Success often depends on how well we manage times of peak activity

It finally happened.

After 35 years in this profession, this particular week was one to remember. There were five – yes, count them, five – Mondays.

Times of peak activity are when the clinic is painfully busy.

As we've learned from other industries, these times help establish a reputation, test one's skills and determine profits.

Such times define how good your medicine and surgical skills are to the staff and to the public.

When a practice is busy but runs efficiently, clients notice. Efficient time management attracts more clients and the clinic prospers.

Peak times of activity can demonstrate improved productivity and the efficient delivery of excellent health care.

Peak times are stimulating, because it is then we are professionally challenged and learn the true state of our training, staffing, weaknesses, skills and internal limits.

These busy times call to mind a concept called "Peak Time Management."

During the hours when everyone in the clinic is engaged in providing veterinary services and attention to patient care is palpable, quality of service can reach new heights.

Conversely, when times of peak activity control the staff, quality of care declines. Frustration can spin out of control, and we see signs of stress: anger, popping off, sniper attacks and slammed doors. Clients notice that, too.

A familiar business concept

Most businesses have times of peak activity.

Restaurants are a key example.

Daily business in a restaurant will include perhaps one or two hours of peak time, but then it trolls along the rest of the day, getting ready for the next peak period.

Black Friday, the day after Thanksgiving, is when some businesses begin their annual profit collection. They operate all year in the red until the holiday season and then count on the busy final weeks of the year to generate profits for the whole year.

Road contractors in Minnesota have only the summer months to build roads, so that is their seasonal peak time.

The business of veterinary medicine once seemed to be seasonal – perhaps still is within some niches – but cancer, cardiology, oncology and other "real medicine" concepts happen daily and have smoothed out the seasonal swing.

Mainstream astute businesses build their business plan, staffing plan and hours of operation around times of peak activity. They learn to process and fulfill customer needs when the customers are there and ready to spend money.

Lunch-hour businesses and seasonal businesses know that folks tend to want to eat at noon and that Christmas spending patterns are unlikely to change, so they operate accordingly.

Creating peak-activity times

Sometimes, but not always, a business can "create" a time of peak activity. Veterinary practices, for instance, can do so within their existing service paradigm.

A dental awareness month might be targeted in an otherwise slow month to help generate business. It depends on the service to be offered and whether the pet owner is, or can be, motivated to act during that time.

Drop-off services in veterinary clinics are the most useful way to turn a quiet morning into a peak time. This can be accomplished by scheduling geriatric and presurgical screenings and otherwise routine diagnostics in the mornings, away from a busy afternoon.

Is it better to create a busy time – or go with the flow when people are mentally prepared for a seasonal activity?

To answer, consider a Dairy Queen banana-split sale. In January or in July, a banana-split weekend sale will triple the amount of product sold. In January, three goes to nine; in July, 150 goes to 450. Human nature wins.

When creating times of peak activity, it is important to consider human needs and the locale associated with veterinary services.

When clients must wait one or two hours to see the veterinarian, they are likely to visit other practices that manage peak times efficiently.

Don't keep them waiting

If clients are forced to wait, two reactions are typical:

• This is a good doctor – notice how long people wait for him.

• This doctor makes us wait, so we are going elsewhere.

(Tragically, some veterinarians enjoy keeping clients waiting.)

The reality is that keeping clients waiting too long is disrespectful of their time. They notice; they move on.

In the real world of marketing, one way to assess a business is to time the cars lingering in the parking lot. This indicates service time within the business. If customers are detained too long within – it is time for competition to move in.

Keep in mind it is more typical for practices to stop growing because of struggles within the hospital, not because of competition in the city, county or region.

Poor management of peak time undermines quality of care and slows business growth.

The concept that "adversity is the mother of invention" can be a positive one for a busy veterinary clinic. However, when a clinic is unable to handle times of peak activity with a certain flair, panache and dignity – the time has come to re-evaluate the hospital's business practices and view events of peak activity as times of opportunity, not times to regret.

Michael H. Riegger DVM, Dipl. ABVP

Dr. Riegger, dipl. ABVP, is the chief medical officer at Northwest Animal Clinic Hospital and Specialty Practice. Contact him by telephone or fax (505) 898-0407, Riegger@aol.com, or www.northwestanimalclinic.com. Find him on AVMA's NOAH as the practice management moderator. Order his books "Management for Results" and "More Management for Results" by calling (505) 898-1491.

12 steps to make the most of your busiest periods

1. Identify daily and weekly bottlenecks.

Find ways to improve client flow during these times.

2. Identify times when clients wait more than 15 minutes.

Find ways to keep appointments on time.

3. Identify which appointments can be moved to quieter times.

Consider surgical rechecks, cancer treatments and client conferences.

4. Identify which appointments can be made at discharge.

Consider vaccines, suture removal, surgical recheck, etc., for quiet times. Make sure these next appointments are offered and scheduled before clients leave today.

5. Identify interruptions and distractions that occur during times of peak activity.

Eliminate them or move them.

6. Identify the most likely time for emergencies and walk-in traffic.

Set aside "blank" appointment times in anticipation of them.

7. Identify which staff positions are most lacking during current time of peak activity.

Hire spot labor, adjust the schedule – but do whatever it takes to have more than ade quate staffing during these times.

(Hint: Hire an assistant for the technicians and assistants.)

8. Identify current peak times of activity and peak times of quiet.

Find ways to divert some of the action from peak active to peak quiet periods.

(Hint: Do routine diagnostics, radiology and ultrasound later – and only emergency diag nostics, radiology and ultrasound during times of peak activity.)

9. Identify soft-labor duties that occur during times of peak activity.

(These would include cleaning, telephone recalls, payroll, employee human resources duties, reviews, interviews, banking and inventory.) Move these non-essential duties to quiet times.

10. Identify facility issues, such as parking (and computer) bottlenecks.

Eliminate them; make more room in a crowded parking lot by whatever means possible.

11. Identify non-peak times.

Make sure these times are used to train staff and to make sure that service is outstanding, as excellence during the slower times makes for greater client traffic during the times of peak activity.

12. Identify personnel per veterinarian.

Aim for at least eight staff members per veterinarian. That number should be split 1:1 into technician-nursing duties and soft duties, such as telephone, customer service, check-in, check-out.

(Hint: Veterinarians must learn to delegate everything except diagnosis, prescribing and surgical duties.)