
Wellness appointments are scheduled up to a year in
advance, and incentives ($25 discount coupons) are
offered to encourage clients who miss annual vaccination appointments to come to the clinic. This enhances client retention and encourages preventive
medicine.
CASE STUDY: Natick Animal Clinic
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Communication Among Veterinarians
To help ensure that a good relationship is developed
among patients, clients, and primary care veterinarians, the doctors are paired off for coverage and generally work opposite shifts to cover one another’s
cases. Client concerns are conveyed to either the primary or the covering doctor. Master problem lists
are established for each patient, and all computerized medical records can be accessed off-site.
Standards & Protocols
Receptionists, technicians, and doctors work together to ensure patients are in exam rooms within
10 minutes of arrival. Once the preliminary patient
questionnaire is completed, the receptionist brings
the travel sheet to the back area and also notifies the
outpatient technicians. By using a designated slot for
the travel sheets outside the back of each exam room,
technicians and doctors can always see if a patient
has arrived. In addition, on arrival every client is entered in Natick’s computerized schedule (AVImark)
as a “check in” so staff know when patients arrive. “If
a client has been waiting 15 minutes or more, the
receptionist checks with the technicians assigned to
outpatient or tells me and I investigate why this is
happening,” says Harding. “When we renovated
Natick in 2007, we designed the practice so that my
office is up front—this allows me to hear much of
the client interaction.”
Natick Animal Clinic has established recommendations for prophylactic deworming, ectoparasite control, and heartworm prevention, as well as standard
protocols for vaccinations, senior blood analysis, and
drug/therapeutic monitoring blood analysis. Recommend and refuse codes assigned for specific diagnostic tests and treatments are included on the
invoice so the client will have a reminder of what
took place and what was recommended during each
visit.
The hospital creates monthly “report cards” for doctors that are used to assess adherence to various protocols. When the receptionist checks out a patient,
all items are coded and included on the travel sheet.
Harding then runs reports using the codes and places
generated data into an Excel Doctor Report Card
(see page 38) that calculates totals automatically. The
best grades are given to doctors with the highest compliance rates. The chief of staff reviews the report
cards quarterly, and results and goals for improvement are discussed at the yearly budget meeting.
Where They Are Now
Harding reports that since the primary
care model was implemented, the newclient base has grown each year and
complaints have decreased to fewer
than 12 annually and rarely concern
quality of care. Clients are satisfied
and maintain a strong bond with the
Natick Animal Clinic community
team. For practices looking to shift
to the primary care model, Harding emphasizes that, “getting buyin from the staff is a must.” She
also encourages talking about the
model’s challenges at staff meetings during the transition period
so the team can work together
to find solutions. “Be patient,” she offers. “There are bound to be mistakes along the way,
but the model provides the framework for improved
client satisfaction and more referrals over time.”
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