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Veterinarian Technician November 2007 (Vol 28, No 11)

Management Matters: Creating and Implementing Effective Forms

by Katherine Dobbs, RVT, CVPM, PHR

    Author's Note

    I am a fan of forms. When I need to get something done, I tend to think in a linear fashion. This step-by-step mentality has led me to create forms for my own use in my capacity as a practice manager, such as forms for performance evaluations, interviews, and personnel records. I have also developed forms to be used by the practice team. But when new forms are created, the staff are not always appreciative. For them, completing forms is often perceived as more work piled on top of their already busy day. That is an understandable reaction, but it can be overcome if a form is effective. In the course of my efforts to create and implement new forms, I have learned that the effectiveness of a form depends heavily on involvement of the entire staff.

    In veterinary practices, being "paperless" is becoming more common. Yet even paperless practices often need to use paper forms to record information, which is then scanned or entered into a computer database. Instead of using paper forms, more electronically advanced practices may opt to use writable PDF (portable document formats) or HTML (hypertext markup language) files; these electronic files allow information to be entered in certain fields. Regardless, it is difficult to eliminate forms altogether. If staff members groan every time a new form is introduced, the practice manager may want to consider the purpose of forms in more detail. The practice manager may think of a form as a way to obtain useful information, but staff members may think of a form as a work interruption that requires them to record useless data. To ensure that the forms used in the practice are effective, it is important to be aware of the process of form development and implementation.

    Establish the Purpose

    Every form used in the practice should have a clear purpose. When creating a new form, it is important to weigh the extra work the form will create against the benefits management expects to gain once the form has been implemented. A form should not overlap or duplicate information that is already being obtained in another form. If created with a clear purpose, forms can help solve or prevent a problem. As shown in the examples in the box on the next page, forms can be developed to collect data, direct activities, aid calculations, or save time.

    Collect Data

    Data collection forms are used to obtain information that will aid the operation or affect the growth and improvement of the veterinary practice. Some examples include client and patient forms containing information for a new appointment, flow sheets used to collect charges, client satisfaction surveys, and financial estimate forms with client consent signatures.

    Direct Activities

    Forms are often developed to direct the activities in a practice. Examples of these types of forms include patient care treatment sheets, flow sheets, and change-of-orders sheets. Typically, these types of forms are initially filled out by a specific team member — in many cases, the veterinarian — and then are forwarded to other staff members, such as those on the technical team.

    Aid Calculations

    If complex calculations are performed routinely, a special form can be developed. This form can include information and progressive calculations to help staff determine, for example, the amount of intravenous fluids to administer to a patient, the amount of additive to place in the fluids, the recipe for total parenteral nutrition, or the flow rate for a blood transfusion. The staff could perform these calculations without a form, but using a standardized form improves consistency and reduces calculation errors by capturing and processing the information needed for the calculation. Other types of forms include those used by management to analyze the finances of the practice and to create reports as needed.

    Save Time

    Forms can be used to save time because they can eliminate the need to repeatedly write the same information. For example, checklists can be used in medical records so that the veterinarian or staff member can check off or circle information instead of having to write everything. Electronic forms can save time by reducing the need for data entry. For example, new-client registration forms can be sent electronically to computer-savvy clients; the clients can complete the forms on their computer and return them via email before the scheduled appointment.

    Create and Develop

    Regardless of the type of form, its creation should begin with its purpose in mind. The practice owner or manager identifies the data that need to be collected, the activity that needs to be directed, or the calculation that needs to be performed. Sometimes, a staff member discovers a problem that can be solved by creating an appropriate form. A draft of the form is then created to illustrate the format of the new form.

    At this point, the team must be consulted. Staff members who will be required to use the form should have input in this development phase. The rough draft of the form should be disseminated, and feedback should be solicited, either by asking team members to submit individual comments or by arranging a group discussion. Management should explain why the form is being developed and its purpose. Team members should be encouraged to express any concerns at this stage. Staff need to understand why the form is important to the practice and that their buy-in is needed to implement the change successfully. The fact is, a form that will not be used is not worth the paper it is printed on!

    A form is printed on paper, not written in stone. Protocols change and evolve, good ideas come to light as the form is put into daily use, and different data may need to be included or collected in the future. The manager — or the supervisor of an area using particular forms — should frequently initiate a review of the forms and update them regularly as the practice evolves. For example, the technician supervisor should initiate the review of all patient care forms, and the front office supervisor should initiate the review of all client information forms. When a change is made, the team must be informed and given new instructions. If the change is significant, it is advisable to consult the initial development team members and ask for their feedback again.

    To prevent multiple versions of the same form from being used in the practice, all copies of the previous versions should be discarded, and the date of revision should be documented on the bottom of the current form to help staff identify the most recent version. In addition, to prevent further duplication, one staff member (e.g., practice manager, office assistant, front office supervisor) should be responsible for maintaining the forms. If the original forms are stored on the staff member's computer, it is advisable to have a backup copy of the documents available for other team members to access; however, it is preferable that the documents be saved in a format that cannot be modified by anyone other than the manager. Putting the name of the file at the bottom of the form will help save time in locating the correct file. If the original forms are retained as hard copies, they can be kept at the front desk or another assigned location.

    Implement and Instruct

    Once the form is finalized, it should be presented to the entire practice. Staff meetings are a good time to announce the creation of a new form. The team members who helped develop the form need to see the final product, and the rest of the staff need to become familiar with the form. Each person's role should be addressed (e.g., where this form will be filed by the reception staff). With the entire team present, management should discuss why the form was developed, how it will be used, and what results the practice is hoping to see from use of the new form. Once the form is implemented, management must ensure that it is being used as intended. Praise should be given to the team when the form is used correctly, but consequences should result if a team member is purposely not using the form or is using it incorrectly.

    Review and Revise

    A form is printed on paper, not written in stone. Protocols change and evolve, good ideas come to light as the form is put into daily use, and different data may need to be included or collected in the future. The manager — or the supervisor of an area using particular forms — should frequently initiate a review of the forms and update them regularly as the practice evolves. For example, the technician supervisor should initiate the review of all patient care forms, and the front office supervisor should initiate the review of all client information forms. When a change is made, the team must be informed and given new instructions. If the change is significant, it is advisable to consult the initial development team members and ask for their feedback again.

    To prevent multiple versions of the same form from being used in the practice, all copies of the previous versions should be discarded, and the date of revision should be documented on the bottom of the current form to help staff identify the most recent version. In addition, to prevent further duplication, one staff member (e.g., practice manager, office assistant, front office supervisor) should be responsible for maintaining the forms. If the original forms are stored on the staff member's computer, it is advisable to have a backup copy of the documents available for other team members to access; however, it is preferable that the documents be saved in a format that cannot be modified by anyone other than the manager. Putting the name of the file at the bottom of the form will help save time in locating the correct file. If the original forms are retained as hard copies, they can be kept at the front desk or another assigned location.

    Discontinue when Appropriate

    Some forms only serve a purpose for a specified period, whereas others become obsolete over time. During the review process, the practice manager should assess whether the form still has a purpose. If the form is no longer considered useful, the manager should discontinue its use, announce the change to the staff, and explain why the form is being discontinued. It is important not to discontinue use of a specific form without informing the staff because some team members may try to continue using the form, or worse, others may assume that the form was ineffective or that their refusal to use it resulted in its elimination.

    Conclusion

    Form is not just another four-letter word; forms can be an integral part of the practice by collecting necessary data, directing patient care, providing consistent calculations, or helping to save time for the veterinarian and staff. To get off to the right start, the reason for creating a form should be identified first. Then, the staff should be involved in the development of the form. Forms must be revised as needed and discarded once they have served their purpose. By reforming the forms in the practice, managers will have a formula for success!

    NEXT: On the Cover: A Talk with Deborah B. Reeder, RVT

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