The importance of the whole practice team in client communication

The importance of the whole practice team in client communication

Successful delivery of veterinary care relies on much more than clinical skills and expertise. Effective teamwork and communication are crucial; both can immediately and positively affect patient outcomes and client perceptions. How you communicate in practice plays a central role not just in the outcomes you achieve for your patients and clients but also in how you experience your workplace with important consequences for your enjoyment and wellbeing at work. But communication in practice is a more complex activity than two people talking to each other. 

Take a few moments to think about Fred. Fred is a three-year-old Labrador who has been brought into the practice vomiting. You take a history from Fred’s owners and examine Fred. You think he might have an intestinal foreign body, you explain this to his owners, admit him and get started. Over the next three to four hours, you perform diagnostics, confirm he has a corncob stuck in his small intestine, perform an enterotomy to remove this, get him settled into his kennel for recovery and update his owner.

Think about the number of people you communicated with to co-ordinate Fred’s care and the different ways in which you communicated. Here’s a few you may have thought of:

  • A written consent form completed in discussion with his owner
  • Dosages of drugs on an ops board
  • Post op care instructions on a hospital sheet
  • A scribbled note to reception staff asking them update Fred’s owner halfway through the op

Now consider how many times a misunderstanding or a miscommunication might have led to a mistake that could have impacted Fred’s care or resulted in a complaint from his owner. These misunderstandings or miscommunications can happen despite our best efforts and intentions; and, can be made more likely by lots of factors. In Fred’s case maybe you were short staffed leaving insufficient time for you to handover before returning to consults, maybe there’s a strong hierarchy that inhibits clear and open communication between veterinary team members, perhaps it’s something as simple as the printer being broken so there are no hospital sheets; the list goes on. 

This is what communication in practice really looks like. It’s messy. It involves lots of people, communicating in different ways and the effectiveness of that communication can be impacted by many things outside your individual control. Understanding this messy reality is crucial if the professions is going to ‘fix’ the problem poor communication can pose.

Delivering veterinary care is a team sport and with practices getting busier and the procedures and care delivery getting more complex, focusing on how you communicate and work as a veterinary team is crucial.

Uncovering the 'messy details' of veterinary communication

We know that communication does go wrong and can impact patient outcomes in practice. A piece of research1, conducted by VDS Trainer Elly Russell, analysed 100 VDS cases of alleged professional negligence involving canine veterinary patients and found that communication played a contributory role in 80% of cases. In most cases, more than one communication problem was identified, and these problems tended to be interdependent. Over half of the communication problems involved communication within and between veterinary team members and could have resulted in delayed treatment, patient harm and even patient death.

So, effective team communication is crucial in preventing mistakes and patient harm in practice and the creation of safe, high-quality outcomes for patients and clients. But when mistakes happen in practice, it also impacts practitioners and their teams. Veterinary professionals involved in mistakes in practice report emotional distress and fear about the consequences of being involved in a mistake. This distress and fear itself may lead to less open, effective communication in practice, potentially contributing to a viscous cycle leading of poor workplace culture, increasing vet stress and even vet burnout.

There is, therefore, a strong argument for focusing on the messy reality of how veterinary teams communicate in practice, but this can be hard for a couple of reasons. Firstly, there tends to be an individualist orientation to communication and competency. Communication is a core competence in several regulatory frameworks including RCVS Day One competencies. Individuals are recruited, trained and assessed, not teams and there may be a tendency to think that competency is stable and independent of context: if you are a competent communicator on one day, you will be on the next; if you communicate effectively in this team, you will communicate effectively in the next. It is harder on a practical level, to train veterinary teams than it is to train individuals, so we don’t tend to do it as much.

The second is that it can be harder to focus on system level issues that impact how we communicate in practice, rather than individuals skills.  

How do we organise our work? 

What work processes do we use? 

How do we make sure that information and knowledge is where it needs to be when we have lots of people potentially working in different places or out on the road?

Do we all have a shared mental model of how we communicate and collaborate to deliver safe, effective care? -Re-organising work processes, even redesigning our buildings or how we use them to optimise communication; and giving veterinary teams the time to reflect and consider how they can optimise the way they communicate with each other could all help but might feel harder to tackle than focusing on how one individual communicates.

So, what can you do? Simply taking some time to consider how you communicate as a team is a great place to start, even better if you can do that together as team! Ask people what’s working, what helps smooth the cogs and what gets in the way of good team communication. Steer your conversations towards those system issues to identify some ways you can create a work environment where everyone feels able to contribute and communicate effectively. There’s a great opportunity to deliver better care, improve client satisfaction and have a happier practice team if you dig into how your practice might be set up to better support teams to communicate more effectively.

What can you do?

  • Start to think about effective communication as something the whole practice achieves together, not something one individual engages in in a consult room with a client
  • Stop, take time together to notice how you are communicating
  • Ask yourself what's getting in your way as a team
  • Think about what you need to do to make it easier to collaborate and communicate effectively
  • Consider what might stop you making those changes.

With workloads high and teams under pressure, it can be hard to find the time, but it is important to prioritise time for your veterinary teams to explore and improve how they communicate with each other. If you don’t, the consequences could be poorer outcomes for your patients, unhappy clients and, importantly, an unhappy team. 

Practice Culture Survey

In 2021, the VDS Training team supported over 40 practices by running in-practice Culture Surveys to help them measure, review and discuss the culture of their team, as well as implement changes to help improve team dynamics and veterinary wellbeing.

With a specialist focus on communication, VDS Training also offers a range of courses, coaching and bespoke training to support and develop you, your veterinary team and the wider veterinary profession, so you can focus on the animals in your care.

Visit the VDS Training website to explore our range of courses, workshops and e-learning programmes, or get in touch with us on +44 (0) 1565 743862 or email info@vds-training.co.uk.

Notes

VDS Training Services Limited (trading as VDS Training) is a wholly owned subsidiary of The Veterinary Defence Society Limited.

1Russell, E, Mossop, L, Forbes, E, Oxtoby, C. Uncovering the ‘messy details’ of veterinary communication: An analysis of communication problems in cases of alleged professional negligence. Vet Rec. 2022; 00e1068. https://doi.org/10.1002/vetr.1068

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