Increasing efficiency and productivity in uncertain times

The economic and business environments are in a state of flux. Economists expect this uncertainty to continue for some time, with a recession predicted for the first half of 2023.¹

Veterinary practices are not immue

Indicators at an industry level are mixed. Average annual revenue per patient is up nationwide since before the COVID-19 pandemic, as is the average number of patients with at least 1 transaction in the past 18 months.² However, the average number of visits is down, and the number of lapsing patients is increasing.²

Remaining resilient during uncertain times requires thoughtful consideration of the factors that are within our control. It also requires that we do more with existing practice resources.

The good news is that we have opportunities for improvement in this area as an industry. Data from the 2022 American Veterinary Medical Association (AVMA) Veterinary Practice Owners Survey suggest that if companion animal practices could increase efficiency, they could also increase productivity—and ultimately see more patients without hiring more staff (see Figure).³

How do we get there? The solutions lie in our teams and business operations.

Assess your current state

Any serious improvement effort starts with an honest assessment of the status quo. Start by studying the current economic landscape and how your practice is doing relative to the average practice:

Identify and address your bottleneck

Inefficient workflows and processes are some of the greatest drains on efficiency—and common causes of frustration. It pays to give your practice a checkup in this regard.

Start with the most common consultation seen at your practice. With your team, trace every step the client, patient, and team members take to complete the consultation. At every step, ask yourself where the real value is generated and where time and effort are spent without contributing to patient outcomes and service delivery. For example, how many times in a wellness consultation does the veterinarian or veterinary technician need to enter the treatment room? Do you need to navigate around equipment or inventory to get to the microscope? How much space is there between the cytology sink and the microscope?

Make your practice management software work for you

Technology solutions can simplify or automate tasks in veterinary practices, and in so doing, create time and space for enhancing patient care and strengthening client communications.

A powerful example is practice information management software (PIMS), which can be used to automate or facilitate appointment scheduling, reminders, electronic patient and/or client records, prescription processing, invoicing, accounting, inventory management, and other routine functions. The cost of incorporating PIMS into a practice is generally far less than the cost of managing these activities on your own.

However, it can sometimes feel as though we are working for our PIMS, rather than our PIMS working for us. This month, take the time to increase your team’s capability on the PIMS, and learn how to best leverage the automated functions. As part of your “most common consultation” exercise, include the medical record and post consultation follow-up as part of your review. Integrated laboratory and diagnostic imaging results, well-written templates, and well-written discharge instructions take an investment of time to set up but pay dividends in quality of medical records and efficiency.

When reviewing your PIMS, be sure to research options and choose a software option that also ensures the long-term privacy and security of your practice data.

Befriend technology

Other examples of technologies that improve efficiency include online appointment schedulers, telehealth services, and online pharmacies. If you’re an AVMA member, check out the AVMA’s free purchasing platform, Direct Connect, which can simplify purchasing and inventory and also let you see current consumer prices on pharmacy products. If your practice already has 1 or more of these technologies, take time to ensure they’re to-date and, like your team’s skills, being tapped to their fullest extent. Technology can only increase efficiency to the extent that it’s used.

Optimize physical space usage

An efficiency checkup also includes examining how your available space is used. Underused rooms or areas are expenses, especially when they’re not generating revenue. One popular strategy is to increase use of available exam rooms to allow the highest possible number of appointment slots per day, as with high-density scheduling.⁴ For example, a veterinarian and well-trained assistant can be assigned to cover 2 exam rooms together as a tag team, with the assis- tant performing the initial patient screen, then moving on to the next room when the veterinarian takes over.

Strategies that optimize use of available space not only increase efficiency, they also can increase revenue without raising prices.

Rely on your team

One way to maintain or boost efficiency with available resources is to tap the skills of all veterinary team members to the fullest extent, based on what’s allowed by your state Veterinary Practice Act and each individual’s education, qualifications, competencies, and comfort level.

When the team is engaged to meet the administrative needs of the client and patient, veterinarians are freed up to focus on diagnosis, prognosis, treatment, and surgery, which leads to us giving our undivided attention to the client and patient. Veterinarians see more patients, productivity increases, and the practice becomes more profitable. Importantly, other team members are empowered to practice at the top of their credential as well, and overall employee engagement improves.

Engage your team

What does engagement have to do with efficiency? The level of employee engagement has significant impacts on several key business outcomes. Notably, highly engaged teams (in the top 25%) perform better than less engaged teams (bottom 25%) when it comes to positive outcomes such as customer loyalty, productivity, profitability, and well-being.⁵ They also have fewer negative outcomes, such as turnover, absenteeism, staff or patient safety incidents, and quality concerns.⁵ All of this affects efficiency.

Here are some tips for optimal engagement and performance:

• Evaluate and develop your management and leadership skills.
• Model self-care so other team members feel supported in doing the same.
• Provide and support a clear vision and goals for the practice.
• Leverage the unique strengths of each team member.
• Provide and encourage opportunities for mentorship, career growth, and personal and professional development.
• Ask your team members how they like to be rewarded, then recognize and reward them accordingly for work well done. Don’t assume the answer is always money or praise.
• Promote a culture of belonging and collaboration, where every team member’s role and connection to the practice’s mission is clear.
• Ask for and consider staff input when identifying necessary changes to workflows, roles, or processes.
• Support team growth through holding team meetings and team-building activities, celebrating team wins, and promoting diversity, equity, and inclusion.
• Support individuals’ health by offering and encouraging paid time off, parental leave, an employer-sponsored employee assistance program, and other health-promoting activities.
• Support team health by promoting psychological safety—ie, the ability to share one’s thoughts, ask for help, admit mistakes, etc, without fear of being ostracized or shamed.
• Consider options for greater flexibility, such as flexible work hours, creative scheduling, and/or job sharing.

It’s also worth noting that practices with a practice manager score higher on efficiency than those without one.⁶ If your practice does not have a manager, you don’t necessarily need to look outside the current team to fill the role. Consider fostering an interest in a promising team member and supporting their training.

The bottom line

Uncertainty about the future of the economy doesn’t mean you’re powerless to determine or influence your practice’s fate. You can take back control by engaging your team and optimizing the efficiency of systems and processes within the business to make the best use of the resources you already have on hand. Your whole practice will benefit, and so will patients and clients.

References

1. Nolen RS. Economist gives big-picture view of economy, veterinary profession. November 2, 2022. Accessed November 15, 2022. https://www.avma.org/news/ economist-gives-big-picture-view-economy-veterinary-profession
2. Burns K. Turn to data when the decisions get tough. November 3, 2022. Accessed November 17, 2022. https://www.avma.org/news/turn-data-when-decisions-get-tough
3. Burns K. Study explores secrets of highly efficient veterinary practices. October 26, 2022. Accessed November 15, 2022. https://www.avma.org/news/ study-explores-secrets-highly-efficient-veterinary-practices
4. Catanzaro TE. In multi-tasking techniques (high density scheduling). Accessed November 16, 2022. https://www.vin.com/apputil/content/defaultadv1.aspx?id=3871698&pid=11274&
5. Gallup, Inc. Building a high-development culture through your employee engagement strategy. Gallup.com. Published February 21, 2020. Accessed December 14, 2022. https://www.gallup.com/workplace/285800/development-culture-engagement-paper-2019.aspx
6. Bain B, Ouedraogo F, Hansen C, Radich R, Salois M. 2021 AVMA Report on Economic State of the Veterinary Profession. AVMA; 2021:43.