How using a system-level approach can make you a better clinician

Veterinary teams know that clients come in with a list of concerns. And oftentimes, they may have little to do with their pet’s presenting problem. These concerns include financial stress, speaking a different language than the veterinary team, mobility, transportation, housing, etc. Consequently, all of these issues can detract from getting the best care for the pet. Although everyone’s desire and best intention to make this happen, logistics can get in the way.

But what if there were systems in place to ease those burdens for both teams and clients?  

Setting up and automating such systems—before you need them—is a great way to achieve that goal. Generally speaking, it does take some effort up front. But the benefits veterinary teams, practices, clients, and patients reap are well worth the work. 

Taking a system-level approach to your practice requires a few steps: 

• identifying client needs and existing resources 

• preparing ahead of time for gaps in services 

• building collaborative community relationships 

• automating processes 

By all means, a systems-level approach doesn’t just help you reach more people and pets. It also frees up your team to do what they do best: provide the best medical care possible for your patients.  

Implementing a system-level approach for an all-around win 

By building systems that enable automatic responses to the common hurdles mentioned above, veterinary professionals can spend more time focusing on medicine. Because they know that other services within the system will address other needs the client may have, they simply have more time and headspace.

As a result, a system-level approach is a win for clients and patients. But it’s also beneficial for the veterinary team as a whole.  

When a system is in place to ensure the cost of veterinary care is covered, for example, the team isn’t tasked with trying to piece together a one-off way to provide financial assistance. They also don’t experience the moral distress of being unable to provide necessary care to a patient due to a client’s lack of finances. The team gets to help animals, the animal is able to receive care, the client is able to keep their pet with them, and the practice receives payment through the system. 

However, if this sounds unfamiliar that’s for good reason. Michael Blackwell, DVM, MPH, director of the Program for Pet Health Equity at the University of Tennessee, Knoxville, notes that a system-level approach is simply not something most of us are familiar with. 

“We don’t operate in such a system today,” he said, “and just striving to see such a system come to be will solve a lot of problems that we’re challenged with today. That’s financial [challenges] and beyond.” 

Defining a system 

If a veterinary practice were to be a one-stop shop without need of system-level care, it would provide everything that anyone—animal patients and human clients alike—could want regarding their veterinary visit. Pets can receive the care they need, financing is set up to address the barriers that might interfere with your ability to help the patient, and any other client support required, like assistance with medication administration or transportation, is included in the model. 

However, this is not a model that you’re likely to find in our current world. And that’s why you want to be a part of a system. 

“Let’s assume that there are not such entities that I can walk through the front door of, and all of that is there,” Blackwell said, “but the community has all of those pieces that go into good patient care, client services and client support.” 

That’s not the whole story, though. For this to work, the services and resources must not simply exist in the community—they must have a clear way of working together.  

“It’s simply a matter of formal collaborations and connections—such that these predictable things that we get challenged by are accounted for,” Blackwell said.  

This involves planning out how to handle those predictable challenges—like a financially fragile client struggling to cover an emergency vet bill, or working with a client who speaks a different language—without having to figure out a custom solution, in real time, every time the issue arises.  

“The system would be: ‘This is what automatically happens when you have a client who is in this [predictable] situation,’” Blackwell said.  

Setting up a system in your practice 

Tools like checklists and consistent processes have been shown to help reduce mistakes in medicine. With that in mind, let’s consider what strategies we can use to create automatic systems in clinics that minimize the risk of clients and patients falling between the cracks. 

Begin by looking within your own practice. Hold a meeting or send around a staff survey to gather the following: 

• Identify the needs of clients (generally, what is the practice seeing?)  

• Identify pre-existing resources (pet food banks, financial assistance funds, low cost spay neuter, pet transportation)  

Once you’re clear on the most common challenges your clients face—and have an understanding of what resources are available in your community—you can take steps toward connecting said clients with the necessary resource.  

An optional intake questionnaire is a simple way to accomplish this, although it is important to make sure clients understand they can always decline to answer any or all of the questions, like:   

• Would you like to hear about options for financial assistance today?  

• Do you have any housing concerns?  

• Do you have transportation concerns?  

• Do you have any concerns about giving pills or liquid medications to your pet? 

• Do you have any language or communication preferences? 

The human aspect 

A system like this requires a bit of a shift, moving from working as a singular veterinary practice to a community care model.  

“The veterinary practice is part of the community care model,” said Blackwell, “but the community care model is about the system—a system of referrals.” This allows veterinary professionals to do what they do best while setting their clients up with assistance from other professionals who get to do what they do best. 

“Another way to say this is, if we were to assume that we are doing a really great job with patient care—and yes, we’re making adjustments on the spectrum of care issue and so forth—it is the client care piece that needs some attention,” Blackwell said. “But we don’t have to do that ourselves. That’s where the collaboration enters in.” 

Because, he continued, “This is not a conversation about veterinary medicine doing a poor job with what we’re charged to do, which is to take care of animals. This is about, in order for us to continue to do a good job—and an even better job—let’s shore up the client part of the VCPR. 

“And, by the way, that system actually helps to attend to the mental and emotional health of the veterinary care team,” he said. “It’s all the human stuff [that we need to work on], not the medicine.” 

Photo credit: © AAHA 

 Disclaimer: The views expressed, and topics discussed, in any NEWStat column or article are intended to inform, educate, or entertain, and do not represent an official position by the American Animal Hospital Association (AAHA) or its Board of Directors.