ABSTRACT: This article explores the role RVNs can play in all veterinary consultations within the practice and highlights the benefits to staff, clients and patients alike. It will explain how to make the changes and discuss the advantages and disadvantages of implementing such a system. The benefits to individuals will be considered, as well as the effects on the practice as a whole. A significant advantage is that new services or products can be promoted by the nurses, thus reinforcing the bond with the practice and recommendations by word of mouth from bonded clients are invaluable in promoting and maintaining a healthy client base.

A few years ago, Steve Garner, a veterinary surgeon from North America, developed an idea to change the work flow within his practice. He was looking for a way to maximise his time working as a diagnostic vet within a three-vet, small animal clinic. Clients were often kept waiting to see a vet because either the previous appointments took longer than the allocated time or extra patients were fitted in at busy times. This caused stress to the staff and resulted in less time being spent with each patient.

Called ‘Safari’, Steves model ensured that each member of the practice team – be it receptionist, nurse or vet – could carry out the tasks they were trained to do to their full ability, while at the same time improving the service the practice provided.

Receptionists had time to talk to clients, nurses were able to provide care for the animal as well as use their knowledge to educate and advise owners, and the vets could focus their time on the patient and the concerns of the owner because the other routine tasks involved in a veterinary consultation could be carried out by a nurse (Figure 1).

However, changing the way a practice works requires thought, discussion and commitment from each and every member of staff. Involving nurses in the consulting process requires trust and teamwork, which must be developed from knowledge and understanding of what is required. Vets, in particular, can initially find delegating parts of their role to a nurse daunting as they are, in most cases, used to working on their own, often with only a few minutes per client.

Regular practice meetings involving all the staff are key. Discussion and revision of treatment protocols greatly enhance the confidence of the team to deliver a standardised approach to the care given. Training can be in-house or from external sources – for instance, company representatives may advise on best practice with respect to their products which will enable a standardised approach from the team.

The main changes within the practice involve restructuring the appointment diary and revising the nurses rota.

How it works

In the Safari model, each consulting vet would have access to two consulting rooms with a nurse based in each. Each room has an appointment booked at the same time, 30 minutes apart. Ideally, one appointment should be a longer appointment – an annual health check and vaccination or an ill patient, for example. The other room can be used for a shorter appointment – a second vaccination or post-op check, for instance (Figure 2).

The nurse then runs the appointment and the vet sees each client and patient once the initial work has been done by the consulting nurse. By allowing 30 minutes for the appointment, the client spends much less time in reception, has up to 30 minutes in the consulting room with the nurse and 10 – 25 minutes with the vet and nurse.

The vet has plenty of time to talk to the client and can complete a thorough clinical examination. The vet should verbalise what he/she is doing in order to allow the nurse to record the findings on the practice management system.

Benefits for nurses

•   development of medical knowledge and clinical skills

•   understanding of the needs of individual clients and the opportunity to build a relationship with the client

•   the opportunity to play a vital role in client education and support

•   increased contact with clients on this basis gives clients a greater understanding of the role that the veterinary nurse plays within the practice.

Benefits for vets

•   better use of professional time – the vet concentrates on diagnosis and treatment

•   more time to focus on the patient

•   more time to investigate cases away from the consulting room.

Benefits for receptionists

•   calmer reception area as there are fewer people and pets waiting in reception

•   the increased ‘density’ of consulting nurses means that there is potential for free nurses to help on reception at busy times

•   nurses can be readily sought to triage emergencies.

Benefits for clients

•   less time spent in the waiting room

•   more time with a veterinary professional

•   feeling more able to ask questions in a confidential environment

•   greater contact with members of the practice team engenders more confidence in both them and the service. This is especially important when their pet is to be hospitalised

•   clients and their pets are able to develop a bond with all staff, not just the vet.

Benefits for patient

•   less time in reception with other animals, so that species such as cats and exotics are not unduly stressed

•   weight, condition score, parasite control and general health will be discussed at each and every appointment

•   a clinical examination will be performed at each appointment (depending on practice protocol)

•   more holistic care as time is available to ask general questions about the patient rather than a focus on 'what is wrong’.

Benefits for practice

•   perception that consultations are longer and more time is spent with the client increases bonding to the practice

•   promotes greater communication between staff in the practice as a whole, as well as in the consultation rooms, thus mi
nimising the potential for misunderstandings

•   staff find greater fulfilment in their roles which can lead to increased staff retention

•   use of nurses to support the consulting vet enables targeted health care and time to promote new products

•   may result in increased nurse numbers allowing a more flexible rota. Turnover should be increased which will allow employment of more nurses, possibly at the expense of an additional vet or receptionist.

Conclusions

Whilst this model is not ideal for all situations, it can be adapted to work in any size of practice. The times of day that these appointments are implemented can be chosen to fit in with rotas.

In my experience staff, clients and patients all gained in knowledge and understanding, whilst practice procedures were standardised resulting in clearer communication, fewer complaints, a more relaxed working environment and ultimately increased profit margins.

A significant advantage is that new services or products can be promoted by the nurses, thus reinforcing the bond with the practice. And recommendations by word of mouth from bonded clients are invaluable in promoting and maintaining a healthy client base. 

Author

Helen MacDonald rvn

Helen MacDonald has worked within the veterinary sector for the last 20 years. After qualifying in 1994, she spent time teaching veterinary nursing before returning to a small animal practice as head nurse. Helen then worked as a locum before eventually becoming practice manager in a small animal hospital. She is currently employed by Xograph Healthcare as a veterinary territory manager in the South West.

To cite this article use either

DOI: 10.111 l/j.2045-0648.2010.00008.x or

Veterinary Nursing Journal Vol 26 pp 28-29

Veterinary Nursing Journal • VOL 26 • January 2011 •