Continuity of Care—The Client’s Perspective

You have asked…

What are clients’ expectations for continuity of care?

The expert says…

From a client’s perspective, continuity of care is important because it builds trust and increases satisfaction. It assures pet owners that their pets are receiving great care even after they leave the veterinary hospital.A Shared ResponsibilityClients see continuity of care a little differently than practice team members see it. Team members may feel that continuity of care is primarily their responsibility. Clients, on the other hand, see continuity of care as a shared responsibility between themselves and the practice team. They would like to do their part in helping to keep their pets healthy.

Clients want their pet’s condition and plans for care explained to them when they visit the hospital. They also want to know how to care for their pets once they bring them home, as well as what to watch for and when they should call for help. When clients contact the veterinary hospital, they expect knowledgeable team members who are familiar with their pet’s case to be available to help them when they have questions. It is also reassuring for them to know that team members will recognize when a situation requires the veterinarian’s involvement.Every Experience CountsFrom a client’s perspective, continuity of care is built on their interactions with practice team members and how well team members communicate with them. Client perceptions are shaped by things such as:

At the Veterinary Hospital• Was the client given laboratory results on the same day that tests were run (when possible) and did the doctor who ordered the tests discuss the results with them (which allows the results to be explained in the context of the pet’s condition and the client’s specific concerns)?

• Were all medications dispensed and other recommendations (eg, scheduling a followup appointment) discussed before the client left the hospital?• Did a knowledgeable team member go over the written discharge instructions on how to care for the client’s pet at home in case there were any questions? In addition, did they receive instruction on how to administer medications, supplements, or food?• Was the bill accurate and did the client understand the charges?

At Home:• Did the client receive a postdischarge call at home to follow up on how the pet was doing?• Were appropriate reminders for follow-up appointments and laboratory tests made in a timely fashion?• If the client called the hospital, were questions and worries met with appropriate concern? In addition, were phone calls returned and laboratory results communicated in a timely manner?• Were requests for prescription or diet refills handled by the client’s preferred method of communication (eg, telephone or email)? And did all of these communications occur in warm and genuine ways; not by people who were just “doing their jobs” but by people who showed they cared about the client’s pet?

More Than Just MedicalEach time a client has a positive experience with a member of the veterinary team, it reinforces the feeling that you are providing a safety net as the client tries to continue the care begun at the veterinary hospital. Therefore, even if continuity of care is good from a veterinary perspective (eg, complete and accurate records for others to use for follow-up, patient rounds that take place at shift change), it is crucial to set continuity standards that meet client expectations as well. This not only ensures good service, but creates a high standard for both pet and client care.

Do It RightKeep in mind that, from a client’s perspective, it is not enough to do all of the right things. Things need to be done in the right way as well. For instance, what do your discharge instructions look like? Are they blurry copies that have things crossed out and handwritten notes scribbled in? Wouldn’t it be better if the discharge instructions were printed on the hospital’s stationery and customized with the pet’s name and pertinent information?

It is also important to understand that clients pay attention to how things are said, not just what is said. If someone is rushing through discharge instructions and clients don’t have a chance to ask questions, they will perceive that they and their pets are not important to you—even if the surgery or treatment was a complete success.

Building RapportContinuity of care means not only providing the information clients need to take care of their pets and feel supported, but doing it in a way that builds rapport and trust. This is not just the veterinarian’s job—clients expect all veterinary team members to be able to answer their questions, even if the answer is, “Let me check with the doctor on that.” Team members need to know it is okay to tell clients that they will find out as long as they follow through and get the answers they promised.

Asking “What are clients’ expectations for continuity of care?” gives practitioners the perfect opportunity to step back and look at the practice from the outside in: What ways do clients experience veterinary medicine differently than the people that work inside the practice? What do clients need from veterinarians and their teams to feel included in the circle of care provided for their pets? Once you answer these questions, you’ll be able to provide care that meets your clients’ highest expectations.

Going with the FlowClients like to talk to someone at the veterinary hospital who is familiar with their pets. This can be difficult in multidoctor practices where patients are not always seen by the same veterinarian. Here are some suggestions to help maintain continuity of care and a seamless practice flow:

• Give same-day results, when possible: Providing as much information as possible during a visit helps keep the primary doctor on top of a case and provides clients with timely, important information about their pet.• Avoid phone tag: Running laboratory and other diagnostic tests in-house while clients wait helps eliminate “phonetag” associated with contacting clients at a later date.• Ensure easy access to patient files: Going digital helps eliminate headaches when tracking down files. Otherwise, they can be easily “lost” on another doctor’s desk, in a call-back bin, or any multitude of places within the hospital.• Keep files updated: Meticulous recordkeeping, including notations for phone calls and case management plans (eg, “if this develops, then consider plan x”), will help ensure that anyone who picks up the file will know precisely what is going on with each individual case and what the long-term management plans are.