Lifelong Care, Issue 4

Published by the American Animal Hospital Association with a generous educational grant from

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LifelongCare . . .

Tools Techniques Conversations

Sustaining Success

Your Next Step in Lifelong Care

Published by the American Animal Hospital Association with a generous educational grant from

™.

LifelongCare . . .

Tools Techniques Conversations

Health Risk Assessments

Taking preventive care to the next level

Published by the American Animal Hospital Association with a generous educational grant from

™.

LifelongCare . . .

Why Change Now?

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Quiz: Is Your Practice Change-Ready?

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Why People Change

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A Process for Change

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5 Steps to Align and Sustain Change

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Tools Techniques Conversations

Pet Wellness Report® Implementation Toolkit

Published by the American Animal Hospital Association with a generous educational grant from

™.

LifelongCare . . .

Tools Techniques Conversations

Quiz: What is Your Change IQ?

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Pet Wellness Report (PWR) Action Plan: Measuring Success

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Caring Conversations Build the bonds that get results.

Published by the American Animal Hospital Association with a generous educational grant from

™.

LifelongCare . . .

Tools Techniques Conversations

Lifelong Care from Zoetis™ is an initiative providing veterinary practices with educational tools and resources to help move veterinary care toward a healthier, proactive model.

For more information, go to zoetis.com/lifelongcare.

Sustaining Success

Your Next Step in Lifelong Care

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2 Lifelong Care

©2014 American Animal Hospital Association (aaha.org). All rights reserved.

In Brief

The first three issues of Lifelong Care emphasized the following points: • Thriving veterinary practices strive to nurture long-term client relationships that lead to consistent, Lifelong Care.

• Goal: To have owners of all dogs and cats in the practice receive an HRA annually for each of their pets.

• Lifelong Care is a proactive health care approach, conceived by Zoetis, which encompasses prevention, detection, and treatment personalized for each pet.

• Creating a standard protocol and workflow, assigning responsibilities to staff, providing training, communicating with pet owners effectively, and following up are the building blocks of success for any new medical service, including an HRA.

• A proactive care approach emphasizes prevention, early detection of disease, and timely treatment intervention. Lifelong Care is the extension of this proactive approach throughout the pet’s lifetime.

• A health risk assessment (HRA) helps clients identify their pets’ health risks; it also serves to underscore and help prioritize your recommendations.

• Among veterinary HRAs, only the Pet Wellness Report® (PWR) from Zoetis incorporates all three keys to success: • A standardized, pet owner–completed, online questionnaire to discover modifiable lifestyle risks • Comprehensive laboratory screening to identify subclinical risks • Communication and follow-up to help clients understand findings and act on your recommendations • Success with an HRA depends on every member of the practice team working together.

• Zoetis offers many tools to help practices implement the PWR. You can find them here: aahanet.org/Library/ Lifelong_Care_Resources.aspx.

• Compassionate conversations with pet owners can help bridge the gap between the care pets are getting and the Lifelong Care they need.

• A health risk assessment (HRA) process, such as the Pet Wellness Report (PWR), provides the foundation for compassionate conversations that build relationships while shifting clients’ expectations from reactive veterinary care to a more proactive, Lifelong Care approach.

• Everyone on the veterinary health care team can practice compassionate communication.

The August issue of Lifelong Care lays out the principles and techniques. Use it to improve your own performance and to train team members.

What We Mean When We Say HRA

A health risk assessment (HRA) is a patient evaluation process. lt is based on integrating the results of a pet-owner-completed lifestyle risk questionnaire and comprehensive lab screening.

These findings combine with the routine history and physical exam to bolster the veterinary team’s understanding of patient health and health risks. With caring conversations, pet owner communication and pet care partnership is enhanced through this process. The Pet Wellness Report is an example of a comprehensive veterinary health risk assessment.

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Enhancing Preventive Care 3

Q

Fast-growing practices focus on wellness and foster the bonds with pet owners and pets.

1

Why Change Now? For most veterinary practices, sluggish growth remains a stubborn problem. Fortunately, recent studies by AAHA1 reveal two simple truths: • Wellness drives growth.

• Strong bonds drive growth.

Easier said than done? Not really. Using a single tool—a health risk assessment like the Pet Wellness Report— you can expand wellness care and strengthen client relationships.

Integrating the tool into your practice means changing your workflow and how you communicate with clients. That’s where things can get challenging.

Your practice is built to deliver care to pets and service to pet owners. It isn’t necessarily built for change. But sometimes, your practice’s success depends more on your ability to change than on the quality of your medicine.

Any fundamental change should add value to your practice, clients, and patients. As we examine how change happens and how to make it happen effectively, we will consider the health risk assessment, a service

Grow More Now 2 secrets to sustainable growth:

• Wellness care • Strong relationships

• Health risk assessment like the Pet Wellness Report

1 tool serves both:

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4 Lifelong Care

process important for Lifelong Care. Adding a health risk assessment process to your health care approach can be a fundamental change. We will examine how this change can happen and how to make it happen effectively using the Pet Wellness Report as our change example.

In traditional veterinary medicine, owners bring their pet in only when they get a reminder for vaccines—or worse, only when the pet is hurt or sick. We will look at a more proactive approach and a tool to help implement it: the Pet Wellness Report® (PWR). The PWR is a service tool that gives veterinary hospitals the opportunity to change how they are valued by pet owners. If implemented well, the PWR can change the conversation from sickness to wellness, from treatment to prevention, and from “call us if your pet is sick” to “trust us to help your pet live a long and healthy life.”

For that to take place, we must understand how to make change happen effectively and how to help our associates and staff transform their individual behaviors, so they can use the tool to its full potential. We also must create a different level of awareness for pet owners to help them commit to a proactive relationship with us. Done well, these measures will create healthy pets, healthy practices, and happy families.

We must implement change in two areas related to the PWR: • Team members: Create internal behavior changes so team members have different conversations and interactions with pet owners.

• Pet owners: Encourage our clients to think and act more proactively in managing their pet’s health.

Quiz Is Your Practice Change-Ready?

Take the quiz to find out!

Circle true or false as it best represents your practice over the past 6 months:

This quiz can reveal your practice’s culture and preparedness for change.

My practice quickly adapts to changes in the market and has effectively implemented internal innovations, such as a new therapy or a better way to serve our clients. True False

If your practice is not change-ready, take action to change the culture. For example, listen carefully to team members’ complaints, empathize with their feelings, and collaborate to resolve the issues. Collaboration helps staff focus on the opportunities.

Practice leaders involve everyone in the change process and allow many opportunities for honest feedback as change is introduced and rolled out. True False

Scoring:

Count the number of times you circled TRUE. My employees are used to change and rarely complain about changes happening in our practice. True False Ideas for change come from everyone, not just management or ownership. True False When we implement a new process or procedure, our team meets it with enthusiasm and a “can do” attitude. True False Leaders spend most of their time developing staff, coaching, and focusing on the future of the business instead of putting out fires or dealing with resistance to change. True False The staff is fully accountable for effectively implementing changes and making them sustainable. True False There is continuous and effective communication among functions in the practice and between front-office and medical staff. True False In general, staff spend their time proactively moving the practice forward and not merely following orders. True False Our team regularly meets to examine our processes, services, and pet care and to explore ways we can improve. True False

8–10: You have the culture, leadership, and accountability to sustain behavior change and consistently improve the hospital.

5-7: Your practice may struggle with quickly implementing and sustaining change.

0-4: Your practice will find change very challenging.

Managers may feel they are the only ones fully committed to change. They spend too much time trying to push change.

Whatever your practice’s score, it can become more change-ready and accountable. The first step? Create commitment.

Leaders who effectively plan for and support change move their teams toward commitment.2 Note the difference between compliance and commitment. Compliance means following orders. Commitment means that everyone takes ownership and engages in making it happen: Change is everyone’s job.

Resistance • Certain failure to change

Compliance

Commitment

• Struggle

• Growth

• Change feels slow and hard

• Change is sustainable

• Leaders put out fires

• Leaders focus on the future

• Task and instruction driven

• Capability and improvement driven

• Creates followers

• Creates more leaders

• Business is not nimble

• Business adapts and innovates

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Enhancing Preventive Care 5

Why People Change The key to executing effective change is knowing why and how individuals change. Because hospital-wide innovation requires many individual behavior changes, our process for executing fast, sustainable organizational change is based on what drives team members to modify their behavior.

People are motivated to change when four criteria are present:3

1. They Want to Change

2. They Know How to Change

This is the most difficult requirement to achieve, and yet it drives the other criteria and is the foundation for successful behavioral shifts. Every behavior change starts with an internal desire, the “why?”

Much of the work done on behavior change teaches us that if we help others identify how a particular change positively affects them, helps them achieve their personal goals, or helps them move closer to something that they care about, then they will be much more likely to fully engage in the change effort.4 Norman Doidge, MD, writes in The Brain That Changes Itself, “The good news is that our brains are essentially plastic for our entire lives and always capable of change. Change, however, still must begin with a desire for something to be different,” Doidge concludes.5 We must help others reach their own conclusions about why they want to commit to a change rather than simply telling them that they should.

Even fully committed team members may be stymied if they don’t know how to bring about the required change. As leaders, we must clarify expectations and make sure that our staff has the knowledge, tools, and resources they need.

For example, implementing the Pet Wellness Report (PWR) requires a new kind of conversation among team members and clients, a process to encourage pet owners to complete the report, and a method to help pet owners understand the value and significance of the PWR findings. Allow the team to offer ideas on how to handle these changes, such as incorporating the PWR within the wellness plan offerings of the practice.

Once specific behavior changes are identified, the “how-to” must be worked through meticulously so that all team members have a detailed understanding of exactly what to do.

“Understanding why and how to change are the first steps, but still not enough to succeed in implementing and sustaining change. You must incorporate all four of these steps for success.”6

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6 Lifelong Care

3. They Believe They Can Change 7,8

It’s easy to look at a team member and think, “They understand why and how, but yet they still resist change! I don’t get it!” What is happening here?

Sometimes people fail to change because they lack confidence to perform new tasks or fulfill new responsibilities. We can say, “Make sure you have a thorough conversation with the pet owner about the PWR and what it means for the health of their animal,” but that’s easier said than done.

Did you provide the team member with the training necessary to accomplish this confidently? For example, did you provide each team member with a PWR to complete on their own personal pet so they can appreciate the value of the HRA process for themselves?

Associates and staff are in the habit of having certain kinds of conversations with one another and with clients; changing those conversational habits may not be easy. Staff may not be confident in their ability to discuss wellness instead of sickness or to successfully address clients’ questions or resistance to a new process or philosophy. From your point of view, their hesitation may look like stubbornness or resistance. Rather, their hesitation results from the lack of proper training and belief in their own ability to perform effectively.

Help team members gain confidence through competence. Encourage them to try one or two new actions at a time, and recognize their progress. Remind your team that change is a process: It’s not about being perfect today, but getting better every day. As team members’ confidence and competence grow, so will the rate and sustainability of the change.

4. They See Others Doing It What people see shapes their behavior more than any instructions, employee handbook, or email memo.6 For example: Your hospital’s change track record speaks loudly. If management has a history of telling the team to change but then later abandons the change, how believable will your next change attempt be? Won’t they just wait for this change attempt to dissipate as well? If, on the other hand, your practice makes change decisions collaboratively and sticks to the change even when unforeseen obstacles arise, your staff will know from your track record that there is no going back. This new change then can happen quickly and fairly easily.

As we work through the change process, we must make a conscious effort to support those who are setting the right example. People who work hardest to make the change happen need to know that they are doing the right thing and that management appreciates their efforts. A quick “thank you for being a leader” can mean even more than a financial reward.

Pay special attention to recent hires. New employees strive to fit in. They are experts at noticing how things are actually done (as opposed to how we say they should be done) and adopting the behaviors of employees who appear to be successful.

As you observe new employees, ask yourself: Are new hires adopting the right role models? Are they mistakenly assuming that long-term employees are doing things correctly? Are they picking up bad habits that may prevent growth or quality care?

It is never too late to start modeling healthy change behaviors, and it begins with the practice leaders. Don’t expect your team to change if you can’t learn to lead the change yourself.

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Enhancing Preventive Care 7

1

HRA as Change

Define the change

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Align behaviors From innovation to habit: A 5-step process to align and sustain change in your practice9

3 Commit despite difficulties

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HRA as Habit

Support people and momentum

5 Sustain the change

A Process for Change

belief in their own abilities to implement and sustain Leading change is a process, and, like any change. So resistance to change should be expected. process, there is a series of steps that generally assure a Resistance, though, can be a great ally. If we make good outcome. We should understand and follow this the effort to understand what is process to get the results we want. difficult for people and what they In addition to the process itself, don’t understand or agree with, we need to understand: We may assume that people we can address those issues and • how and why behavior change naturally resist change, keep the change process on track. happens in individuals; but the truth is that people Opening your eyes and ears to • how to deal with common resist change they don’t other perspectives will help you challenges and roadblocks; and understand or agree with— lead change more effectively and • how to plan for, address, and, that is, when they perceive efficiently. where possible, prevent resistance change is being done to 7 Our team members are to change. them instead of with them. brimming with ideas, creativity, It’s easy to tell ourselves that and energy; let’s use them to people naturally resist change shape and improve the change process! Let’s create an and that is why most change efforts fail. The reality environment where our staff is comfortable voicing is different: People willingly move, get married, have concerns, challenges, and potential roadblocks so we children, change jobs, and initiate other huge changes 7 can work together to make the change easier and more in their lives. Call someone into your office and offer sustainable for everyone. Ask for and appreciate their them a raise; see if they resist that change! constructive candor.

People resist change they don’t understand or agree Now that we know how change happens in individwith. They resist when they perceive that change is uals, we can see that shifting the team mindset from being done to them instead of with them. If we feel reactive medicine to a more proactive, Lifelong Care we are forcing change on our team, we probably are. approach will require more than just telling our staff to Top-down implementation may seem efficient, but it implement a health risk assessment (HRA) process. We often leads to employee pushback, which can stall or need to adopt a well thought-out change process and even derail the change process entirely. align our leaders’ behaviors with the change we intend First, assume that not everyone is going to initially to sustain. understand and accept the why, the how-to, and the

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8 Lifelong Care

5 Steps

to Align and Sustain Change

Step 1: Define the Change The first step in leading change is to define the end state or new normal and how you will get there. How you define and communicate the path toward change can impact whether your practice arrives at the desired new place or whether it stays right where it is.

Focus on the opportunities ahead by building a story, vision, or goal. This will build excitement and initial momentum for your change effort.

Are you ready to define the change? Ask yourself: • Can you explain the change in detail?

• Why is this change worth the organizational effort?

• What will each team member’s role be in the change?

• How will we measure the success of the change?

• What are the key milestones or timelines associated with the change?

assumptions, and staff dynamics, may hinder hopeful innovation. Fortunately, there are eight actionprinciples, or vectors, we can use to align our hospital with the change we wish to achieve (see “8 Vectors of Change” below). By leveraging these eight vectors of change, we can create a set of forces that push change forward rather than hold it back.

8 Vectors of Change9 Communication Clarity Culture Leadership Coaching

Step 2: Align the Change When we think about opposition to change, we usually anticipate pushback from reluctant staff. But other forces, including workflow, protocols, habits,

Structure

Organizational Change When you align all the forces of change, you will achieve a more lasting result, quickly and efficiently.

Process Talent

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Communication Practices often create a series of memos, documents, and other communications that tell employees about a change; however, we must also help members of each department or functional team understand how they are affected by the change. People do not attain the level of understanding they need to act differently from communication directed at them. They attain such understanding only by participating in a series of conversations. This takes time. A more important change needs more time set aside to support the change process with your team.

Explore these questions with your team: • Does everyone know why we are considering a move to the Lifelong Care approach? What does this new health care goal mean to us?

• What will be different about our practice if we are successful at implementing this kind of care?

• This transition may entail hard work. Is the reward worth the effort? Why?

Clarity To successfully execute change, everyone in the practice must understand how the shift will affect their job responsibilities and behavior. Remember, people often resist change they do not understand or agree with. To ensure that everyone makes an informed choice about whether to embrace or resist the change, we must be very clear about what the change entails (why, what, and how). Only when we are sure that individuals are making knowledgeable choices can we have the appropriate conversations with any individuals who choose to resist.

It’s important for leadership and staff to explore the change together so team members can process how to think, act, and prioritize in the new state.

Encourage your team to think through the following questions together: • What does working in a hospital that practices Lifelong Care mean to you?

• What behaviors need to be different for us to do this successfully?

• How do we need to think differently about our care and our conversations with the pet owners to sustain these new behaviors?

• In my specific role, how do I help lead our adoption of a health risk assessment?

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10 Lifelong Care

In defining the transition from transactional care to Lifelong Care, it is helpful to look at the difference in care from the pet owner’s perspective. Examining the “before” and “after” versions of an everyday scenario will help your team think through the reasons why making the change is worth the effort.

Before: Transactional Care “Well, Mrs. Chlippo, that about does it. Cheeto is up to date on his shots, and I didn’t find anything unusual in my examination. He’s looking great.

We’ll run the blood tests and stool sample and let you know if anything shows up. He’s due for a dental cleaning in 6 months, and we’ll give you a call to schedule that when we get closer to the date. Meanwhile, keep him on the flea/tick and heartworm preventives; you can pick them up at the front desk . It ’s $129 plus the preventives; they’ll talk to you about that up front. Thanks for bringing him in.”

Many pet owners call the veterinarian only when something is wrong with their pet or in response to a vaccination reminder.

Owners may feel that the visit intrudes on their free time. They walk away from a quick exam and some shots with a bill and, possibly, a sense that they paid for more than they received. In this scenario, pet owners experience veterinary care as a transaction rather than as a valuable relationship.

After: Lifelong Care “Mrs. Chlippo, thank you for bringing Cheeto in to see us today! We want to share with you some new tools that will help us care for Cheeto even more effectively. Our goal is to give Cheeto the longest, happiest life possible, so we want to focus on preventing illness or injury, not just treating it when it happens. Because of that, we would like to have you help us capture a complete picture of Cheeto’s health, environment, and lifestyle. As in human medicine, anything we catch early can be treated much more successfully, more inexpensively, and less painfully than things we catch later. So we want to make sure we proactively look for anything that might be a risk for Cheeto’s health. Here’s how you can help us do that for him…”

This pet owner receives a complete health risk assessment (HRA) for Cheeto. She understands what the information means and how the practice will use it to stay in front of Cheeto’s health. Imagine how that experience compares with Mrs. Chlippo’s previous, transactional experience.

Discuss as a team: • Which outcome is better for the pet? …for the pet owner? …for the practice?

• How can we make the client experience before, during, and after the visit be more valuable for the pet and the owner?

During this discussion, your team may offer ideas you had not anticipated. Fold the good ideas into your change process. Letting others shape the change motivates them to own it.

HRAs work only to the extent that pet owners adopt them.

While the Pet Wellness Report (PWR) supports a more proactive, lifetime of care approach, it will not, by itself, change pet owners’ behavior or help grow your hospital.

That will happen when pet owners have a new perspective on how they partner with you to care for their pet. Changing your own behavior, through a different kind of discussion, will be the catalyst for helping pet owners to change theirs.

If you don’t believe, neither will they.

The answers to these questions are likely to evolve over time as understanding and perspective grows.

Don’t just ask such questions once, but continue to ask throughout the weeks and months it takes to make change habitual.

Culture Culture might best be defined as the set of habits and attitudes that currently exist within a hospital.

Habits and attitudes are hard to change, but with effort and a plan we can succeed. For change to succeed, team members will need to think differently, interact in new ways, learn new skills, create new processes, and tolerate some initial discomfort. Give careful thought to how the culture must shift to execute the new strategy or focus.

Consider these topics: • What in our current culture needs to change for us to implement Lifelong Care?

• What cultural tendencies will get in our way as we try to make this shift?

• What habits do we need to change to succeed with this implementation?

• How can we support one another through the transition?

Leadership If you want employees to behave differently, you must lead the charge. Change fails when leaders continue “business as usual” while expecting staff and clients to behave in new ways. Employees model their leaders, and “do what I say, not as I do” erodes a leader’s credibility.

On the other hand, leaders who define and execute their own set of

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Enhancing Preventive Care 11

new behaviors can be a catalyst for change and growth.

Set aside some time for the leadership team to discuss: • How will team leaders behave differently to model and support the transition to Lifelong Care?

• What activities could appear as not “walking the talk”?

• What leadership actions might give permission for people to resist this change?

Coaching Ultimately, practice-wide change comes down to individual change. Coaching helps individuals adapt quickly, build skills and capabilities, improve performance, and achieve results. If you are trying to drive organizational change without effectively coaching your change agents, then your chances of success are dramatically diminished. Plan your coaching campaign around these areas of concern: • Are we having conversations throughout the practice that help promote, clarify, and support language and actions consistent with Lifelong Care?

• How will we help people align their individual goals with this change?

• What kind of discussions can break through resistance and create commitment to adopting a health risk assessment (HRA) like the Pet Wellness Report?

Structure As a hospital evolves, its structure must evolve, too.

Silos and turf wars that develop over time can remain unnoticed until a significant change brings the dysfunction to light. Altering the structure of teams or team leaders is one way practices can break down communication silos and facilitate collaboration.

A fundamental shift, like the one from reactive to proactive care, provides an ideal opportunity to strengthen your practice’s structure. Practice owners and managers must decide how the practice should be built to maximize success, answering questions like: • Does your organizational structure support or hinder a model of Lifelong Care?

• Do the staff and meeting structures facilitate learning and communication across teams?

• What kind of training structure would best support implementation of an HRA like the PWR?

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12 Lifelong Care

Process A process is a series of steps that we take to accomplish a goal or produce a specific result. Protocols, diagnostic or treatment algorithms, workflows, standard operating procedures: these are some of the tools we use to work efficiently and avoid errors. The problem is, those very tools can create obstacles to change.

Some practices want to operate differently, but they cling to processes that prevent changes from taking root. To ensure that your practice’s processes align with the results you desire, analyze your assumptions: • Which processes need to shift to support a culture of Lifelong Care?

• Are there conflicts between processes we currently use and the new message we are trying to send to staff and clients?

• What about our • exam process?

• check-in and check-out process?

• appointment-scheduling process? (For example, do 15-minute appointments allow meaningful discussion and relationship building; or, do initial HRA appointments need to be longer?)

Talent There is a strong link between your vision for the practice and who you hire to help you get there. Do you recruit new employees using yesterday’s philosophy while trying to build tomorrow’s practice?

When you are committed to change and growth, hiring is not just about the candidate’s skills and experience but also about how they adapt to change, whether they generate new ideas, and how much passion they bring to client service and pet care. That’s true for existing staff too. Use the following questions to evaluate your staff and potential new hires: • Are your people currently capable of treating pets from a Lifelong Care perspective?

• Even very talented people need training and tools to be effective in supporting a change process. What training and tools do your team need?

• Are we recruiting new talent through this lens and looking for new hires who are committed to a proactive approach to medicine?

You are the cheerleader of change!

Step 3: Commit Changes of any magnitude will always lose momentum as they evolve from a new idea to an organization-wide change. Don’t quit! Any sign of wavering leadership commitment will tell the practice team that it is okay for them to back down, alter, or stop the change. As leaders and managers, it is critical that we push through the tough times and lead people through the change with us.

Here are some ways to push through a lull: 1. Expect it, be ready for it, and commit your team to getting through it. (See page 8.)

2. Proactively work with individuals who are struggling with change, and keep encouraging the entire team.

You are the cheerleader of change!

3. Set the example by doing things that demonstrate your own commitment to the change. The leaders will struggle too. Don’t hide those struggles; use them to show the team your commitment to continuous improvement.

4. Revisit again and again why the change is important and refocus on how it will help the pet, the pet owner, and the practice.

Step 4: Support Supporting your practice team is critical if you want to build new habits and patterns that align with the change you wish to create. Any new behavior takes practice

and repetition. As leaders and managers, our job is to create opportunities to coach staff so they can practice, improve, and perfect their new behavioral habits.

Encourage, promote, and reward those who are leading the change, and work one-on-one with those who need help overcoming change obstacles. Providing in-the-moment feedback and coaching is critical when building confidence and competence within a fragile new culture.

Step 5: Sustain When perspectives have shifted and new behavioral patterns emerge, the transition is underway. New individual behaviors can take hold and transform the culture throughout the practice.

As new employees join the team, they see these behaviors not as new but as standard practice. Managers take steps to ensure that new hires and staff who continue to work in the practice are committed to sustaining this new vision and achieving all of the benefits that inspired the pursuit of it in the first place.

Staff support never ends. Coming from other backgrounds, new hires may require training and mentoring to grasp new concepts and practices around Lifelong Care, the PWR, and compassionate communication. Existing staff will benefit from refreshers as well as the process of sustaining success continues.

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Quiz What is your Change IQ? What have you learned about behavior change?

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To impact change most effectively…

A. the leader(s) need B. the leader(s) need C. the leader(s) need drive the change.

D. the leader(s) need the new way.

to model the change. to tell others how to change. to develop a new policy to to hire all new staff to train

Behavior change is most likely to occur if…

A. financial incentives are offered.

B. people read, see, and hear about the change in multiple ways.

C. people think they will lose their jobs if they don’t change.

D. people feel a positive, personal connection to the change.

Answers

1. a. Among the many things leaders may do to impact change, they first and foremost must model the change they wish to create.

2. d. Change is most likely to occur (and last) when it helps people achieve or participate in something they feel good about: a personal goal, a better lifestyle, a new opportunity. Finding

3

The first step in creating change is…

A. align B. define C. commit D. sustain E. support

ways to tie the change efforts to individual values and goals, such as “make a difference” or “promote pets’ Lifelong Care” will help sustain the momentum when unexpected challenges arise.

3. b. Define is the first step is creating change. If people know where they are going and feel a part of the definition of future success, they are more likely to embark on the change journey.

4. False. To drive change, align these eight

4

True or false: To lead a practice through change, we must align the six vectors.

forces: communication, clarity, culture, leadership, coaching, structure, process, and talent.

5. False. Even the most consistent use of the PWR will not result in client follow-through unless your team’s conversations with clients change,

5

True or false: A health risk assessment (HRA) process such as the Pet Wellness Report (PWR) will prompt more clients to accept the veterinary team’s recommendations.

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14 Lifelong Care

too. The August issue of Lifelong Care describes a host of communication principles and tools that build a strong client relationship and commitment to a more proactive, lifetime of care approach to their pet’s health. (Access it online at aahanet.org/ Library/Lifelong_Care_Resources.aspx.)

Measuring Success

It’s easy to believe your change process is a success. Measuring results proves it.

What would measurement look like if our goal is to change the way our practice team and clients think about proactive pet care using a health risk assessment (HRA) process like the Pet Wellness Report (PWR)?

Establishing targets and measurements early in the change process helps our team focus on the goals and track individual and group progress. Early successes will keep team members engaged in the change process and create excitement and momentum. This is especially true when we have laid the groundwork by helping our team connect to the importance of the change in the first place.

Any time we look at change success measures we should consider both inputs and outputs. Too often, businesses look only at outputs. Because inputs determine outputs, however, measuring results begins with inputs. Here are some sample measurements for shifting your practice and clients to Lifelong Care:

Inputs

Outputs

Measures of success for individuals: • What do we say at check in?

• What do we say prior to the exam?

• What do we say during the exam?

• What do we say at check out?

• What open-ended questions can we use to demonstrate the value of the HRA to the pet owner? (Examples: Tell me if anything surprised you on Benny’s Pet Wellness Report results. You indicated on the report that you missed some heartworm doses. What challenges did you face?) Practice will allow each team member to find his/her own words and voice.

What other outputs can you think of that would be helpful to measure or that you can access from your current record keeping system?

Has everyone practiced their part of the Lifelong Care conversation? Good measurements include an individual’s ability to demonstrate comfortable, confident, and effective answers to the following points in the service process.

Remember, don’t look for perfection; look for growth each week. For team training ideas, see the August issue of Lifelong Care Caring Conversations, aahanet.org/Library/ Lifelong_Care_Resources.aspx.

Measures of success for the practice: • How many pet owners did we touch with a Lifelong Care conversation this week?

• How did we improve our ability to have Lifelong Care conversations this week? What specific improvements did we make?

• What roadblocks to implementing the HRA did we overcome or address this week?

What other inputs would help you to measure your team’s success in implementing this change?

• What success stories can we share from this week regarding our change process?

• What percentage of this week’s wellness visits included a PWR? • What is the increase in the number of [specific laboratory tests] performed since we implemented the PWR? • How many times has proactive testing helped a pet by catching a “hidden” disease or condition?

• What percentage of your clients are completing the PWR questionnaire?

• What pet owner observational and lifestyle findings are being addressed? What impact is that having?

• What are your clients saying about the PWR? • What is the difference in revenue per pet for pet owners committing to the PWR versus those that don’t?

• What is the impact on social media reviews (Yelp, etc.) and other word-of-mouth marketing?

Conclusion Change is not easy, even when it is done for the right reason. Planning for change, following a process, and committing to it as leaders can make all the difference. There is no growth, no improvement, and no success without change. Learning to do it well can create a more positive future for our practices, our profession, and the pets we serve.

Your Zoetis representative can help you get up and running with the PWR and help you keep the momentum going.

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The American Animal Hospital Association is an international organization of nearly 6,000 veterinary care teams comprising more than 48,000 veterinary professionals committed to excellence in companion animal care. Established in 1933, AAHA is recognized for its leadership in the profession, its high standards for pet health care, and, most important, its accreditation of companion animal practices. For more information about AAHA, visit aaha.org.

Lifelong Care Web Conference Series: Your Path to a Sustainable Lifelong Care Initiative Lifelong Care: A Path to Better Patient Health

Zoetis (zō-EH-tis) is the leading animal health company, dedicated to supporting its customers and their businesses. Building on a 60-year history as the animal health business of Pfizer, Zoetis discovers, develops, manufactures, and markets veterinary vaccines and medicines, with a focus on both farm and companion animals.

The company has more than 9,300 employees worldwide and a local presence in approximately 70 countries, including 29 manufacturing facilities in 11 countries. Its products serve veterinarians, livestock producers, and people who raise and care for farm and companion animals in 120 countries.

Lowell Ackerman, DVM, DACVD, MBA, MPA, shares a new approach highperforming practices use to increase client visits and improve patient health today and tomorrow. bit.ly/1w5DXdJ

Driving Lifelong Care with Pet Health Risk Assessments (HRAs) Reap the benefits of HRAs. Karen Felsted, DVM, MS, CPA, CVPM, explains how to easily implement these lifelong care tools in your practice. bit.ly/1temiwQ

Lifelong Care: Essential Skills to Communicate Value and Drive Compliance Carol Barton, DVM, MS, of frank™ fame, shares the secrets of getting clients on your side with compassionate communication. bit.ly/1pIojQH

Continuing your Lifelong Care Initiative Randy Hall, discusses how you can sustain your practice’s Lifelong Care initiative. bit.ly/1DtAQxu

References

1. State of the Industry reports, American Animal Hospital Association, 2013, http://bit.ly/1u7PfN6, and 2014, http://bit.ly/1o9CESo. 2. “Leading Through Influence,” by Randy Hall, 4th Gear Consulting, 2014, 4thgearconsulting.com/leading-through-influence-workshop.

3. “It’s Time to Change the Way We Change…,” by Bethany Swartz, 4th Gear Consulting, 2014, 4thgearconsulting.com/blog/its-time-to-change-the-way-we-change.

4. Change or Die, by Alan Deutschman. (HarperCollins, 2009), bit.ly/1nAKEk2.

5. The Brain That Changes Itself, by Alan Deutschman (Penguin, 2007), bit.ly/1eBxoAB. 6. Professional observation, Randy Hall, 4th Gear Consulting.

7. “People don’t resist change. They resist being changed,” The Fifth Discipline, by Peter Senge (New York, Currency and Doubleday, 1990), p 155.

8. “It’s not true – people don’t resist change,” Wilson Perumal & Company Blog, bit.ly/1ohtani.

9. The 8 Vectors of Organizational Change, by Randy Hall, 4th Gear Consulting, 2014, 4thgearconsulting.com/organizational-change.

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