Team Meetings, a route to a successful practice.

In my experience the institution of regular, productive team meetings has met much resistance in practice. There are many reasons for this; they are not commonplace at this time, there is pressure to be generating revenue at all time, everyone in practice thinks that they are too busy to spend time in meetings, there is little guidance relating to veterinary practice on how to run meetings. This not an exhaustive list, I am sure that everyone reading this will be able to come up with a reason (or is it an excuse?) why meetings cannot be done. But regular team meetings are a vital tool in keeping every member of the team involved in the efficient running and improvement of the practice. Without meetings, leaders struggle to lead their teams, team members do not feel valued or listened to, team members have no idea of what direction the practice leaders want to take and if their values are compatible with their leaders, an “us and them” culture is created, there is no opportunity to learn what works and what is not working, and when there is an issue there is no structured approach to investigate and learn from it.

The first step that is required is the scheduling of a team meeting at a suitable time in the working day. A time when the consultation list tends to be quieter so the diary can be blocked off and the meeting scheduled into the diary for that day. This blocking of appointments must not be seen as taking time away from revenue generation, the benefits gained from meetings will be seen in a happier, more productive team, better work up of cases and better communication within the team and with clients.

An agenda must be made along the lines of 

  • A review of the last meeting including progress on any actions agreed on.
    • Clinical audits in which what has worked well and what has not, and what can be learned.
    • Discussion of any significant events in a “no blame environment” (to encourage an honest discussion of any difficulties that any team member is having).
    • Implementing, reviewing and modifying protocols.
    • Discussion of client feedback.
    • Agreement on actions required and assigning responsibility of these actions to the appropriate staff member. 

This agenda must be circulated to all team members well before the meeting. When everyone knows what is going to be discussed they can prepare their thoughts prior to the meeting. 

Approximate timings of how long agenda items will be discussed for can be made, and the meeting scheduled to last no more than 1 hour.

Suitable food and refreshments need to be ordered.

All team members who are working that day at the time of the meeting are to be invited. This may involve diverting phones to other branches during the meeting or assigning a team Diverting the phones to another branch or assigning a team member to answer the phone whilst the meeting is going on. It is important that it is not the same team member who is asked to answer the phone every time. It is also important to recognise that some team members will not be available to attend and it may be a good idea to alternate the day of the week that the meetings take place to allow for days off.

Stick to the agenda and timings. Have someone take notes which can be circulated to all team members after the meeting.

There are some resources available to help structure team meetings. The best one that I have found that is specific to veterinary medicine, all be it related to practice and America can be found at:

There are two items on the meeting agenda that I would like to talk about now, significant events and clinical audit.

A significant event is when something unexpected happened with a view to understand how it happened, what can be learned from the event and what measures must be implemented to prevent it from happening again. All the information and resources that are needed to understand significant events, how to log them, how to investigate them and how to discuss them with your team can be found at:

https://knowledge.rcvs.org.uk/quality-improvement/tools-and-resources/significant-event-audit/

To progress as an effective practice, it is vital that we learn the lessons that these events can teach us. This must be done in a “no-blame” environment, it is not a witch hunt, it is a process to allow us to understand all of the circumstances that led to the event, and to put in place processes that are designed to stop it happening again. Mistakes happen, unexpected results happen, what must not happen is that we fail to learn from them, and they are repeated. I strongly believe that having a structured logging, investigating and learning process in relation to significant events, a process that allows us to feedback to clients when appropriate goes a long way to making team members feel valued and clients to be reassured that we are committed to providing the best service to them that we possibly can. In turn this helps to retain both staff and clients which helps the practice grow and develop.

Clinical audit allows as to measure the success of our treatments and procedures. It is a tool that enables us to measure improvement of our treatments and procedures, which ones work best and most consistently. It helps identify what further training is required so allows more focussed CPD for our staff. It measures our performance against other practices in the country. All the information and resources that are required to understand and undertake clinical audit can be found at:

https://knowledge.rcvs.org.uk/quality-improvement/tools-and-resources/clinical-audit/

Clinical audits can be assigned to anyone in the practice, a process made easier if appropriate codes are set up in practice management systems, such as grades of post-operative complications, to enable quicker gathering of information, and so give an opportunity to any team member to be involved in the improvement of the quality of care that the practice offers.

Team meetings open and maintain channels of communication, provide and “no-blame” environment to discuss significant events, and to monitor and improve the quality of the services that we provide. They will boost team morale helping to retain staff members and facilitate their development. They will improve the service that we offer our clients, giving us material to present to them to show our commitment to offer their pets the best treatment that we can. All these are big wins for blocking off an hour a week in the diary.

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