3 steps to internal compliance

I spent several summers working at Dairy Queen in my teen years. Besides the 40 pounds I carried away, I gained an understanding of the importance of standards. A banana split at one franchise should be the same as the split at another, mainly so clients know what to expect. But also because surely some food scientists somewhere formulated the perfect combination of pineapple, strawberries, and chocolate syrup dribbled over ice cream and half of a banana. I knew exactly what they'd decided because the recipe was posted in an easily accessible area. At first, I relied on it incessantly. Soon I could rattle off the ingredients. I still can, years later.

Of course, the importance of the services your veterinary practice offers far outweighs that of an ice cream shop. You're charged with the care of animals—and that's vital to pet owners' happiness. That's why it seems so important to put together a guide to the regular preventive care items you provide, so that your staff members know what to talk to clients about and how to support your recommendations.

"A lot of people see standards of care as a way for people to legislate and tell them what to do. Really, the goal is just to create agreement within your practice about care—so you can communicate recommendations to clients more effectively," says Karyn Gavzer, CVPM, MBA, a veterinary business consultant with KG Marketing & Training Inc. in Springboro, Ohio.

Consider this, says Gavzer: Most clinics use protocols for puppies and kittens. "So why would you resist protocols in other areas? Just do for adults what you do for puppies and kittens."

Definition of a standard

Basically, a standard of care is your statement about how you'll approach wellness care. (For another definition, see "On the Right Side of the Law.") So, for example, for dental prophys you might say: "We'll recommend a dental prophy for 100 percent of patients with Grade 2 dental disease or worse."

On the right side of the law

As you start, keep in mind these overarching guidelines:

• You should set standards of care for all high-volume preventive care areas at your practice, but you don't need them for every procedure. "So when you set standards, you're really only looking at a handful of areas," Gavzer says, "including heartworm testing and prevention, preanesthetic testing, vaccinations, dental prophys, senior pets, nutrition, parasite control, and spays and neuters."

• Standards should be short and to the point, says Gavzer. Of course, you may need supporting documents for training and to use for discussion.

To get started, follow these three easy steps. But keep in mind, you must do all three for your standards of care to really work, says Gavzer.

1. Gain doctor consensus

"Doctors typically have different opinions," says Gavzer. "But you're asking your staff members to work with one hand tied behind their back if doctors disagree about high-volume preventive care issues. If you can't agree, no matter what your staff members say, they're wrong with someone."

The worst part is the disjointed message you send to clients. "Your staff members can't say, 'We believe in this.' So for the benefit of your patients, clients, and your staff members, you must get on the same page," she says.

Seem impossible that all the veterinarians in your practice could agree? Try this exercise: Hold a meeting and start with something simple that you disagree on, such as dental prophys. Remember these rules, Gavzer says: "If you're the one who wants the standards to change, you need to bring in supporting information. Then everyone else needs to keep an open mind and listen.

"I find veterinarians very rewarding to work with when it comes to gaining consensus, because they generally want what's best. It's not so hard, you just need to follow those ground rules."

2. Put them in writing

Once you agree on standards, put them in writing, says Gavzer. "Then print the documents and put them in binders in several places around the hospital," she says. "You want them to be easy for staff members to access."

Another benefit of putting your standards in writing is that you can use them when you're hiring. Gavzer suggests showing your standards to a potential hire and asking whether he or she agrees with them. His or her answer will help you determine whether the person's a good fit for your practice.

3. Educate your team

"Just knowing about your standards isn't enough," says Gavzer. "Your team members need to know why these are the right standards for your patients." Let them know that when you're following a set standard, you're more likely to prevent problems, she says.

Next, teach your team members how to talk to clients about your standards of care. Convenient copies of them are a great training tool. Team members can access these guidelines whenever they need to until they reach the point that they remember them. You could also hold meetings and do role-playing, for example, to help staff members learn how to talk to clients about the standards.

A way to track compliance

Once you've decided what standards of care you want to provide and trained your team to deliver these consistent messages, you can measure clients' compliance. This way, you know how you're doing compared to your goals.

For example, let's say you have 600 senior dogs and 200 senior cats among your 2,000 active patients. First, you could look up how many senior screens you ran last year. You might only have run 100 out of 800 senior patients. This gives you the information to set your goal for next year. And your standards of care will help you get there.

"Standards of care help you make sure you're very clear about what you believe is best for your patients," says Gavzer. "And they help you see how well you're doing at delivering the care you believe in."