Flow charts help staff execute tasks properly

Many dairy veterinarians benefit by being skilled at training lay people to do appropriate tasks. This is true for in-house practice procedures, and also for things done by lay people on client farms.

Table 1

Written protocols have long been recognized as valuable tools to help execute tasks properly.

If the written protocol is prepared in a format that provides visual support to the concept, then understanding and compliance is enhanced. Flow charts, which use symbols and diagrams to illustrate procedures, can be generated through a number of computer programs, including Microsoft Word. Dr. Tom Fuhrmann has used them extensively in his DairyWorks training sessions, as have other veterinarians and managers.

Table 1, p. 4F, illustrates a flow chart for a receptionist who takes incoming calls from dairy clients. All of the steps could be described in straight text format, but the flow chart adds a visual component, as well as a more interesting presentation.

Shapes help create it

Following the system described by Fuhrmann, different shapes represent different scenarios that receptionists will have to perform with even routine calls. A circle begins and ends the process. Rectangles denote actions, while diamonds are question points. Thus, every diamond has two possible courses proceed from it, depending on the answer to the question. The arrows denote the flow of action as the call progresses.

Of course all of this may only take a minute or two, and experienced receptionists do all of this automatically. For new employees, the diagram is very helpful.

In Table 1, the boxed statement in the upper left identifies the document, and states the practice attitude toward callers. This helps the receptionist understand how he or she is to interact.

The process begins with the phone ringing, depicted by the yellow circle. The first action of the receptionist is to answer it.

The green action box reminds her to try and get to it promptly. Others in the office can be directed to assist if she is already on a line or busy elsewhere. This avoids the phone ringing for long periods while everyone assumes someone else will get it. The box also states the proper greeting.

Table 2

The first question, reflected in the blue diamond, is important. If it is a client requesting a farm visit, then there follows a definite protocol for the receptionist to adhere to, depicted by following the arrow to the left. If it is any other type of call, then the various options are simply too numerous to outline, so the receptionist is directed to simply determine if she can handle it on her own, or whether she needs to refer it to a doctor or other staff member. In many cases, she will simply have to take a message.

Get the facts

Returning to the farm call scenario, she needs to get basic facts, depicted in the green box to the left of the first blue diamond. From these facts, she must answer the next question: Is this an emergency? New employees need to have training in what constitutes emergencies, and to have a list of terms and slang used by clients to describe them.

His or her next action depends on the outcome of the emergency status. If the answer is yes, she attempts to contact the most available doctor. Special requests are not likely to play a role in emergency situations.

Non-emergencies

If it is not an emergency, then she has to respond to any special requests, such as to have a particular doctor, or to come at a special time, or to bring special equipment. This is reflected by the next blue diamond. The receptionist needs to know the practice policies for dealing with such requests. These policies need to be written in a form to which the receptionist can easily refer, especially when they are new.

The flow chart shows the receptionist must decide if honoring the request is feasible or not at the time it is made. For example, if a client asks for Dr. Brown, and he is in the area with a relatively light schedule, it should be possible to honor it, and the receptionist can accept that request.

If Dr. Brown is 30 miles away with a full day already planned, the client must decide to accept either another doctor or another day. The receptionist should offer explanations and alternatives, instead of simply denying the request.

All arrows eventually lead to the same conclusion, which is confirming information, thanking the caller and ending the conversation. The yellow circle is used, denoting the completion of the process. While your own practice flow chart will most likely differ from the one presented, the benefit of the chart should exist in any setting.

Many applications

Flow charts have a place in many different practice situations. Cleaning and autoclaving surgery packs, plating milk cultures, handling blood samples and performing fecal exams are a few examples.

Once you become comfortable with using flow charts, you can enhance your value to clients by working with them to prepare flow charts for farm employees.

Table 2 is an example of a decision chart designed to help calf feeders recognize a sick animal. This chart was created by Mr. A.J. Wormuth, at the Agway Heifer Facility in Elba, Penn. Other applications on farms will be colostrum handling, sick cow exams, milking procedures, cleaning processes and feeding protocols.

Adequately trained personnel are an important component of both veterinary practices and dairy farms. Veterinarians with sound training skills are well equipped to make their own businesses run smoothly, and also provide training to the lay staff on the farms they serve.

Flow charts are an improvement over written protocols that employ text alone. The visual impact of a flow chart helps the trainee understand how actions follow decisions.