Common sense approaches encourage patient care recommendations

Common sense approaches encourage patient care recommendations

Jul 01, 2003

Statisticians and consultants struggle to measure lost hospital income ranging from uncharged services to excessive discounting. Rather than bemoaning a poor economy and flat hospital revenues, why not establish protocols that enhance likelihood of pet owner follow-through on your care recommendations? Let's narrow your action plan by first assuming your clients trust your advice and have the best of intentions for pursuing your recommendations. Many times, clients do not comply with suggested follow-up services, diagnostics and future vaccination series, simply because they forget.

Don't make the mistake of falling into the negativity trap by believing clients purposely avoid follow-up care. Like everyone else these days, responsible pet owners have complicated schedules and active lifestyles. Deferring action reflects oversight more often than neglect. Your practice management challenge is to increase the odds in favor of timely client compliance through courteous staff assistance.

How often have clients told your receptionist they couldn't schedule recheck appointments because they didn't have their calendar with them? How many clients say they will call later to schedule the appointment and never do? What about the client who opts to wait a few days before having a blood test, X-ray or other diagnostic test performed on her pet? Or, the client who apparently ignores a routine reminder notice, but comes in months later for a specific problem with her pet?

Is your staff aware of how they can effectively handle such situations? This article addresses these different, common situations that reflect client short-circuits. We offer protocol solutions that encourage client compliance with suggested treatments.

Nailing a recheck appointment In the first frequent occurrence, a doctor or technician has made a solid recommendation for follow-up care. The client is advised to schedule a follow-up visit for a recheck examination, a second series of boosters or laboratory testing. The client does not have her calendar or appointment planner with her, so she says she will call later to schedule the appointment. This client means well, but forgets to call.

Do not file the patient chart when the client leaves the practice; otherwise, the client and pet will be overlooked unless the client eventually calls to establish the second appointment. To assist the client and assure proper treatment of the pet, institute a tickler reminder system in your computer or by using a daily planner log. Call the client in approximately five days, if she has not already called to schedule the appointment.

In many cases, you will experience a grateful client who will arrange an appointment time and will apologize for forgetting to call. In the least, the client will appreciate the fact that an employee called to inquire about the pet's status.

Waiting on a diagnosis The second typical scenario involves a client who wants to wait a few days before incurring the added expense of an X-ray, blood work or some other diagnostic procedure in case the pet improves on its own.

Do current hospital procedures direct an employee to call the client in two to three days to see how the pet is doing? Or is the chart filed, assuming the client will probably call if the pet shows no improvement?

We strongly recommend the former procedure. A telephone call to inquire about the pet's condition does not need to be completed by a veterinarian. Instead, assign a receptionist (or preferably a technician) to handle the task. Even though your hospital procedure manual may require telephone calls to such clients, do you know for a fact that they have been completed? Identify a second individual, possibly a staff veterinarian, for perpetual review of the completed callback lists to supervise the completion of this important task. A standard form or checklist to maintain the tickler system and periodic self-audit of compliance helps enforce timely, ongoing completion of phone calls (Table1, p. 24).

Ignored reminder system The third event is the client who receives a reminder notice but fails to act. Six weeks, six months or perhaps a year later, the client appears with the pet because of illness or injury. We assume the practice's reminder system is up to date and every effort was made to contact the client several times before giving up. Practices always experience a certain proportion of the client base that is on temporary leave of absence. When the client self-reactivates, an effective receptionist checks the record to ascertain what reminders are delinquent. This requires a two-pronged approach: Well-developed staff habits of reviewing the record for delinquent procedures, and a well-educated staff that knows current, baseline prevention and wellness care for each species and patient age group.

Anytime a client presents an animal for a perceived problem, a great opportunity presents itself to ascertain and resolve all delinquent reminders. An even greater responsibility is identifying those services for which reminders do not exist, but are important to the preventive healthcare of the pet.