By Stith Keiser | Blue Heron Consulting
This article was written for and featured in Today’s Veterinary Business.
If I could assign one word to the feeling around change in this hospital, it was “fear.” Not the kind of fear like that feeling of excitement or pre-game jitters, but the primordial, fight-or-flight type of fear. Fear for some that came down to fear of life or death, sickness or health. When it comes to obstacles, fear ranks pretty high on the list of hurdles to overcome.
I’ve been faced with the challenge of fighting negative attitudes, complacency and lack of training. I’ve even managed excitement around offering a new service or growing a hospital team. But rarely have I had to manage change when the obstacle was deep-rooted fear. What I learned through this case was that the same tried-and-true components of change management would work, when executed genuinely and effectively, even when battling a hurdle this intense. The result was probably one of the smallest measurable victories I’ve experienced when it comes to the magnitude of what was changed — yet it was probably one of the biggest success stories of change I’ve seen.
The Diagnosis
This case study starts with a multi-doctor, small animal, multi-million-dollar grossing hospital in a small, rural town. The past two years, since the pandemic began, had been plagued by declining client experiences. Long client wait times, often two to three hours in length, with pet parents sitting in their vehicles in a shadeless parking lot being scorched by the sun were exacerbated by curbside-only service and a lack of contact with the hospital’s well-trained and compassionate doctor and technical team. As a result, new client numbers were dismal, and invoices were down year-over-year as clients were increasingly frustrated. Even as the rest of the country began easing pandemic-related precautions and mandates, this hospital had a handful of team members who were paralyzed by the fear of COVID-19. In surveying clients about their experience, their biggest frustration wasn’t with quality of care or even the wait times themselves. It was the fact that due to this hospital’s location, clients had no options for “bio breaks.” When a client would inquire about using the hospital’s bathroom facilities, after sitting in their car for hours, they were turned away at the door.
Before you laugh at what may seem like such a minor problem, I take the time to share this case because this seemingly minor problem was the symptom of an irrational fear among the team. So, how did we fix it?
The Treatment
Start with why. This concept is no longer novel or innovative by itself, but I believe it is the first, and most important, part of managing change. Recognizing that the team in this case had created an unwelcoming and unsustainable situation, we started with “why.” Every team member sat down with ownership to discuss their individual why — why veterinary medicine, why this particular hospital and why they chose to come to work every day. As you might imagine in our profession, most of the team members were there because of their love of pets, people and the opportunity to serve that bond. After identifying these trends, we came together as a staff and discussed how those individuals’ whys contributed to the why, or mission, of the hospital. In this case, that manifested as a mission that emphasized the hospital seeking to “provide our community’s animals and people who care for them with comprehensive, compassionate veterinary services with integrity. We aim to exceed our client expectations by being reliable and providing high-quality and individual care for each pet …”
Define success. Building off the hospital’s mission, our next step in managing change centered on acknowledging that the client experience that had been created was not aligned with what the team promised themselves and their clients through their mission statement. They were in fact not “exceeding client expectations” and “providing for our community’s animals and people.” Upon recognizing this, we had each department — the veterinarian team, front desk and technical team — evaluate each step of a client’s experience with the hospital and brainstorm opportunities for improvement.
While every veterinary hospital should emphasize employee safety and hear out their concerns, this case involves a team that was unable to pull back, look at the options and see how its policies were negatively impacting clients. There are ways to elevate employee safety while also catering to the needs of clients. In this case, the team wasn’t ready to eliminate curbside, but identified opportunities to alleviate the painfulness of the wait. Specifically, adding shaded seating outside, offering all clients a bottle of water and a snack, adding a concierge position to improve communication and attentiveness and, as small as this may sound, opening up the bathroom facilities.
Evaluate the bus. Regardless of the change you’re managing, after the team has defined success, it’s imperative to get all team members on board. We did this through education around the virus, beefing up cleaning protocols, and equipping the team with the knowledge and resources to take a step toward the definition of success they created. I’ve been in way too many hospitals, including my own in some cases, where once change is announced, a naysayer is allowed to poison the well and sabotage the mission. As a profession, especially in today’s hiring market, it can be tough to make sure you’ve got the right people on the bus and in the right seat. I challenge my clients, and my own team, to build a dynasty. For those who are sports fans, think about Alabama or Clemson football. For our neighbors to the north, pick a winning hockey team. Don’t like sports? Think of any organization that consistently outperforms its peers. In doing so, I imagine you’ll find that the dynasty they created was based on having a team of all-stars. If you’re not willing to part with team members who don’t believe in the mission, you will always battle with implementing change.
Develop a plan and execute it. We’ve probably all been part of teams that could brainstorm great solutions and walk out of a staff meeting excited about the new plan, yet the plan lacked structure, accountability and the means to execute. When change fails, it’s often because we, as leaders, don’t help create and communicate the plan, everyone’s role within it and a timeline for completion.
Measure, track and celebrate success. Whatever you’re changing — whether it is related to quality of care, financial health, culture or anything else — must have metrics for success. Change rarely occurs overnight and it’s up to us to identify appropriate metrics to measure the change, track it and celebrate success along the journey. What is an afterthought to some is actually critical in keeping the team engaged, on track and committed.
The Results
Helping this team overcome their fear led to an almost immediate improvement in the client experience and patient care, and it opened the door to small, yet measurable steps toward getting back to the hospital’s reason for existence. If change management can overcome something as primeval as fear, there is nothing we can’t do in our hospitals.
