September 2009

Compliance: Taking quality care to the next level
John W. Albers, DVM and Thomas A. Carpenter, DVM

Abstract:

In 2009, the American Animal Hospital Association, supported by Pfizer Animal Health, conducted a national research project, combining surveys and interviews, to quantify practice team improvement of pet care compliance and examine pet owner adherence to recommendations and direction for dispensed or prescribed medications.

This study is documented in two AAHA publications, “Compliance: Taking Quality Care to the Next Level;” and its companion publication, “Six steps to Higher Quality Patient Care.”

Compliance: Taking quality care to the next level

The recently updated compliance study demonstrated that practices that have implemented compliance programs have significantly raised the bar for compliance in their hospitals. The common traits shared by many of these programs are listed below as six steps to higher-quality patient care.

Set the strategic direction

The improvement of compliance takes the commitment of the entire practice team. Leadership must provide very clear support of the initiative. The team will look to leadership to provide them with direction and any resources that are needed to succeed. This support may include continuing education, in-house training and a clear roadmap of responsibilities. Many practices have appointed a compliance advocate to champion the cause.

Gain team buy-in and align the organization

To achieve buy-in of the team it is important to include them in the initial strategic planning. This can be done in part by presenting the results of the original compliance study followed by the recently updated study. Hospitals that have achieved staff buy-in successfully focus on the quality of care. The passion that team members have for quality care allows them to share a clear focus on why it is so important to improve compliance. At this stage it is critical that all practice members agree to support this effort and understand their individual roles.

The best way to ensure consistent performance of all team members is to agree upon protocols and guidelines for the hospital. It is important that the goals are clear. Once again, this cannot be determined in a back room and then rolled out. To ensure success, the team members should assist in the design of these protocols.

Once the protocols are set it is time to set goals for the compliance program. The goals should be challenging but achievable. Remember that when a goal is reached it is time to celebrate.

Prepare for the client visit

The 2009 study revealed a common tool that has become an important aid to improving compliance: the compliance checklist. The checklist works best when put to use prior to the client’s visit. The checklist is based on the protocols and will guide the team members during the appointment. All team members will have agreed-upon roles in this process.

Educate and communicate with clients

In the original compliance study the greatest cause of failure was the lack of a clear recommendation. This is where education and communication come into play. It is vital that the client hears and understands the recommendation. For years we placed the blame on the client when compliance failed. We now realize that if we do a better job of education and communication then the bar of compliance is raised.

Communicating the need and the value of recommendations is critical. Clients may need to receive this information in multiple forms to allow them to make the best decision.  The study showed that hospitals that have designed multiple touches in multiple forms have the highest success with their recommendations. Again, this is where the checklist and defined roles are so important.

Follow up with clients

Follow-up begins before the client leaves. This is the time to schedule future appointments and procedures.

After the client leaves it is important to have systems in place to allow for tracking of recommendations. Reminder calls should focus on the patient’s needs without being too intrusive. Technology is available to meet the client’s expectations. Many practices allow the client to choose the method of contact.

Before the next visit, all recommendations are reviewed and if the client has not complied a plan for reintroducing the subject should be implemented. This is very important because if the recommendations are not repeated the client will question the importance of the recommendations.

Sustain the initiative

Team training must be ongoing to sustain the compliance improvement program. Periodic reporting of results at team meetings shows the continued support of leadership in the practice. Nothing makes a team more motivated than celebrating your successes.

Dr. Albers serves as AAHA Executive Director and can be contacted at john.albers@aahanet.org

Dr. Carpenter is the president of Newport Harbor Animal Hospital in Costa Mesa, Calif. He served as AAHA president in 2007-2008. He can be reached at tcarpdvm@cs.com

Questions or comments? E-mail EconNews@VetPartners.org.

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AAHA is the only organization that accredits animal hospitals throughout the U.S. and Canada. AAHA-accredited hospitals voluntarily choose to be evaluated on 900 quality standards that encompass all aspects of pet care — from patient care and pain management to team training and medical record keeping. Visit www.aahanet.org for more information.

© 2009 American Animal Hospital Association. All rights reserved.