What Keeps Hospital Leaders Up at Night (and What To Do About It)?

by | Jan 14, 2025 | Veterinary Practice - Views, Views

Animal Health Views - Hospital Leaders

In November 2024, the VHMA released survey results gleaned from asking hospital leaders “What keeps you up at night?” While answers ranged from decreasing client visits to profitability to the election, the top three concerns, by a wide margin, included:

  1. Reduced client visits
  2. Staff dependability/reliability
  3. Shortage of staff (credentialed technicians)

For those of us “in the trenches,” these probably don’t come as a surprise and there has been a lot published recently around these topics, including helpful guidelines from AAHA, AABP, and AAEP around better leveraging the credentialed technicians we do have. Realizing these resources exist, this blog will focus on being “brilliant in the basics,” highlighting practical and often simplistic solutions that many of us may be aware of, but are not yet implementing in our hospitals.

Tackling Decreasing Client Visits

Declining client visits stem from various factors, including economic pressures (and their impact on pricing; I touched on this in depth in December’s blog post), increased competition, and a lack of perceived value in Veterinary services. Addressing these factors requires a multifaceted approach.

  1. Enhance Client Education & Outreach – Educated clients are more likely to prioritize Veterinary visits. Use platforms like newsletters, social media, and in-clinic materials, supported by a team-based approach to education, to emphasize:
    1. Preventive care benefits: Stress the cost-saving and health advantages of regular check-ups. Another recent survey suggests pet owners perceive a gap on many hospital websites between the services being listed (almost all hospitals have that list in one form or another) and the actual benefit provided to their pet.
    2. Value propositions: Highlight your hospital’s unique services, such as advanced diagnostics or personalized care, with an emphasis on the benefits.
    3. Automated reminders: Reduce no-shows with text or email reminders whether through your PIMS, a third-party vendor, or even the old school postcards if that what resonates best with your clientele.
  1. Optimize Appointment Scheduling – We live in a world where most people want what they want, and they want it now.
    1. While more hospitals are moving to providing online booking options, many hospitals have not yet truly evaluated whether this might be a helpful benefit for their clientele.
    2. Telemedicine options: Virtual consultations can capture clients who may skip in-person visits. For detailed suggestions, pick up any recent edition of Today’s Veterinary Business or AAHA’s Trends Magazine (which is going digital only this year) for more insight.
    3. Flexible hours: Extended evening or weekend hours accommodate busy schedules. This one sounds like a potential no-brainer (if you can figure out how to staff it), but buyers beware that extended hours aren’t just moving clients who would have booked during the day to booking in the evening or weekends. I’ve seen some hospitals that have tried this and picked up minimal new clients or appointments; they just simply saw a shift in when existing clients, who would have booked anyway, scheduled their appointment. Consider a client survey to test the demand and be sure to track any impact in overall appointment booking capacity and new client numbers if you choose to try this.
  1. Strengthen Client Relationships – Personal connections build loyalty. It’s as simple as that. Foster them by:
    1. Personalized communication: Follow up after visits with thank-you notes or reminders.
    2. Community engagement: Host pet wellness workshops or sponsor local pet events to stay visible and approachable. This one can be a slippery slope (as hospital leaders, we all already get hit up by many local organizations seeking sponsorship). While I am a fan of supporting the community, I encourage leaders to create some parameters:
      1. Given the hospital brand and mission, what types of events/organizations most closely align with the hospital’s brand and are likely to reach clients who want what that hospital offers?
      2. Craft a budget to inform spending behavior.
      3. Look beyond just typical “sponsorship.” At one of my hospitals, we’ve reduced (though not eliminated) traditional sponsorship in favor of team members serving on local boards and at community events. We’ve found that getting our team facetime with the community has been more valuable than just paying to have our logo stuck somewhere.

Improving Staff Dependability

High absenteeism or turnover often stems from poor management, poor morale, inadequate training, or lack of recognition. Addressing these requires a focus on workplace culture and employee satisfaction.

  1. Cultivate a Positive Work Environment – A healthy workplace culture promotes dependability. Focus on:
    1. Open communication: Regular team meetings encourage transparency and feedback. If you’re like me and you have the best of intentions around this, then get busy. While things will pop up and a meeting may have to be rescheduled, we do our best to hold regular, scheduled staff meetings, complete with a printed agenda, clear objectives and time dedicated to ensure future “action items” are identified, owned by someone, and have a deadline. We’ve noticed a positive impact to our culture (and patient care and operations and financial heath).
    2. Recognition programs: Celebrate staff achievements through awards, bonuses, or simple acknowledgments.
  2. Provide Professional Development – Investing in staff growth fosters commitment. Offer:
    1. Continuing education opportunities: Cover the cost of courses or certifications. While this is pretty standard for veterinarians, many hospitals overlook management and their support staff. Whether it’s through a large conference or the plethora of online CE, consider discussing this in your annual goal-setting meetings with each team member, allowing you to build out a schedule and ensure it aligns with your budget.
    2. Cross-training programs: Help team members expand their skill sets, increasing versatility.
  3. Implement Clear Expectations – Ambiguity in roles can breed disengagement. Establish:
    1. Detailed job descriptions: Outline specific duties and performance metrics.
    2. Accountability frameworks: Use tools like performance reviews and goal-setting sessions.

Addressing the Shortage of Credentialed Technicians

Credentialed technicians are leaving the profession due to low pay, limited career advancement, and workplace stress. Addressing this shortage involves improving recruitment and retention strategies.

  1. Enhance Compensation and Benefits – Competitive pay and benefits attract and retain top talent. Consider:
    1. Market analysis: Benchmark salaries to ensure competitiveness.
    2. Comprehensive benefits: Offer health insurance, retirement plans, and paid time off.
  2. Build a Strong Technician Pipeline – Collaborate with educational institutions to attract new talent:
    1. Internship programs: Partner with vet tech schools to provide hands-on experience.
    2. Scholarships and sponsorships: Support students pursuing Veterinary technician careers.
  3. Promote Career Advancement – Every team has “rock stars” and “super stars.” I’m currently reading “Radical Candor” (which I’ve found to be a really insightful book for leaders), and the author defines rock stars as employees who are solid as a rock, but may not be seeking expanded roles or titles. Super stars, on the other hand, are driven by the opportunity to climb the ladder. As leaders, it’s important to know who your rock stars and super stars are, so that you can offer them the opportunities. To that end, I’ve had luck with:
    1. Leadership tracks: Develop pathways for senior or supervisory roles, or even the opportunity for a team member to “champion” a specific topic important to your practice – oral health, nutrition, etc.
    2. Specialization options: Support certifications in areas like anesthesia, dentistry, or behavior.
  4. Improve Workplace Conditions – Supportive environments retain staff. Focus on:
    1. Efficient workflows: Use technology to reduce manual tasks and stress.
    2. Empowerment initiatives: Involve support staff in relevant decision-making and hospital improvements.

Metrics for Success

Whether related to client acquisition and retention or support staff recruiting and retention, we can’t measure what we don’t track. To gauge the effectiveness of your strategies, track key performance indicators (KPIs) like these:

  1. Client retention/bonding rate: Measure loyalty through repeat visits. The national average, according to the VHMA is about 65% over an 18-month period.
  2. Client conversion rate: I was recently reading an article in Today’s Veterinary Business that estimates the average hospital only converts about 36% of clients calling a hospital to inquire about services.
  3. Appointment booking trends: Monitor changes in scheduling frequency.
  4. Employee turnover rate: Assess staff satisfaction and retention efforts.
  5. Technician utilization: Track how effectively credentialed technicians are used in their roles. I mentioned the recent technician utilized guidelines released from several associates in 2024 and all three have helpful resources in this area.

Moving Forward with Resilience

While decreasing client visits, staff dependability, and technician shortages present formidable challenges, they also offer an opportunity for growth and innovation. By focusing on client education, fostering a positive workplace culture, investing in professional development, and leveraging technology, Veterinary hospitals can not only overcome these hurdles, but emerge stronger and more resilient.