029 - Dr Francesca Brown - Healthy Vet Professionals = Healthy Vet Clinic Bottom Lines

Part 2 (of 2) with Dr Francesa Brown on how to have a healthy vet clinic and a healthy bottom line.

Dr Brown covers:

• What KPIs to measure
• Where to start in supporting your team to be / get / stay healthy
• What questions to ask
• How to implement and how not to implement
• Johari Windows
• The real and true cost of staff turnover

She also asks for input / support / information as she gets ready to start her next research project.

VetStaff
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About DISC-Flow®
DISC is a research-backed and science-based personality profiling tool used to understand our behaviours, communication styles, and work preferences. It’s about understanding what makes you – and the people you work with – tick.

Julie South is a DISC Flow® Certified Trainer, who describes DISC-Flow® profiling as being like having a cheat sheet to better understand yourself and other people. When you know this, it helps you play to your personality strengths, work better in teams, and communicate better.

If you’re keen to find out what your personal DISC type is, what type of leader you are, or what your clinic’s team composition looks like, then get in touch with Julie to find out what's involved.

How to get more bang for your recruitment advertising buck
This is what VetStaff is really good at so if you'd like to stretch your recruitment dollar, please get in touch with Julie because this is something VetStaff can help you with.

How to shine online as a good employer
If you’d like to shine online as a good employer to attract the types of veterinary professionals who're a perfect cultural fit for your clinic please get in touch with Julie because thi...

Transcript

Julie South: 0:06

welcome to episode 29 of pores claws, and wit noses. The Kiwi veterinary sector podcast, celebrating all creatures great and small, and the fantabulous professionals. Who look after them all. I'm your show host Julie south. This is the second episode of the two part series with Dr. Francesca brown of the Otago Polytech. If you haven't listened to the first part yet, I highly recommend that you do that before you carry on with this episode, because this one kind of slots into that one, you can find the first part as episode 28 at paws claws, wet noses dot F M I'll put the show notes on, or put the link on this week's show notes as well. Uh, this week, Dr. Francesca carries on from where we finished up last week, we talk more about leadership KPIs to measure in your clinic and then help. And then the help that Dr. Francesca is asking of you as a clinic, owner, or manager for the next research that she's embarking on. If you're attending the combined fitness fair conference this year in Christchurch coming up pretty soon and June or the third week in June, 2021, be sure to register for her presentation as part of the business track. And if you haven't already please click the follow button on your favorite podcast channel so that you don't miss out on future episodes of paws claws with noses. They count for any podcasts that you're listening to follow, click the follow button. It doesn't cost anything to do that. An old vet told my father when he was a student in Glasgow.

The VetPodcast: 2:05

He said, if you want to be a success in veterinary practice, just keep the bowels open and just arrested. God. Nutrition is not an opinion. It's a science. They called me that weird herbal needle. That, and I, I just remember thinking. Well, I'm still gonna do it cause I know it works and I've got the research to back it from reminiscences of the real James Harriet son to Pete nutrition, to acupuncture the big podcast, discusses current animal health issues from around the world. I'm veterinarian Brian greeter from New Zealand, just search for the fit podcast. Wherever you get your podcasts from paws, claws and wet noses is sponsored by vet staff. If you've never heard of it, staff it's new, Zealand's only full service recruitment agency. 100% dedicated to the veterinary sector and Fitz staff has been around since 2015 and works nationwide from Kate, rehang it to the bluff and everywhere in between as well as helping Kiwis fit staff. Also hubs overseas, qualified veterinarians find work and art here, or New Zealand. Fit staff.co dot indeed.

Francesca Brown: 3:22

We actually saw it in the research with the employers so that they had it right. And the employer said, no, not quite. And so feedback is really, really important and regular feedback. There are surveys like gout 12, which is, you know, got. 12 questions, looking at wellbeing at different levels from the basic stuff. So it's kind of designed a little bit like Maslow's hierarchy, you know, where there's the basic needs and then up to really quite high performance areas. And you can use that, or I, uh, what I used and. The research I did is I designed a work environment survey based on what I'd been exposed to in education, but tailored it for veterinary practice. Then also particularly challenging areas and veterinary practice. But we know I imagined we're not looked at that against gout 12 later. It was a similar kind of thing as well. It was looking at basic, we basic needs been met trust in the team. Respect what, what's your feeling around leadership? And, you know, we think that the leadership's kind of transformation or is it dictatorial? That kind of thing. I looked at things like. Did they think that they were being paid enough to meet their own financial needs? So it's not about asking what people are paid. It's asking them are your needs being met because everyone's needs are different. And, you know, there's a certain amount level that people needed. And this was one thing actually in these three high-performing practices, and this is not an excuse to poorly pay, but that. They stripped practices still weren't performing that well on pay. It was about 60% agreement that they were being paid enough to meet their financial needs. And it was both fits. Uh, so the, the loss on how high they scored a that was beaten allied bitten professionals. It wasn't just the bitten professionals. So they didn't, they, they hadn't scored as well on that as everything else, they were well on the 80% and higher. Um, but looking at your basic needs, Respect, uh, I looked at position descriptions. Did they know what their job was? You know, those kinds of things. Did they think that they had a professional development plan that was helping to develop them, you know, or, uh, and you know, talking about funds and things to do that because one of the things with. Staff is one of the needs of staff has, is actually they need to have a pathway, some sort of professional development and practices would go, well, I don't need anyone more than that. So why would I bet it's not about that. It's about developing the person and making them feel valued. So I'm going to develop you make you feel valued. Maybe a position will develop there because of the skills that they grow into or do you know, it's okay to grow them out of your job. If you really don't want to grow your business and you want to sit here, why then grow that person out of the job and take someone else on, you know, It's the right thing to do. So I was looking at those sorts of things in the feedback, and then what we did was, you know, what I would do say if we were doing that on a regular basis is look at well, what were the things that were the poor scores that we could actually make the biggest difference on and go right here are three goals for this year. Not, not try and do 25 goals because it's not achievable. Choose the three that are going to make the biggest difference, but not as the boss, keep the team to choose what are the three things. If we're going to choose three things this year, Get a better score on what are they going to be, and then rerun exactly the same survey again, 12 months later and see did those things shift, but what our shifter cause sometimes. If one thing shifts, it'll shift other things too. So it's not, you know, it's not a click, you know, you don't just go, I'm just going to meet her those again. You've got to measure everything else's and then look at it again and go, where are we going next year? So if you don't have that, you actually don't know. Um, it's, it's a blind spot, not knowing what your staff are actually thinking. And yeah. Yes. It would be really nice to think that the staff will always tell you, but they won't even in the best cultures, there's some people just never say anything. And in poor cultures, least people will say things. Yeah. And so by giving them a, uh, an outlet to say it, and then not, I think one of the things we're feedback and people who aren't used to receiving feedback is that it's a fence of. And feedback can be really, really offensive. So it's actually learning is the receiver of feedback to actually go, what are, I don't think that, so why do other people think that what what's the view on, on that and how can we make things better rather than going, oh my God, I've got to bet that feedback away because I feel offended by it. So as a really challenging thing to do, but when you get your head around it, feedback comes so much more valuable. And as a team, you can work together to improve things. Um, cause often the feedback is not personal. It's not actually personal. It's just the way things are done. It might be process driven. It might be communication driven. One of the, the Gallup questions is that, or the, the, one of the Q 12 is that the, the manager that the employee feels like they are. Needed and respected at work because the manager checks and with them, was that a regular standard operating procedure in these clinics? How often did they meet great offer? It wasn't always formal. So in one of them they meet, I think they were meeting weekly for about 15 minutes. They were catching up, but another one, it was more done in formerly during the day that makes sure that they went around and had a chat to everybody. And maybe that helped. And with the task, well, just chatting to them and saying how things were getting on. So it varied between the practices, but what they tried to do is make sure that there was a one-on-one conversation. Regularly with each of the staff. They also talked about having, you know, I'm open door policies and making sure that staff felt like they could come and talk to them, but not in a way where it was disruptive. So, you know, they would say, you know, have you got time now for 10? Or can we make a time for chit? So not, not just that constant, you can come in anytime and dump on me. Um, but in a, in a more controlled way, but they all, and the reporting from the staff was they felt they could go and approach the. The leadership team if they needed to, but a step back from that was also, I can talk to my colleagues if I think somethings. So I think. One of the things in a healthy team situation is that you don't always go to the boss when there's a problem. Your first step is to just talk to the person while there's problems later, and this was happening and these practices, they felt like they could have the conversations at a low level and it didn't have to escalate it a lot. I've heard that some clinics have like timeout spaces. Well zones when a professional is just it, you know, they've just had a horrible experience or a horrible outcome, and they just need to, to, to just decompress. Do you all clinics have that as well? Yep. They will hit okay. Solely a timeout room, but they all had a staff room space. So there was a space in a knot. We make the operating table, the staff room, you know, it was actually the head of staff room space where staff could go, these guys all made sure they had T-Rex together. Now one of the practices was bigger, so they had the two shift to break. So they had half the team and then half the team. So. Like I said, I could keep running the smaller ones they do. They would do it all, you know, all at one time where they would stop and pause, but also all of them allowed the staff to walk away for five minutes. One of them had a nice garden area where they could sleep out, which was not client space. It was a staff space, um, where they could walk out and. You know, take a deep breath or, you know, if it wasn't tea time, then the staff rooms were empty. People could walk away. One of the practices was starting to introduce mindfulness in the morning where they had a session for five to 10 minutes each morning, just getting everyone in the zine and breathing together as a group morning, Taiz, it's really easy for the receptionist to. To be excluded from team events. So did this, did these clinics when they had their combined morning teas? Where the receptionist's part of those as well. Yes. Yeah. Yep. Yeah. So they, they very much were inclusive. And this is actually going back to the language conversation. They, they talked about the team is that the whole team, you know, they didn't talk about the vets or the veterinary. So that was the team run and the bank, no, it was the whole team and everybody had a, um, a valuable, um, part to play. And another way that, that was shown to was one. Take the climate were really hot on telling me how, when they do rounds and they talked about clients and case or cases, sorry. Um, they would ask the opinion of. The veterinary nurse, the keynote hand, you know, if the receptionist had been involved, you know, maybe they had a bit of a chat with the client, they would be involved as well, so that they could get all those different perspectives on what was happening, what was going to be the best for this animal. Yeah. I like, you know, often the front, you know, the front of house, people find out more about the loving environment of the animal and the client than the vet. Does, you know, those sort of things. Yeah. Which make a big difference to what you're going to do. Don't know whether you'll be able to answer it.

Julie South: 11:53

Two questions: do you know what the consult times were for these clinics? I didn't ask specifically, but I'm pretty sure they were 15 minutes, so they weren't extra long ones. And I didn't, you know, all those things in hindsight would have been good to do. I didn't delve into whether they lengthened the consults and actually charged for them.

Francesca Brown: 12:10

So they did. I know they definitely linked them the consults when they were needed, but I'm not sure if they yeah. Hey, no extra charges for them. Yeah. And do you know, second Christian, do you know whether these clinics were, whether their fees were market comparable or were they more or lower, higher or lower than, okay. You know, I didn't, I didn't look specifically into those for them. I know one of them was quite an expensive clinic and the clients told me that, but they still wanted to go there. So w you know, one clinic. Pure location, large city, you know, it's expensive to have a building and near and functional in their area. Um, and the client said if there's one thing that changed it with a favor at the same time, though, you know, they're all saying, we love this place and we're always coming back and the staff are great and they care for my animal, you know, everything's positive. Yeah. Um, it's only when you force them to say, well, what's one thing you'd change that. That was, you know, and actually it was only. It wasn't that, you know, it wasn't that whole entire, it was maybe half the clients put that down, but the others had lots of other little things. Insurance was insurance, pet insurance, pat of. Of the clinic. So high level of pet insurance at there at the clinic that I just talked about, um, that had relatively high fees as well. They also had high pet insurance. They, and I said, how have you done that? I said, I said, it's your clientele? Isn't it. It's where you are. And they went, no, our clientele, uh, across the spectrum. So they have rushed to poor clientele and they said they didn't, as far as they were aware on what they'd done, they didn't have. It wasn't more insurance at one end or anything like that. They had insurance across the board. They said it's because they believed in it. They explained it to the clients in a way because they believed it. And then the clients believed it and bought it that way. Any of these clinics paid the teams, a base salary and.

Julie South: 14:04

Uh, KPI some kind of KPI bonus,

Francesca Brown: 14:07

not the three clinics that were the three ones. There was another practice that did, um, it was done even when it was done evenly across the board. Um, that particular practice had heaps of perks as well. It was. Yeah. So this is quite another interesting thing that would be interesting to look at as there's quite a lot of pics that come with working in a veterinary practice and some practice have an incredible number of pigs, but. I don't know that practices are all that good at valuing them and the salary package. And sometimes it's hard because if you go to get free Veet consults, so I've got teen animals. So I do really well out of it. Whereas someone else has only got one. They don't do quite as well, so it's quite hard to value it. But, um, I think there is a value in. Some of those things, which could be, you know, looked at alongside the salaries there's being, you know, uh, so some, you know, yes, the salary is a poor and use that need to be dealt with, but there are some benefits we forget to advertise, like yes, as a seller,

Julie South: 15:00

I've put together a package for a vet. and there was that got an increase in actual increase in salary. They also got. Other benefits and the other benefits amounted to about$20,000 per annum. And there was more, so that was the first 12 months at the 24 month Mac. There was more still and yeah, they add up and, and the clinic. Yeah. Is the, the longevity of the staff is very, very long. Um, you know, some of the, the staff have seen clients, kids come through, you know, clients and then the kids come through the practice.

Francesca Brown: 15:53

And, you know, that tells you something about the practice pinnacle culture. It's one of the things, um, even though, um, you know, these practices still were not as low as some of the others, but a little bit lower on. You know, whether their financial needs were being met, they all said, I love working here. The culture is so good. I want to stay because I don't think I'd find such a good culture somewhere else. And, you know, they felt that they were well looked after where I was speak, did well valued, you know, all of the things that people want and that they could do their job and unpaid it.

Julie South: 16:22

Okay. So somebody is listening to this and they're thinking, I, I need, I need, I want, hopefully I want. Because with want comes desire. I want to change how things are in my clinic. Where would you suggest that they start? What should they first look at? What would be their first steps? I think the first steps would be to sit down and see where they were now.

Francesca Brown: 16:52

So I think probably for a practice that's already, frankly, you know, not one that's starting from scratch. One that's already functioning is actually go, let's get some sort of measure of where we are now, because I think I know where we are, but I actually don't know surely what everybody thinks. So let's. Get a picture of where everybody's at, where everything's at. Um, it's, uh, I think it's a good idea to get someone outside to do that because if you run that they're not going to trust necessarily, particularly if there is some underlying not, you know, not trust there that you might try and interpret comments and feedback is from them and then point fingers. And you don't want that to happen. If you get it done externally, you get a report that doesn't show all of that stuff. And so, um, you can take away any. Any risk of personalization, I guess, out of it, get a measure of where things are at and the meter will give you some ideas of how your leadership has Jude, what sort of support you need the other vision and values actually meaningful to the staff, because maybe, you know, yeah, they're there, but we don't even know what they are, or, you know, you're asking questions about, can they, can you actually say them, you know, if I went and asked any of your staff, could they tell me what they were through to, you know, Whether the rostering systems working for them, whether that proficiency in a professional development and their position descriptions, do they respect, you know, their leaders or do they feel like they respect us as a team member? You know, lots of, all of those questions. Yeah. Figure out where the practice is at, and then sit down with someone and make a plan about what needs to happen. And often it's going to start with, as a team collaboratively, we need to sort out the vision and values again, and you could say, but my team changes and therefore we're going to have to keep changing. No, no, you just need to do it once as a team and get it right. And then start building it in. And then as new people come on board as the practice grows or whatever, they come into to that culture that you've already got going. But if you've got a culture where the vision and values are just a piece of paper in a dusty drawer, um, they aren't actually been enacted anyway. So get them sorted out. What do they actually mean? What does each value mean? If, if there's some indication there and even if there's not to be fear that leadership needs, some maybe that needs some support with leadership has get some leadership support and then. Stop working with the team on working out some KPIs for improving it for the, what what's most important this year, what are we going to do and really engage in it. and you've got to buy into it. You've got to walk the talk, but without fail, the staff told me that their leaders walked the talk for these three practices. They were absolutely there doing what they see, everything that came out of the mouse was actually what they. Mint can, what, what would you say to a clinic that saying I don't have time for that. I can't sit around. I can't organize morning teas for all my team at one time. I can't take half a day off for. Team team meetings. Yeah. So there's, there's a couple of things. And again, that needs time to sit down and think about why, why is the, why are you saying I can't? Um, is it, I can't, because actually you're trying to do two or maybe three jobs, which I think is the case for some veterinarian. So we're trying to be a full-time clinical vets and full-time practice managers and everything else that you need to be in business. And it might be that you've actually got to sit down and look at the business model and go. Actually, I can't do three jobs. I've got to break that up and we've got to employ someone to do different parts of it. And for that, you have to let go to be fair to do that. but you also have to the budget that as well. So putting that into your budget, how are you going to make that work? Um, and then the solutions don't need to come from you. You just need to lead the solutions. The team have the solutions you've got. So much expertise and a team. You've just got to give them the floor to be able to come up with the solutions and they donate some boundaries around what's realistic and what's not. Um, and you know, you might have some knowledge that they don't have, but together you can, you'll be able to work out solutions and. You can't fix everything tomorrow, but you can prioritize and go. These are actually yeah. Three priorities. So it might well be that the first priority is you're understaffed because actually you're doing three jobs. So you need to sort that out that might be priority. Number one, then you sort that out, which then rolls onto the next thing.

Julie South: 20:59

The three clinics that you ended up studying were their teams, the employees and their teams. Or full time, 40 hour a week employees, or? Okay. So what did that look like? Um, so often they were four day, week vets or pat time vets and vet nurses as well. They worked with, uh, What all of these teams decided as a lot of the staff that they wanted that were important to their teams didn't want to couldn't work full time.

Francesca Brown: 21:34

I mean, some people can't, they can't function full-time maybe because they've got so much else on or they simply don't want to. Um, so what these teams had is they did have a plethora of pat timers and they said this challenges on that, which there is, and that's around communications because sometimes one team member will never work with another team member. So it's really important to be aware. Um, and formulate a communication plan. That's going to work when you've got part time teams, but there's a patch on teams that are happy. And when they're communicating well between each other, so good quality notes, good handovers clarity on who's on at what time and whose roles are, what people's roles are. Um, they had happier staff staff's needs would bring me to when you ask. Then the question around what's the rostering working for them. You had it really high, um, reports on that. And you know, these practices did everything they could to try and work a roster that allowed, um, their staff to go and coach a sports team, or watch the kid at assembly who was getting an award or, you know, those things that become really, really important. And actually I think what happens and from what I could see as the employee and, you know, in my own team, I've got a lot of part timers and we have a lot of flexibility and it's about that. They give back twice as much as you give them, because they're so grateful that you let them go to assembly or let them coach the sports team or whatever it was that, you know, they, they needed to do. and, and you think some people do take the mick but I don't think they're there. They're not the majority, the majority of people just are so grateful and will give back and give extra all of the time. And we all know, you know, um, and veterinary clinic staff at giving all of the time, because. Animals don't get sick with an eye-opening hours, um, or the consult. Doesn't always, you know, the last 15 minute concept could end up being a couple of hours by the time things are done for the client. So, you know, they give all the time. And so being able to give back to them is really, really important and, and it can be done, but it's about communicating. And one of the things I did talk to a practice that we reported on in my masters. They said, I want to tell you about our wellbeing journey and how we staffed up. And they staffed up in a way there, and they are still on the wellbeing journey, but they fixed their staff up. What they did was they gave too much autonomy to the staff. So they forgot to say, this is our values. We're here. We're a customer service business. Therefore we need to have X number of staff on between these times and we need this. And so they had staff just choosing when to work and when not to work and signing in and out. And there was all sorts of, kind of. And, and now that he laughed with me and said, yeah, I know it's pretty logical. Isn't it. Now when you look at it, but so the business has to give a frame around it and say, as a team, this is what we need, but you guys let us know how you're going to make that work so that it's going to work for you guys too. Yeah. And then people will give and take some people go, well, I can't make it that time, but I'll get the next one, you know? And it was the same as sharing holidays. I've heard from practice. I don't do a great job at sharing, you know? The Easter and the Christmas holidays and these practices shared them really well. They had it all documented about who had had what holiday. And if people wanted to swap, it was fine, but they all showed even as an it, and it wasn't a case of the bosses going well, we don't, we're the boss now we don't work Christmas. I worked at as well, but on the same rotation

Julie South: 24:42

Talking about rosters last year, I placed a vet who went from locum to permanent. And the reason she was a locum was because she liked working three or four days a week. And she liked being able to go overseas. That hasn't happened. But the, the clinic that wanted to hire her said, yeah, she wants to work three days a week. These are the days. And they were broken up and Monday, Wednesday, Friday, that's no good to anybody that wants to take to go away. And so we went back and we negotiated and started off, well, the other vets work, these rosters, we can't possibly change these guys to match this new incumbent. It just won't work. So I went back to them and said, let's, let's pretend we have this clean white board where everybody can put their wants. On this as to what days they want to work and it start afresh, everybody. And that team got juggled around and they got juggled around to the way they wanted. It was such a great outcome.

Francesca Brown: 25:56

Yeah, no, look, I believe watching those three practices that did there. I believe it. That can happen. We don't have to stick to these traditional rosters or, you know, it's always been like that. So why would we change it? I can remember when, uh, one of the practices I worked and, um, when I was still in clinical practice, we worked something like eight till two, and then we would work again from four to six and had this two hour. Now, if you've got a family and stuff that doesn't work well between 12 until you'd go off, depending on when you're finished and back on at four and it didn't work, you know, but. Somebody could work for eight hours at the beginning and someone you could never cross over and run concerts at a different time. I know, a locum I did, they said we start consults at four. And I said, well, no, I'll start them at two because clients want to come in, no, run them and used to be busy as till four o'clock. And then I could go at four and I'd done more consults than I would've done between four and five, you know, just because. I was allowed to change it, but so many places you just note, we've always done it this way. This is what the clients want. Exactly, exactly. These clinics actually ask clients what they wanted. Was that part of the, the values. Do you know. Actually, I didn't ask that question, so I can't answer it for them. Um, but you know, you can tell from the clients are happy. So I guess that was a good thing and yeah, they didn't seem, um, there wasn't feedback from the client, you know, and the feedback that I got from the clients, it wasn't anything about this, too many pat time stuff. I don't see the same person there wasn't any of that. Um, Sort of feeling because you do hear that feeling sometimes you hear it, but is it true? Yeah, I'm not sure. Yeah. I hear it a lot from visits, but I wonder whether it's vets think the clients think that or because it really is, is true. I think that there's probably a balance between seeing someone differently every single time you go to having some continuity between two or three people. I was thinking about, you know, the local GP practice. They are so big now GPS don't work five days a week. They work three approximately, and they do six set of 10 shifts or something like that. Um, so they've usually got an off site that does the other days during the week. So. It minimum, you say two, maybe three because of the holiday, like him as well.

Julie South: 28:04

Francesca, you're speaking at, you're one of the speakers presenters at the INSEAD VNA in ZBA conference next month in June. Yes. Yes. This is sort of your topic. What sort of clinician do you think will benefit most from attending? Your presentation.

Francesca Brown: 28:28

So I guess my aim and my presentation is to keep regurgitating the research, you know, refer back to that and that, but it's actually to start changing the narrative to now to let's work together to start making some changes in how do we support each other? What are the things that we need to do, helping, maybe helping people that are teamed to actually have a look at the blind spot a little bit, and try and dig into that a little bit and heavyweight, but more of a think about. Playing really, really critically reflective about what they currently do. And have they actually tried things or is it a mess? What they're thinking, you know, about how they do things and encouraging people to be brave into. Get seek feedback and make some change. So I think anybody that's a practice manager or in a leadership role in a vet practice sitting around a board table, any of those things or anyone who aspires to get into leadership. So you're maybe aspiring to be a veterinary nurse or lead, you know, lead veto of a team because you don't have to own the business to do leadership. There's all sorts of leadership roles. And actually coming into that, I, I believe that. We should try and encourage as many people on the team to lead aspects of the practice as possible because they take ownership of it. And so I think there's a lot that can be learnt. Certainly as the owner of a practice, you sit the culture and you sit the, the, um, the overarching strategic vision and values and things. But everybody within the team contributes to that culture and the leadership and buying and things. And I, you know, so I think anyone who aspires for positive change in the industry for the wellbeing of staff, which will. Move on to being the wellbeing of animals and the clients, and the literature will tell you that that also improves the financial outcomes for the practice as well. Should, you know, come and listen and be part of the group. Cause I think what would be great is to start getting groups that talk to each other, and maybe I know there's this whole secretive can talk about the business, but actually if you start sharing a little bit more. You're all going to grow your business rather than taking from each other. You know, we've all got things this year can actually be a lot more collegial. I think, I think we like to think we're collegial and we are in a way, like when we go to conference, we're pretty sociably, collegial, but business wise, we're not always as collegial as perhaps we could be.

Julie South: 30:48

So somebody listening to this podcast, they could be thinking what that I've got. What sort of things might they be considering the staff turnover. absenteeism..

Francesca Brown: 31:01

Yeah. So turnover. Um, so the literature will tell you that it's anything turnover around 15% per annum is problematic. You're always going to get the odd staff has to leave because stuff, people will go back to where their families are often, or maybe a partner gets a job overseas, things happen. You can't do anything about those ones. Um, but if it starts to crawl higher than that, Um, most of the literaturewill tell you it's around usually around the team culture in the management of the team. And that's the reason that people leave. They might not tell you that either. They might not be honest about why. Um, but if you're too nervous, creeping over 15%, that would be a risk. And yeah, absenteeism, if you've got people that are, you know, using all of this at clave, or maybe even taking unpaid days when they, you know, you use all their sick leave, it doesn't mean they're lazy or that they're. Got a hang over or whatever it can often mean. They actually physically cannot come to work because the culture is so toxic. They're not going to be able to cope. They know they're not gonna be able to cope that day. Um, and so that, that can be some, you know, it's worthwhile looking at that in saying wonder why that, you know, actually asking why that's happening, that the thing about, um, Absenteeism from sick leave, but also people changing, moving on to other jobs as two for one is it's really expensive to re-employ staff. It's not just the cost of advertising or the recruiter. Well, the cost of the recruiter. Absolutely not. It's actually, it's up to, depending on the lecturer, two to four times, the annual salary per four, a year for one, one change over. And that's because this slower, um, it takes another team member out to actually train them up. The trust with the clients is not there because they don't know them in a new that, you know, there's a whole pile of things that build into it. So actually, if you were having a. You know, and some practices, Centive this concept of a veterinary nurse or any of the allied federal officials has been kind of disposable and they'll just leave every two years and that's fine, but actually you could pay them double and keep them. And that would cost you about the same as them changing over every, every two years. That's that's the reality. And what also happens is. If savvy new employees will look at the practice and find out what your turnover is, and they'll see how long your staff have been there and the ones that are worth employing probably won't apply because there'll be wondering why they'll be thinking there's a toxic environment in there. There's some reason why people are leaving. I don't necessarily want to be there. And it's a small industry word gets around as well. So it actually will negatively affect your versus even more because you might not, you might get the best step counts for your jobs as well.

Julie South: 33:36

Yeah, I know. Listeners. I did a recording on an episode on what people are looking for when they start at your place and how you can get more bang for your back. So I'll put a link to that in the show notes page as well, because people are doing their research online before they start with a clinic, they are going online to find out what people are saying, what employees are saying about that clinic.

Francesca Brown: 34:03

In terms of job to satisfaction. And these are, termed the hygiene factors, there's working conditions. So what are the conditions that you're working under, you know, 50, 60 hours a week in a building that's running water on the insides of the windows ends, you know, it's freezing cold or boiling hot, or, you know, really noisy and you can't get away from the noise or there's no tea room note. That kind of thing. And when we, and I'm talking about a companion animal practice, I guess if we talk about working conditions as you know, and what you're expected to on farms that would fit as well, um, coworker relations. So what's the team like what's the culture like is everybody getting on? That's really important having a set of policies and roles, um, and. I'm sort of really cautious of policies and roles in the fact that policies and roles within needed and when they're actually functional, not roles that are roles for roles that are never, that everyone just ignores anyway. But actually, if we need a policy or a role for whatever reason say might be around, say radio, radiation, safety. Okay. You need to have some roles around there and we need to all follow them. That's that's fine. But some, some rules might not be, you know, might not be necessary. Maybe post something up and I'm pulling this out of my head rather than from the research, but you know, some places you'll see, they've got a blanket, no cell phone policy. Well, Is it actually functional? Why are we saying that? You know, so what, what is the role around it? You know, is it actually done in consults because we might use it as a calculator or as a photo as a camera. And do you know? So as the role functional, um, and as it necessary, but having the ones that are in place in place,

Julie South: 35:37

or everybody knows there's a no cell phone policy, but nobody takes any notice of it.

Francesca Brown: 35:42

Exactly. So there's absolutely no point in having that role. Fits the case. Yeah. Um, but I think you should always, um, if you're going to have a positive voice, why are we having that role and then, um, use the five whys and then whatever your answer to that is, ask it again, why whatever they'd outsource and dig down to figure out why that role is. And you might forget you don't need it. Yeah. Or actually it's this part of the role that we need, but not the rest of it. Supervisor quality. So that's around leadership particularly, and it's not just the owner, that's the leadership of teams as well. If you put a team leader in place as well. So making sure that all the leadership has got support and mentoring, um, some sort of professional development plan about leadership. And base wage and salary. So that's a hygiene factor too. Okay. Um, and if you go and look at Maslow's hierarchy, which everyone's probably familiar with you, basic human needs, you know, you need to be able to eat and drink and have shelter, no, those sort of things. Um, so there are the hygiene factors and then the motivator factors are around job satisfaction. So the things you look at around achievement. Now can I achieve what I need to, and it might be in the case of, um, success in cases, uh, it might be achieving, maybe he wants to do some extra study and achieving that and never been able to achieve what it is you want to achieve recognition for what you do. So just simple. Thank you. Sometimes might be, um, all of these practices had regular staff awards, you know, which everybody voted on and they tried to share them around, you know, for recognizing cool things people had done. Have some sort of responsibility. And I mentioned that earlier around leadership, like. Is it possible to find something that everybody can take some ownership for and have some responsibility for in the practice. And you actually defer to them for how how does that happen? The work itself, I don't think has virtually ever a problem of veterinary practice. People go to work, to fix animals and care for animals. So I don't think the work itself is something we need to worry too much about advancements. So people want to be able to progress. So a veterinary nurse doesn't graduate as a veterinary nurse and just want to go in there and do the same old job. They want to be able to progress, um, in a vet. The sign, the majority of the same. So like I said earlier, yeah. Creating professional development plans to help them progress how they want to, wherever it is, and either create the roles for them. Cause I think there's opportunity in most practices to do that, but if there's not, you know, they're going to become a specialist, let them go give them the wings and then let them go and personal growth. So that fits in that as well with their professional development. And also I think leadership development as well in other kind of dare I say it, that soft skill kind of development as well around communication. Well-being all of those sorts of things too. So allowing personal growth. And I guess, you know, in some ways, if we interpret that a little bit too, there's also allowing people through the rostering system to ex-US coaching at a local club, or, you know, those sort of things going and being the team coach, because that will feed back into the practice because I'll learn things from dealing with other people as well.

Julie South: 38:30

Did any of the clinics have common development themes?

Francesca Brown: 38:37

They all had KPIs around wellbeing. And so they were ensuring that staff were getting access to either professional development or as a team working together on looking after their own wellbeing. Um, I don't think they didn't have specific themes in terms of everyone was doing one thing, but they were. Trying to make the needs of the staff that were, that were in the practice in terms of what professional development they wanted. And it's absolutely not just about what the person wants, because it might be that as a practice, if you do a performance review process, well, you actually are looking at. Maybe there are some things that, some weaknesses for that person that they can develop that will be better for the practice too. So it's a, it's a two way thing. It's not about giving everything to the employee. It's about working together to identify where the growth areas and needed sort of for the practice, but for them personally as well. Yeah.

Julie South: 39:28

Did the clinics conduct exit formal exit interviews?

Francesca Brown: 39:34

So these one's dead. Um, but they all had really, really low turnover. Um, and so we took, we spent more time talking about how they had modified their employment processes to choose the right people, because the ones that they had lost, um, that they could tell me about what all ones, where they had made a poor employment, and then they could pinpoint what they'd done wrong. Yeah. I believe exit interviews are a good idea, but again, I'm not a hundred percent sure that people will be completely honest. If the person they're. The reason that they're leaving has conducting the exit interview..

Julie South: 40:03

Yeah.Exit Interviews and employee reference checks are something that we, we VetStaff can do for clinics. If that's what they want, a hundred percent independent and confidential.

Francesca Brown: 40:16

The Hertzberg Model is a really good one, I think for picking up the majority of the other aspects. I think the other thing I just looking through the last time I presented this to two other things, one was that these practices recognize when mental wellbeing, because I think there's still a little bubble of a culture out there where some people that they don't recognize it, um, or because they don't. Suffer stress or, or don't acknowledge that, that I'd say she say don't acknowledge that there's suffer streets. That don't recognize that another other people, but they also don't understand that the levels can be quite different than other people in the way they react to things. So these practices were very clear on, they acknowledge it and they put things in place for the four people to manage it. The other thing which I thought was really interesting with these, because as an educator, we. Hit upon clinics that refuse to have students, we'll just make the student experience really bad and others that just are amazing and make these wonderful experiences. And I was interested to know, did these practices that were well, what was the relationship with students? And so, and these three practices in fact in two of them, the students were invited to be part of the focus groups that I did at the practices. And they.often deferred questions to them they wanted to hear what they thought and the students' reports on those practices were amazing. They said best experiences I've ever had felt so welcome and felt like I was part of the team you know, all of it. Everything was really positive. They've picked in the practice. We love having students cause they teach us new stuff. They help us to make sure we know stuff cause we can explain things to them. Um, and so they really, um, so my, I guess my hypothesis that came out of that was that or proposition was there pips of a practices really well. Then they're going to find it a lot easier to welcome and stuff because they're not having to look after their, their own self. So they're able to give to others. Whereas if the practices unwell and maybe they're not accepting students or students having a poor experience as a, as an indication of an unwell practice, because the staff just actually don't physically have the energy to deal with students because they're just. Coping with surviving

Julie South: 42:16

Talking students. Did you do this research because it was something that Francesca was interested in or did you do it because you could see that was research, then it can be included and curriculum.

Francesca Brown: 42:36

I Think I go back to the fact that, um, I'm a typical. Female child. Iguess who wanted to be a vet from when I was five and I saw myself going into practice. And I guess, you know, I saw myself I'd work in clinical practice and I'd own a practice. Do you know, like kind of traditional kind of staffing when I started to get into the realities of it. It's not all, you know, what you perhaps see as a five-year-old and you know, not all puppy kisses and kitten cuddles. And I don't think, I thought it was quite there yet, but you know what I mean? You know, just a little bit of a roast under glass as a feat. And when you go in there and you see that, there's just some, it's difficult to have a family and work and practice. See my, my colleagues and friends leaving practice or going into other things. I see students coming back. You know, they spent thousands training and within five years, I think 85% of vet nurses are out of the industry within five years. Something like that. You know, it's such a valuable profession. Vets cannot function without veterinary nurses, you know, um, We put a lot of investment into, it uses a lot of great career options outside of clinical practice, but we still need visits for short of them now, you know, we still need them. And I think it's all of those things together. So I want to make it better for, I can't do it on my own. I want to be part of the movement to make it better. I think there's some amazing people out there that are doing some really amazing stuff. And I think we need to get those voices heard a bit better, and I think we need to share the stories of success of it better. And so that was, I guess, That's my motivation around doing it in terms of part of the curriculum. I guess we try and teach awareness of wellbeing and, you know, compassion, fatigue, and all of those kinds of things. And also we try and teach empowerment of the professionals too. It's not a, it's about being a suit of really about not just putting up with. But English, no, no, the, the brush or the dust, you know, but actually to stand up and say, I'm a valuable member of the team. This is where I can contribute and how I can make it better for everybody. Yeah.

Julie South: 44:36

That I think is one thing for nurses that one of the good things that has come out of the, with the borders being closed, I mean, we've had shortages for a long time, but with the borders being closed and no, no excess of vets coming in that nurses are now being asked to, to use their skills, the skills that they learned. And it's what I'm hearing is it's increasing the job satisfaction as well.

Francesca Brown: 45:06

Yes, I would have definitely heard the same thing as well. I think our next challenge now is to look at, um, modeling around. Actually increasing the ratios. So these practices, I think the new Zealand's roughly one-to-one across the country, one to one and a half, one, one wheat to one allied beneficial or one and a half hour Viton professionals. On average, these practices were one to three, but we know overseas it's one to four to five. Yeah.

Julie South: 45:33

Yeah. I got a bit excited the other day when I got a one to two.

Francesca Brown: 45:38

Yeah. So these ones were it peak times of the days, they were one to three, so they included a receptionist. And, uh, so between reception staff support staff, but obviously the model was overseas would show one to four. Um, and someone was telling me about one to five as well. So. No, I, I, my experience is a wonderful, was brilliant and I loved working on that practice and I felt like I had good job satisfaction. And I think the staff did as well. So the other staff, so the new research that I'm doing, it's multifaceted and I'm going to be collecting some data around utilization. And then we want to go back and present some models around utilization as well, because at the moment that we get asked, so tell us how to do it. And although we can sort of go a year, but there's nothing clear. So I want to create something that's much clearer. Yeah. Yeah, I, I roadmap. Yes. Yeah, yeah. And how do we move into that space and also, yeah. Get rid of that concept of, but then our nightly spits or I'll. I'll have to do more after hours and things like that. How do we move from there? And I, you know, I know in McLaughlin's, I'm pretty sure it was Iain McLaughlin or no, it wasn't that some Seton Butler's just done the map for Vet council has a different way of looking at after hours. But I also know when it's put on screen in front of a whole pile of each, you get quite a different. Sort of viewpoints on, on whether that would work or not. Yeah.

Julie South: 46:57

That will work for them, but

Francesca Brown: 46:59

yeah. Yeah. Well, I'd rather use the phone I because I don't trust the person answering the call. Yes. So you do get some, you know, some interesting feedback on it, but I think we need to stop moving and to, you know, into that sort of space as well. And so yeah, hopefully doing a little bit of modeling will help with it too and show that it won't. Will actually have positive impacts because vets can be vets. Don't think so. They'll always be something, you know, 3:00 AM. I could talk for hours on all of this.

Julie South: 47:30

I'd love to actually what I would like as after the conference to hear what, what transpired for you? Did you, you know, have you got suddenly people lining up to, to do temperature checks on their clinics?

Francesca Brown: 47:51

Sure. Yeah. Yeah, that would be, but I'll put a plug in here for if any practices that are interested in helping share with me some data, without giving away all their business secrets, to help me with stowing, some modeling around charity, discounting, staff utilization and how you invoice as well. And again, I'm not asking for all your bottom line figures, small, broader stuff. So if anyone's interested, I'd be really interested in. And how, how would they sit? What sort of, how would they send it? Data to you. I'm going to have a survey that will go out. So the survey will be published eventually and spread around. But if anyone's interested in getting it directly, I can say somebody who's got like.

Julie South: 48:28

A listener where who's doing community work, charity work. If they email you. Yeah. That they,

Francesca Brown: 48:37

but even if they're willing to share how they, um, how they put together and voices, cause I'm interested in utilization as well. So, you know, what, what ratios do they have and then how are they showing. No, the support. So there's different aspects of this project are multifaceted one. I'm going to collect all the data in one guy and then break it into three projects. So I'm looking at how things are invoiced for, you know, like, uh, do we have an insert technician? Are they invoice for how's that made up? How are you costing for that? Where did that figure in? I'm interested in where the figures come from. You know, when you create a, a theater fee. Did you just pull it out of your heat or how, how was it made out so much? Doesn't it? And then how do you present it to the client? Cause I'm also, and I don't need the figures. That's just the breakdown of how it's done. And then I'm interested in how clients interpret different bills. So, you know, with very little information, more information, lots of information. So there's, there's, it's a multifaceted thing, but I can send out all the information about what I'm after, but if anyone's interested in helping. Yeah. And then I want to do some models around discounting and charity and how that could become a. Basically a really positive part of veterinary practice rather than we shouldn't do that. And so we'll keep doing it under the table. So if I put your email as a link on the show notes to this page yep.

Julie South: 49:51

What's your deadline, Francesca.

Francesca Brown: 49:53

I'm collecting data this year. Maybe get one project written up by the end for a year. We've sort of got to get started. We're just waiting for ethics approval and then we'll be away. So over the next three or four months collecting data. Yeah. Yeah.

Julie South: 50:04

If you're interested in knowing more about being part of a veterinary kickass mastermind group, then please get in touch. julie.south@xtra.co.nz. I'll put links. On the show notes page for this episode, pawsclawswetnoses.fm. Likewise, you want to know more about doing exit interviews or running an independent temperature check and clinic staff temperature check then please get in touch as well, because these are all sorts of things that that staff can do for you. We don't charge body parts. Thank you for listening. Remember to click the follow button wherever you listen to your podcasts so that you don't miss out on future episodes, actually, as well as so that you don't miss out on future episodes of paws, claws, wet noses. It also applies to other podcasts that you listen to. So just hit the follow button, click the follow button. It doesn't cost you anything, and you'll be notified straight away. Coming up on paws claws with noses. We have Dr. Bryan Gregor of the VetPodcast. Dr. Bryan as I have said before, he's a former clinic owner now retired living the good life, making cheese, getting as much fishing in as he can. in and around Timaru while he's podcasting. As I mentioned last week also, I feel pretty privileged to have caught up with Dr. Bryan on the show because his podcast, the podcast, as what paws claws wet noses has dreams of being when it grows up. Also there's more so wait up because we have also coming up, Dr. Megan Alderson of the Strand Veterinarian in Parnell, Auckland, Dr. Megan is one of New Zealand's great advocates of, and has lots of fun with the serious topic of veterinarian, mental wellness and clinic. Thank you for listening. Ka kite ano kia kaha manaaki te Atua Paws claws and wet noses is sponsored by VetStaff. If you've never heard of VetStaff, it's New Zealand's only full service recruitment agency. 100% dedicated to the veterinary sector VetStaff has been around since 2015 and works nationwide from Cape Reinga to the bluff and everywhere in between as well as helping Kiwis VetStaff. Also helps overseas qualified veterinarians find work Aotearoa New Zealand VetStaff.co.nz