Fetch 2018: Tips for a More Efficient Fear-Free Visit

Julie Reck, DVM, owner of the Veterinary Medical Center of Fort Mill in South Carolina, says that making your practice Fear Free doesn’t have to mean longer appointments. “In fact, I would argue that Fear-Free has actually made [my practice] more efficient,” Dr. Reck said at the 2018 Fetch conference in San Diego.

Then, she provided 10 tips for incorporating Fear Free efficiently in a practice.

1. Understand organizational change.

When a group is undergoing major organizational change, there will be a dip in productivity. “You can minimize the dip,” Dr. Reck said, “but just know its normal.”

She recommended communicating to the entire team why the change is being initiated. Frame it from their point of view by asking whether the team wants to make a goal of reducing the fear, anxiety, and stress that pets experience in the hospital and whether they are ready to take the actions necessary to reach that goal. Making it easy for the team to understand the change makes them more likely to get on board quicker, ultimately decreasing the period of lower productivity.

2. Understand human behavior regarding change.

Human behavior change occurs on the rational side of the brain, not the emotional side, Dr. Reck noted, suggesting 2 ways to move someone to the rationale side. First, share a story. In the case of Fear Free, talk about a patient with severe veterinary visit anxiety whose anxiety decreased exponentially when Fear Free tactics were employed.

Second, ask a question. “If you ask how the team would define the ideal patient experience in 2019, fear will certainly surface in the conversation,” she said. “Then ask, ‘How do we get from where we are now to the ideal?’”

3. Communicate with clients before appointments.

Pre-appointment communication—via phone, email, text, and video—is vital to making processes more efficient and ensuring a smooth visit. The more times and ways you remind clients to bring in a stool sample, for example, the more likely they are to bring one in, saving the time required to collect a sample and removing that possibility of stress for the patient.

4. Stagger appointments.

Instead of scheduling multiple appointments at the same times, stagger them in 15-minute increments. “That way there won’t be a bottleneck during check-in and checkout at the front desk, saving stress not only for pets and their owners but also for your staff,” Dr. Radosta said.

5. Stock your exam rooms.

The fewer times you have to take a patient in and out of an exam room, the faster and better the appointment will go, Dr. Reck said. “You won’t have to spend time convincing the owner to let the anxious pet go, and you won’t have to spend time cajoling the pet to leave the room,” she said. This means keeping exam rooms stocked with all the equipment you’ll need to do blood draws, skin cytology, and other basic testing and procedures that typically would require a patient to leave the room.

6. Stay in the exam room.

Staff coming into and out of the exam room can cause the pet stress. Occupy the pet by feeding treats, and conduct the exam on floor (or use a rolling garden cart if being on floor is too difficult). Use a nonslip floor surface and/or mat, and always use gentle touch.

7. Provide easy access to treats.

Keeping treats in every exam room enables quicker patient assessment, and individual peanut butter containers and other snack items in the waiting area offer clients an easy way to soothe and distract their pets before they have their appointment.

Cats are not as food motivated as dogs are, Dr. Reck noted. Instead, you’ll likely need to engage their other instincts, specifically their hunting instinct and prey drive. She noted that honeysuckle wood is more enticing to cats than catnip.

8. Disinfect quickly.

Choose a disinfecting agent that is easy to use and has a quick contact time. Avoid bleach, whose odor will be much stronger to dogs and cats than it is to people. Dr. Reck recommended Rescue, which comes in wipe and spray form and requires just 60 seconds of contact time.

9. Be proactive about pre-visit pharmaceuticals.

Prescribing calming medications before a veterinary visit makes sense for both the patient and the practice. Oral and injectable medications can be used, and “don’t forget hospitalized and surgical patients,” Dr. Reck said. Oral trazadone can be given with or without gabapentin in a pill pocket or by some other means. Most cats (unless they are very small) can receive gabapentin at a dose of 100 mg.

10. Consider exam room checkout.

Offering a 1-way flow of patients reduces stressful interactions in your hospital lobby, Dr. Reck said. Checking out your patients and taking payment in the privacy of the exam room means clients don’t have to juggle their wallet, their pet, and their discharge instructions, and it allows your front desk team to focus on arriving clients.

RELATED

• Fetch 2018: Multimodal Management of Chronic Pain
• Fetch 2018: Disk Disease Treatment Can Include Steroids