Don't let scheduling troubles weigh you down

The day is running smoothly, appointments are on schedule, and clients are happily progressing from the waiting room to the exam room and out again with precision. Then a co-worker calls in sick. Or a chatty new puppy owner needs some extra tender loving care to get off to the right start. Or an emergency arrives and clients start backing up in the waiting room.

No matter how well organized your team is, schedule sinkers come with the territory. Some timing torpedoes can be out maneuvered. And when you hit one that's unavoidable, you can learn to patch the holes. Here's help.

The problem

Sally's running around like a chicken with her head cut off, getting madder by the minute that no one's stepping in to help.

The solution

Tap the power of training. It's probably the single greatest factor affecting workflow. After all, a co-worker who isn't confident is more likely to wait for input from you or the doctor before acting—and that can slow everyone down. That's why Seaside Animal Care cross-trains its employees.

"Everyone here is prepared to help pick up the slack if we start to fall behind," says Toman. "Our receptionist, for example, doesn't just answer the phones. She can also retrieve lab work, bring patients and clients back to the exam room, or discharge patients."

Well-trained team members can also keep the exam moving by taking medical histories. A few clients will insist on talking to the doctor, but most will readily talk to you if you present yourself with confidence and take charge. "Some clinics don't use their teams to the full potential," says Finnell. "At our clinic we try to limit the veterinarian's work to examining, diagnosing, and dispensing medication. The team handles everything else so the doctor can see as many clients as possible."

The bottom line: In a service business, you'll always hit a scheduling bump now and then. But the issues that throw you off schedule don't need to ruin your day. Practice the tips outlined above, and remember to tackle each challenge with a positive attitude—you'll be surprised by the difference it makes!

The problem

By the time 10:30 a.m. rolls around, clients are stacked as high as your ears. At five o'clock you'd rather check yourself out than deal with the next irritated person who steps up to the counter.

The solution

Get smart about scheduling. You could find you're taking on water before you even raise anchor for the day if you make these three common scheduling errors.

1. TOO MANY TEAM MEMBERS SCHEDULE APPOINTMENTS. It's great when everyone's trained to step in and help out, but if too many people make appointments you may end up confused and overbooked. While everyone should be able to view the schedule to prepare for upcoming appointments, you should limit the number of people who can make changes to the schedule.

In fact, some practices require that any same-day changes flow through one person, who'll communicate changes to the rest of the team. Or you may communicate scheduling changes by holding mini staff meetings halfway through the day to review, plan, and address problems. You can also use a dry erase board to spread the word.

2. YOU DON'T ALLOW ENOUGH TIME FOR EACH APPOINTMENT. "Ten to 15 minutes isn't enough time for most appointments," says Caitlin Rivers, a Firstline Editorial Advisory Board member and a veterinary assistant and technician supervisor at Metzger Animal Hospital in State College, Pa. "In fact, it may give you just enough time to drop the ball. Too often something doesn't get done because you're racing the clock." Some solutions:

• Schedule your appointments in 10-minute blocks, leaving more time open for more complicated appointments. (See scheduling guidelines.)

• Leave a 10-minute slot open in the morning and another in the afternoon to give you time to catch up or to accommodate an emergency.

• Stagger appointment start times so you aren't trying to greet all the clients, weigh their pets, and check them out at the same time.

• Move clients back to the waiting room while you gather medications or instructions so you can start another appointment in the exam room.

Flex-scheduling guidelines

3. YOU PLAN APPOINTMENTS FOR BUSY TIMES. Recognize the workflow patterns in your practice and schedule accordingly. For example, if you know that surgical or dental cleaning patients will all recover from anesthesia around 3 p.m., don't schedule new puppy visits or vaccinations for that time. You can predict that technicians will be busy caring for groggy pets. And then they'll need to meet with clients and review the discharge information. So schedule wellness and new client visits for less busy times. You don't want to rush; wellness visits offer one of your best opportunities for client education and give you a terrific chance to bond with pet owners.

The problem

The doctor gets consumed in talking with clients and gets seriously behind on the day's schedule. You desperately need to communicate to the doctor that it's time to move on to the next appointment.

The solution

Ask your doctors if they'd be interested in setting up a secret code that will help exam room assistants keep everyone on track and on time. In many practices, the exam room assistant gives the doctor a nonverbal clue when the appointment runs over the scheduled time. For example, the assistant might turn over a piece of colored paper on the exam room counter or tug at an ear. When the assistant serves as the pacesetter, doctors are much more likely to stay on track, clients are seen on time, the waiting room remains calm, and you've got a better chance of ending the day on time.

The problem

Clients pace the waiting room like caged beasts—and act more beastly the longer they're there.

The solution

Keep clients from feeling neglected. Even if you're well scheduled and prepared, glitches will still occur. And falling behind is doubly stressful if clients start to get cranky while they wait.

"A few years ago we put TVs and VCRs in all the exam rooms," says Rivers. "At the time we thought the idea was a bit nuts, but it's been great." The team uses the TVs to show educational videos and cartoons. "Clients are a lot less concerned about waiting if their children are happy," she says. "And that distraction buys us a few spare minutes to get back on track."

Mandy Finnell, RVT, a technician at Cherokee Animal Clinic in Overland Park, Kan., says engaging clients is key to keeping them happy. "As long as someone asks them questions or makes conversation, the wait doesn't seem so long," she says.

If the schedule really backs up, team members at Cherokee Animal Clinic offer waiting clients drinks and cookies. Finnell says it also helps to leave the exam room door open when clients wait. "If they can see that you're busy, they're less likely to feel neglected," she says.

The problem

Too much juggling required. How are you supposed to discharge Fluffy, get Mrs. Jones' prescription refill, and pull Bowser's medical records all at once? You need 10 arms!

The solution

Invest in prep time. A minute spent in preparation at the start of the day can easily save you 10 critical minutes at 5 p.m.

"Everyone in our hospital from the receptionist to a kennel worker is expected to know the next three appointments at any time," says Gina Toman, a board member and a veterinary assistant with Seaside Animal Care in Calabash, N.C. If you function as a team, she adds, you get more done, and you never feel alone.

If you know that the next appointment is a vomiting dog, you can prepare the supplies you might need and the medical history questions you'll ask. When the doctor arrives, he can quickly review the history you took, examine the patient, make a diagnosis, and move on to the next exam room.

Going back to our problematic 5 p.m. rush: If you prepared the refill and pulled all records for the day's appointments in a quiet moment the night before, you've got the bases covered and can focus on Mrs. Jones.

The problem

You're answering a call from a client struggling to collect a free-catch urine sample from a fire-hydrant-loving poodle and fielding complaints from Mrs. Smith about her bill.

The solution

Hone your client communication skills. A client who's informed and prepared for a visit will have fewer questions later, when you're trying to wrap up a visit and move on to the next patient.

The process starts when clients call to schedule appointments. Do they understand what the appointment will entail, how long it will take, or how much it will cost? Do they need to bring anything, such as a stool or urine sample, and have you offered advice on how to collect one? "We also provide estimates for each procedure we schedule," says Rivers. "There's no point in scheduling a dental if the client can't afford it."

If a procedure takes a long time or the problem is urgent but the schedule is booked, telling the client what to expect may head off problems later. Perhaps they'd prefer to drop off the pet and pick it up again in the evening, allowing you to treat the pet in between other scheduled appointments.

And don't forget to leverage your team members. Maybe someone else could handle that client call while you discuss the bill with Mrs. Smith.

Scheduling phone appointments

The Veterinary Receptionist's Handbook (Veterinary Medicine Publishing Group, 2000), offers this scheduling tip: When scheduling appointments over the phone, always repeat the day and time of the appointment, using both the client's and the pet's names. Any confusion that can be cleared up over the phone will save time and trouble in the waiting room.

Prevent gross outs

If you'll need a urine or fecal sample, make it easy for clients to pick up empty containers the day before, rather than letting them improvise. Everyone agrees: Client creativity can get disgusting!

Triage your tasks

Not sure which task to tackle next? Create a master list of your tasks. From this list, select a daily to-do list that's more manageable.

Heather Kirkwood is a freelance writer in Overland Park, Kan. Send questions or comments to: firstline@advanstar.com