Quality counts

I embarked on my journey into multiple-practice ownership six years ago with the idea that we had to be better than the average practice. "We're good," I told my team. Yet in all fairness I had to ask myself, "How do we know?" After all, most owners would say the same thing; we're all proud of the care we deliver.

I knew that we had high standards of medical and customer care, talented doctors and staff, and many initiatives taking place at our hospitals. Yet I also knew my view was subjective. And I started wondering how we could be sure we were achieving our goals.

I called a meeting with the practice managers from each of our hospitals. The goal of the meeting: to determine how we could be more than "good." Our conclusion: We needed to develop systems that offer more quality control.

We reasoned that when things were written down, prioritized, and followed up on, team members would be more accountable. So we came up with the Practice Manager Quality Control Protocol. It helps focus team members' energy on the issues that are most significant to running a well-managed, growing hospital.

With control comes results

As an example of how well quality control can work, think about those check-off sheets you've seen attached to the back of the doors in business' bathrooms. They show that someone has taken accountability for cleaning the bathroom. The job gets done, and customers reap the benefits.

Our new quality control protocol achieves the same result, giving us a system for following up on particular items. We can make sure staff members are completing the job—and at the level we need to be a great hospital.

For example, we call clients whose animals are 30 days, 90 days, and 6 months past due. We prepared a page for our staff that explained why these calls are important, and we developed a script. But, using our new quality control system, we realized that we weren't meeting our objective. Staff members at some locations weren't doing the callbacks and others weren't doing them frequently enough. So we re-evaluated and refined the program.

Client wait time is another issue. Our tracking sheet has spaces to record client check-in, appointment, and checkout time. Yet not all of our hospitals use these tracking tools effectively. If everyone used them, we'd not only know whether Mrs. Smith waited too long, but we could tally and track results to learn average client wait times. With quality control procedures in place, we're making sure all of our teams use the sheets—and we know whether clients are waiting too long.

Laying the groundwork

Of course, for quality control to work, you must identify the factors that are critical to your success. For us, an open-door/open-communication culture; managers that manage by walking around, not sitting behind a desk; regular staff meetings and training; and weekly meetings with the medical director and practice manager are key. We hope our efforts help us improve in these areas: circle sheet usage and missed charges, attracting new clients, exceptional service, clients' use of wellness plans, inventory control, follow-up and reminder calls, bookkeeping and accounting, and record keeping.

This list may change as our needs shift or as we master certain areas. But since we've focused on these goals and used consistent tools to measure our success, I've already seen improvements. Managers know how important our quality control protocol is; we're reinforcing our effort by setting up a quarterly-bonus program. But their even bigger reward—and the reward for all our staff members and owners—is that we're striving to be great.

Jeff Rothstein, DVM

Veterinary Economics Editorial Advisory Board member Dr. Jeff Rothstein, MBA, is the president of The Progressive Pet Animal Hospitals and Management Group, which owns and operates hospitals in Michigan and Ohio.