Team solutions and servant leadership at AAHA award-finalist practice
This is a spotlight of one of the 2022 AAHA-Accredited Practice of the Year (APOY) Finalists. The winner was announced at the 2022 Connexity conference in Nashville. The award was generously supported by Zoetis. Learn more at aaha.org/apoy.
"Bigger, better, busier” had always been the focus for Lafayette Veterinary Care Center (LVCC) in Lafayette, Louisiana—until COVID came along.
“Our team was begging for help with the workload, and burnout was a reality in everyone’s mind,” said Nursing Director Danielle Richard: “We knew this was not sustainable for the future.”
An anonymous staff survey revealed many team members didn’t feel heard by management, so LVCC held follow-up meetings to learn more. As a result, the practice implemented a suggestion box to keep the lines of communication open. Suggestions could be made anonymously or not, and in multiple formats: There’s a physical box for handwritten suggestions, as well as virtual ways to submit during and outside of work hours.
Suggestions get triaged and routed through HR to the right department, and every suggestion receives some form of reply in the practice’s Slack channel. Employees can check the progress of their idea there, and if something isn’t possible, the leadership can explain the limitations.
“This has made the biggest impact on our culture,” Richard said. “We had to become realistic with how far we could be pushed, so we honestly examined our team’s struggles and were determined to make the necessary changes,” she said.
Some suggestions are simple things that make a big difference. For example, a new employee suggested training tags on their name badges to show everyone that they’re still learning. “They felt uncomfortable not knowing answers to things,” said Medical Director and Co-Owner Patrick Cutbirth, DVM. “Now, with the training tags, when somebody walks up, they can tell a senior employee versus somebody that's new, and it just takes the pressure off them.”
Flipping the power paradigm
LVCC never closes. The practice has a goal to provide total care to their community, which means offering emergency services 24 hours a day, as well as wellness appointments and a resort with boarding, grooming, and daycare.
Cutbirth and co-owner Garrott Van Bebber, DVM, joined the ownership team in 2013 and 2021, respectively —now it’s the largest veterinary practice in six parishes, with 13 doctors and 140 team members overall. It’s also a family affair. Both owners’ wives are veterinarians working at LVCC: Elizabeth Dietz Van Bebber, DVM, and Heather Stelly Cutbirth, DVM are associate veterinarians.
“I tell our doctors: ‘You’re here to serve, not to have a case served up to you.’ There's an entire culture of supporting the newer people around you [in order] to better support the client. And at all levels there's a servanthood in sacrifice,” Cutbirth said.
Those sacrifices can be quite dramatic: For example, when LVCC lost power during Hurricane Laura, Cutbirth stayed overnight with nine team members who provided patient care, saw emergency appointments, and performed major surgeries with a headlamp. But the work was just beginning as LVCC served all the surrounding areas that were devastated by Laura for several months when other veterinary clinics couldn’t re-open.
Experiencing challenges like this, along with the COVID pandemic and the accompanying wellbeing issues, the LVCC team found ways to work more closely together, rather than letting the stress split them apart. “Servant leadership starts at the top, and with enough time, it becomes self-sustaining,” Cutbirth said.
“I feel like we're one big team,” said Richard, who has worked at LVCC for 10 years. “Whether it's a doctor or the new person at the front desk on their first day, we all treat each other equally, and we're all here for the same reason. We want people who will build relationships, [who are] dedicated to making a difference and creating that ‘wow’ experience—not only for just clients, but for patients and co-workers.”
Staffing and pay rate solutions
LVCC implemented additional strategies to turn the tide of burnout, including:
Promoting several team members to assistant manager positions. Each assistant manager has eight to 10 team members they check in with a few times a month. They set personalized goals for each individual and discuss how to reach them. Employees are encouraged to bring any struggles they are facing.
“In the past, asking an employee to check in with a manager usually resulted in a terrified team member,” Richard said. “Now, it’s quite common for individuals to ask for a check-in; many even look forward to it.”
Overlapping doctor schedules. After looking at their busiest times, LVCC realized they could change doctor’s shifts to have more overlap, which helped with overflow of walk-ins, work-ins, and emergencies.
“Throughout the COVID pandemic, our hospital felt extremely busy. We all felt overworked and pushed to the edge,” Richard said. “Our doctors were more than cooperative, not only with changing their schedules, but they also offered to pitch in where they could.”
Offering “shift diff pay.” In a hospital that is always open, including on holidays, LVCC’s management felt that the team members who worked your “not so average” hours deserved some recognition. Now, any employee who works a shift that starts between 4:00 pm and 6:00 am or any weekend or holiday hours gets a pay increase for those hours worked.
“This is a great way for those employees to know that we appreciate and recognize the sacrifices they make to keep our patients safe at all hours of the day and night,” Richard said.
All the improvements made inside the practice have rippled out to benefit the larger community, and their loyal customer base shows it. LVCC has been voted a Nextdoor Neighborhood Favorite for the past five years on the Nextdoor social media site, and they were recognized as one of the top three veterinary clinics in Lafayette by ThreeBestRated.com in 2021.
The practice participates in year-round charitable and community engagement activities—including showing off their stuff in the Dog Gurus Daycare Games, a competition of off-leash dog daycare attendants and pet centers that puts pet care staff training to the test by letting them demonstrate their dog leadership skills. All of LVCC’s pet care attendants participated in the last games, and each won a medal.
But it’s the real-world community challenges that motivate the LVCC team the most.
“I'm so proud of our practice because we've met the needs of our area. [Before us,] there wasn’t a hospital to take your pets for continuous 24-hour care at one location, which meant consistent care was tougher,” Cutbirth said. “But, again, when things got hard, we haven't run. There was never an option to say we just can't provide service for these people.”
“During the hurricanes, we staffed up on customer care people to approve medications for patients that weren't ours and got legally signed off so that we could help because they didn't have access to a veterinarian. We stayed open here and made ourselves available for everybody without charging an emergency fee or exam fees for a lot of these hurricane patients.”
50 years of AAHA accreditation
Like anything steeped in tradition, the LVCC of today is largely a result of the hard work and dedication of the people who came before. Even with ownership changes, LVCC has upheld its AAHA accreditation for 50 years, passing its first evaluation in 1972.
“Dr. Donald Doiron started the practice based on the highest quality medicine with the best client service over 50 years ago. That dream was continually expanded when Drs. Andy and Kristen Plauche joined with a strong passion for teamwork and structure. Today, LVCC continues to blend high-quality medicine, client service, and a team-focused approach to meeting the standards AAHA sets,” Cutbrith said.
When asked what being the AAHA-accredited practice of the year would mean to them, Cutbirth said: “I think it's a culmination of 50 years of hard work and a laser focus over the last 10 years to just really scale up to meet the needs of the people—we have evolved with what our community needed.”
For Richard, being practice of the year would be validation of the dedication shown by the whole team through the most trying times.
“Between COVID and hurricanes and all the changes we've gone through, mental health has always been at the forefront of our minds,” Richard said. “The fact that we’ve been able to take care of our people and provide for our community—even as we’re here operating off a generator, doing surgery with headlamps—just being able to give back is so important because our community is really close, and we are at the center of that. I feel good knowing that we make a huge difference in people’s and pets’ lives. Watching that evolve over the last 10 years has been really rewarding.”
For a hurricane-tested team like theirs, the regular challenges of daily practice can seem almost mundane.
“A normal day feels almost easy,” Cutbirth said. Case in point: After a computer outage forced them to go back to paper record-keeping for eight long months, now the team doesn’t hesitate when the computers go down: “They walk up, grab the paper forms we have, and everybody knows exactly what to do.”
He said: “If there's a storm coming, we know which generators are going to be plugged up. We know what AC units are going to be attached to it. There's an emergency nurse team. We know where people live and which people will have access to the clinic while still being at home. Two years ago, the western part of the state was devastated. Last year, the eastern part of the state was devastated. And we still have people that drive two-and-a-half to three hours to see us because we were here for them, and they liked the level of care. We know that when hurricanes are coming, those people are going to be here, so we change how we do daycare to be able to afford more dogs and things you essentially access as a shelter.”
Learning from LVCC
If your practice would like to try a suggestion box, LVCC says the best way for employees to get their suggestions heard is to brainstorm solutions.
“When a team member proposes the existing problem, they have to bring forth a suggestion,” Richard said. “So, it’s not just them saying, ‘Hey, here all these problems, please fix them,’ but getting them to really be a part of developing the new protocols.”
“Everything is about perspective and communication,” Cutbirth said. “You explain to them why you're doing a suggestion box, and then you have to be transparent about the results. Own up to the low scores.”
The creation of a system for capturing suggestions solved that big problem of the team not feeling heard and addressed a breakdown in the system that hadn’t been noticeable before.
“[Before these changes], a lot of times a team member might grab one of us and say, ‘Hey, here’s an idea!’ but if we’re doing two or three different things, we might forget, and it never gets written down. Then the team member takes that as them being dismissed, when it was really us just being human,” Cutbirth said. “So, we came up with systems to fill up our weaknesses in a way that makes it so it's not so person-dependent.”
And now, after all their trials in the last few years, LVCC is bigger, better, and busier than ever—only in a different way than they ever imagined.
About the APOY Awards
This is the 13th year for the AAHA-Accredited Practice of the Year (APOY) award, which recognizes outstanding achievements in workplace culture, patient care, client engagement, and community involvement among AAHA-accredited practices. AAHA hospitals are known for their excellence, so this award is highly competitive. The awards committee evaluates each finalist on its most recent AAHA accreditation score, the practice’s mission and vision, team composition, CE and training programs, community service activities, and more. Learn more at aaha.org/awards.