Uniting the Front and Back Veterinary Teams

This is the sixth, and final piece, in a series of blog posts written by Louise S. Dunn, who’s partnered with VetMatrix to provide educational content for veterinarians in different areas of their practice. Louise has 45+ years of experience in the veterinary field. She’s the owner of Snowgoose Veterinary Management Consulting, author of multiple books including “The 5 Minute Consult,” “Pathways to Ownership,” and “Veterinary Clinics of North America,” she is also a Fear Free certified professional.

Who or What is Causing the Discord?

The day starts on a good note, but the tension builds as the hours go by. You overhear two veterinary nurses grumbling in the treatment area, “If only the front desk knew how to schedule better, we wouldn’t be so backed up.” Taking this cue, you head out front to see what is going on only to hear the CSRs saying, “If only those techs in the back would stop chatting and get to work, we wouldn’t be so backed up.”

Both groups are finger-pointing and complaining about the same thing – being backed up. Why can’t they work as a team? Why are they divided into front versus back? 

Doctor putting finger and blaming nurse.

It seems so easy to place blame, to finger point – however, it is important to remember the saying, “when you point your finger at someone, there are three fingers pointed back at you.” What could you be doing or not doing that causes the battle between front and back? 

Many will say the main culprit of this discord is the appointment book that causes the fight between the front and back. The truth is that it goes much deeper.  It is about the culture, poor communication, a lack of understanding of each side’s role in client service, patient care, and even leadership errors.

Culture is unique to your group.  Culture determines how the group works together –it fosters stability and drives its members’ thinking and behavior. It gives the strategy of what, when, where, and how to do things.

Think about that 4:54 pm client calling your practice about a sick pet – are they automatically told to come in, or referred to the local emergency hospital? Is there a “dance” around asking for permission, tip-toeing around the people who will say no in favor of someone who will say yes?  Your culture may be causing the battle between front and back.

Communication is always a primary suspect any time there is discord. Over 80 percent of a person’s success at any job is due to communication skills….also known as people skills (per The Harvard Business Review1). 

Vets looking at computer together.

With only 20 percent of their success based on technical skills, why do so many training sessions concentrate on technical skills and ignore the people skills?  Communication is vital to patient care, client service, and team performance – assess communication gaps when the finger-pointing starts.

Lack of understanding of roles, responsibilities, and pressures is common. Think about the team’s different roles – nurses give full attention to patient care, CSRs focus on client service – there will be times when the roles can seem incompatible.

Without working in every area of the hospital, understanding the pressures of each area can be difficult and may lead to unrealistic expectations from co-workers in the other areas of the hospital. Unrealistic expectations lead to conflict.

Leadership errors are another possibility – remember those three fingers pointing back at you, the manager. Error number one – refusing to accept personal accountability. The buck stops with management and how the team is held accountable. Other leadership errors are: 

  • Failing to develop and train people on the team
  • Aligning oneself with a side
  • Managing everyone the same way
  • Being a buddy and not a boss
  • Failing to set standards
  • Condoning incompetence
  • Forgetting the power of communication 

Management may be the cause of the tension between front and back. Knowing that there are different root causes to explore does not mean that the solution is out of reach. However, it will take some effort to get everyone on the same page and work as a team.

Potential Remedies

Vet professionals working together to check dog.

Upon examining common root causes (culture, poor communication, a lack of understanding, and leadership errors), it is possible to initiate remedies that may address a few root causes at one time. One such remedy is the daily huddle.

The daily huddle is a 5-10 minute long meeting to assess what will happen throughout the shift, troubleshoot potential problems, and agree upon a game plan. Everyone understands their different roles and expectations; communication is clear, and the team knows the goals for the shift.

Team meetings are another tool to quell discord between the front and back. Have the different areas submit challenges, clinical inefficiencies, and other problems. Divide out into groups (groups must include nurses, CSRs, doctors, ward attendants, etc.), brainstorm together, bring up their unique perspectives, and work together to achieve the best solution.

If the different areas hold separate meetings, bring in the lead person for the other area – he/she can listen to concerns, give input from his/her perspective, and work on solutions. Team meetings are also an excellent opportunity to reward the team and conduct team-building activities.

Nurses and doctors having a meeting.

Another solution is cross-training or job shadowing. Cross-training is not always possible in some situations, such as training a receptionist to do the job of a certified veterinary nurse in surgery. Still, the receptionist can gain an understanding of the position by job shadowing and assisting the veterinary nurse.

Scheduling team members to work a shift rotation in other areas will not only help them to understand the roles, responsibilities, and pressures associated with that area, but it will also give an idea of how the roles can complement each other and when it may be necessary to step in and offer assistance (even without being asked). 

While on the topic of training – pay attention to shift leaders, supervisors, and managers. These team members need additional tools for communication and tips on how to avoid fatal management errors that erode team unity. 

Building a cohesive team does require policies and procedures. Review and update any standard operating procedures (SOPs) and job descriptions. Create checklists and ensure collaborative workflows across all areas of the hospital. 

Building a United Team

Veterinarian shaking hands with client.

Looking back at the morning fight over the appointment schedule – consider a procedure to map out certain appointments for sick, well, and urgent time slots. Conduct a huddle at the beginning of each shift to update the team on the appointments and the game plan to mitigate any problems that may arise. Involve the team in a debriefing session afterward to discuss what worked well and what didn’t. 

Discord, drama, disagreement – no matter the label you give it, it is a problem that needs to be nipped in the bud before the negativity spreads and impacts client service and patient care. Clients see and hear. They sense the tension, receive the exasperated sighs and the apologies, and wonder what level of care their pet is receiving. Give the team the tools to successfully work together as a team unified and deliver exceptional patient care and client service.

Read the rest of the Louise Dunn series here:

Leading Your Veterinary Team Through Change

Guiding the Veterinary Team Through Conflict Resolution

What To Do When Training Isn’t Producing Results in Your Vet Team

Raising the Bar at Your Veterinary Hospital

Conducting A Daily Huddle In Any Veterinary Practice

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