Communications protocol can help cement the human-animal bond

Fort Collins, Colo.-Treating a client's emotion is just as important as treating the patient.

It is a premise that went into the creation of a new protocol on trustedcommunications for veterinarians by the Argus Institute of Colorado StateUniversity's (CSU) veterinary college.

The latest protocol caps off a series of guidelines to help veterinariansbuild a bond-centered practice, which is considered one that builds andheals relationships that stem from the human-animal bond, the family-pet-veterinaryteam bond and bonds that exist between veterinarians and their staffs.

Earning client trust is a crucial building block to creating a bond-centeredpractice, says Laurel Lagoni, managing director of the Argus Institute forFamilies and Veterinary Medicine.

The protocols offer veterinarians a "toolbox" of clinical communicationskills and advice to create an atmosphere that fosters a bond-centered practice,Lagoni says.

"In practice, a bond is being presented to you. Fifty percent ofthat bond is human. So, we want veterinarians and staff to very consistentlythink about what the treatment plan is for these people as well as theirpets, and not just pick and choose what cases we are going to provide supporton," she says.

Let it happen

"If emotion is present in the room, it is often ignored by the veterinarystaff, especially when the hospital is very busy," Lagoni explains.Who has time to deal with a grief stricken client when other clients arewaiting to see the doctor?

"The general attitude is there is a medical situation to contendwith, and answers to questions need to be discovered. It is just acceptedthat human emotion is ignored," she says.

Time pressure is a very real dilemma for veterinarians and staff, sheadds, but they can have the best of both worlds. You can build trust, trainthe hospital team on healthy ways to help clients through anxiety or grief,and still keep the caseload moving.

"I think a lot of time people ignore emotion because they, in thepast may have attended to it, and they have a whole stream of emotion comefrom the person which takes a lot of time," Lagoni explains.

"Our premise is let's not ignore emotion, rather let's train theveterinary teams so they are very skilled in dealing with that emotion,"she says.

Lagoni is not promoting becoming a client's emotional counselor but ratherencouraging veterinarians and staff to offer ideas and suggestions for theclient to seek additional help and emotional support.

"It is understanding that a client may be in an emotional crisis,and he or she may be looking for help," she adds.

Respectful communication

Consider this: "Clear, respectful communication is as vital to thesuccess of a bond-centered practice as high-quality medical care. Trustis the foundation of effective communication and of healthy work environments.A bond-centered practice creates work environments characterized by highlevels of trust and skilled communication."

Lagoni says, "We have been trying to hand-select the communicationskills that we know work in a clinical setting. Those are the ones thatyou can pull out and use in emergency situations and you need a decisionto be made very quickly."

Lagoni says that veterinarians can establish trust in a very short timeand it can help them get a lot of information to make decisions and movethrough an emotional time or pet euthanasia.

Emotional SOAP

In the guidelines, the Argus Institute team also came up with an emotionalSOAP (subjective, objective data to assess and create a treatment plan).

According to the guidelines the emotional SOAP is a case management modelfor providing emotional support.

The goal is to treat each case focusing on the patient's medical careand the client's emotional care.

The emotional SOAP looks at factors that would help practitioners assessthe client's emotional state of mind, including physical appearance, bodylanguage and demeanor, and interactions with the pet.

The series of criteria contained in this emotional SOAP will help practitionersidentify a timeframe for owners to get support as well as available options.

Building trust

Lagoni says that practitioners and staff have many opportunities throughouta client visit to build trust.

Whether it is the first visit or an emergency call, the examination roomis the place where trusted communications often occur.

The protocols call for veterinarians to structure examination room interviewsinto three parts, the opening, the body and the closing.

The opening includes introducing yourself. While it is a minor part ofthe entire experience, it is very important, and believe it or not, oftenforgotten.

An example: "It is good to see you again Ms. Thomas. It's been quitesome time since I have seen Trinket. I can't believe how much she has grown!I understand Trinket is ready for her next set of vaccinations. Is thatcorrect?"

The body of the interview, the protocols say, is to gather informationand explain treatment support.

It's important to not create communications barriers by interruptingclients, eliciting "yes" or "no" responses or rarelyget clients to volunteer information.

The closing helps remind the veterinarian to summarize the examination,offer specific treatment and follow-up information and offer another chanceto ask questions.

Lagoni says, the first trusted communication tip is to introduce yourselfand explain to the client what is going to happen during the visit.

Lagoni adds it's important to explain the process whether it is for aphysical examination or more diagnostic testing.

"Detailed directions help them trust not only you, but the hospital'ssystem," she says.

Show them around

Lagoni also advises veterinarians or technicians to take first-time clientson tours of the facility to show clients exactly where their pets are going,including examination rooms, surgery suites post-op recovery and diagnostictesting.

Showing clients around the hospital is a shared experience that helpsclients understand what happens to their pet after they leave.

Consider this

Here are some points from the protocol to consider about building trust:

Commitment: Actions that demonstrate that a person, organization,business or even an entire field is dedicated to something more than themselvesand their own personal gain.

Familiarity: Relationships and surroundings that are known andpredictable. Familiarity usually develops over time, after many encounters.

Personal responsibility: A willingness and commitment to takeresponsibility for one's own behavior, especially when a mistake was made.Lagoni adds that when trust is broken it is often irreparable. Admittingfault is obviously a sticky subject, especially if you consult with an attorney.Lagoni adds, "Legal experts say you should never apologize or admityou might have done something to breech the client's trust. But the folksfrom the mental health field have opposing views to that. They say you doneed to apologize or speak honestly of things that have happened in yourpractice that may have been a mistake or may resulted in a miscommunication,because that breeds confidence in your integrity."

Communication: Open, direct and timely communication, especiallywhen it concerns sensitive or difficult issues, is essential to developingtrust. When this type of communication is absent, people often develop misperceptionsand inappropriate expectations of one another. The key to effective communicationis to expand the focus beyond personal experience. This means sharing perceptionswith others and listening carefully to what others say about their experiences.This leads to a realistic understanding of almost any situation.

For more information on the protocol contact Tammy Mimms at (970) 491-4143or e-mail argus@colostate.edu.