Forward Booking Appointments

Is Your Practice Benefitting?

WA Veterinarian Magazine

by Wendy Hauser, DVM

July/Aug 2015

During the AAHA Yearly Conference in March, the annual AAHA/IDEXX Laboratories State of the Industry1 report was presented. In addition to an in-depth evaluation of data and veterinary hospital survey results, this year’s report included an analysis of 1,001 clients to further determine factors that pet owners rank as critical in strengthening their bonds with their veterinary hospitals. One major factor identified to help drive client attraction and retention was forward booking appointments.

“Forward Booking” appointments refers to the practice of scheduling the patient’s next appointment before the client leaves the hospital. Forward booking appointments is a relatively common practice for medical re-evaluations with approximately 76% of hospitals reporting this practice, yet recent data suggests that only 11% of veterinary hospitals are utilizing this approach for semi-annual and annual preventive care examinations2. What are the barriers to forward booking appointments?

PERCEPTION
In my previous role as a technical services veterinarian I visited an average of 20 hospitals per week. This provided a tremendous opportunity to discuss veterinary business operations and management with a wide variety of practitioners and managers. When the subject of forward booking appointments came up, the reaction was often negative, with the owner or team member stating “their clients don’t want to do this.” According to the results of the pet owner survey as presented in the State of the Industry report, “6 of 10 pet owners said they would forward book their next appointment before leaving the practice. In fact, nearly half of all pet owners said they prefer to as long as a reminder is given.”

PROCESS
The implementation of forward booking appointments can be overwhelming. Follow the steps below to successfully incorporate this practice into your hospital’s daily operations:

Obtain animal health care team buy-in.

  • Explain to the team that clients want tools to simplify preventive care. Forward booking is one such tool
  • Discuss the findings of the State of the Industry report. Despite our perceptions, the majority of clients are used to this method in their everyday lives (example: human dental appointments) and like it.
  • Discuss the benefits to the team in forward booking appointments. Possible benefits include better, more timely care for pets, less overdue reminder phone calls to make (consistently a least favorite staff activity!), and that the appointment schedule runs more smoothly as preventive care appointments are scheduled in advance.

Ask your team what concerns they have with forward booking appointments?

  • In order to have success with this system, the staff must be allowed to have their worries heard and solutions brainstormed by the team.

The hospital must have an appointment schedule that is consistently available one year in advance.

  • Designate a team member to be responsible for inputting the normal hospital operations schedule for the next 13 months.
    • If your hospital does not use a computer based appointment scheduler, purchase the paper scheduling system for the following year.
  • Select a day of the month that the team member will be responsible for updating the schedule, so that it is always complete for a year in advance.
    • The schedule is updated one month at a time within a designated time frame.
  • Objections that might be encountered:
    • We don’t know what the doctors’ schedules will be. The hospital schedule in regard to appointments is relatively stable. The doctors are scheduled normally and adjustments are made to the timetable as needed.
    • It takes a lot of time to input the hospital schedule. There is an initial time commitment. Once the schedule is in place for 13 months, it requires minimal time to update it one month at a time.

Communicating the new policy with clients.

  • Decide who will explain the new procedure to the clients.
    • Will this be the responsibility of the technician, customer service representative or doctor? Clear communication is critical to this program’s success.
    • My hospital successfully implemented this process in 2012. What worked well was when the doctors initiated a brief conversation with the clients explaining that we were beginning to schedule preventive care placeholder appointments in advance. The doctors went on to explain that my CSR would schedule that appointment before they left. It was extremely uncommon that any client objected.

Decide what will be said when forward booking the appointment.

  • When clients understand the “why” behind the recommendation, there is better adherence: “Mrs. Smith, we are committed to keeping Fluffy healthy and happy. Because animals age faster than humans, regularly scheduled examinations are important to detect diseases early. Dr. Hauser would like to see Fluffy in six months, which is the first week in February. How does Tuesday, February 2 work?”

Explain to the client that they will receive a reminder two weeks in advance of their appointment. If the appointment is not at a convenient time, it could be rescheduled during the reminder call.

  • It is important to ask clients how they prefer to receive their reminders: phone, text, email or postcard, and honor their preferences.
  • Design a process for reminding owners. Who is responsible for confirming the appointments? This is one of the most important parts of forward booking, because if clients are not reminded they may not show up for the appointment. It is also an important part of client relationships to make these phone calls. Clients don’t enjoy missing appointments; the embarrassment they might feel could be detrimental to the client bonding.

Differentiate forward booked appointments.

  • Use color coding to designate forward booked appointments. It is necessary that forward booked appointments are easily recognizable so that the advance reminder notification occurs two weeks before the scheduled appointment.
  • By color coding forward booked appointments, the hospital management can track the number of “no shows.” This is an important metric; above 10% missed appointments would indicate that the reminder process needs to be modified.
  • Establish team goals for forward booked appointments, both made and the percentage kept. Celebrate successes as a team!

When animal health care teams embrace the concept of forward booking, everyone wins. Our patients receive more consistent and timely healthcare, clients are appreciative of the ease of scheduling and teams benefit from smoother day to day operations with more client visits.

Wendy Hauser

Wendy Hauser, DVM, a small animal practitioner for 26 years has been an associate, practice owner and has enjoyed a successful practice sale. In January 2015, Dr. Hauser left her position as a Technical Services Veterinarian to establish Peak Veterinary Consulting (www.peakveterinaryconsulting.com). She is highly engaged in AAHA in both new initiatives and leadership and was responsible for helping design and facilitate Colorado VMA’s Power of Ten, a recent graduate leadership academy. The recently published co-author of “The Veterinarian’s Guide to Healthy Pet Plans,” she enjoys consulting with hospitals and presenting workshops on hospital culture, leadership, client relations and operations.

EXAMPLE

Procedures Guidelines:
Forward Booking Appointments

Team member responsible: Sally

  1. Initial Action Step: On August 25, 2015 Sally will input the hospital’s appointment schedule for the next 13 months, so that appointments could be booked from September 1, 2015 through October 31, 2016.
  2. Repeating Action Step: On or around the 25th of each month, beginning on September 25, 2015, Sally will add input an additional month’s schedule, so that on September 25 she will be updating the schedule to include November 2016.
  3. Why?
    • By entering the schedule initially to include 13 months of appointments, clients can appropriately be booked for appointments occurring in 12 months.
    • By designating a specific time of the month for Sally to update the schedule, the process of maintaining adequate appointments for forward booking is ensured.
  4. Sally will program color codes for all forward booked appointments in the computer.
  5. Doctors explain to clients when they would like to see the pet next and that the appointment will be scheduled by the CSR (customer service representative) before they leave.
  6. CSR schedules forward booked appointment.
  7. Two weeks before the forward booked appointment, the CSR reminds clients of their appointment, including what services are due. If the client does not confirm the appointment, two additional attempts to contact the client are made.
  8. The hospital manager tracks the number of forward booked appointments that are kept compared to “no shows.” If there is >10% no-shows, modification of the reminder process is needed.