• Avoiding medical errors and practicing good medicine should be the basic standard of care.

• These medical errors will affect our good reputation and the clinic could be sued.

• Decrease (over time) amount of malpractice insurance premium historically

• Limit the Liability Insurance Expenses to Revenue ratio to 0.25%

• Respectfully ask difficult or hard-to-please Clients to be more reasonable and understanding.


• Avoid Owner/Staff conflict on a problem or solution; move forward together.


• Bad news should be delivered in person by the treating veterinarian immediately.


• Buy a cost-effective professional liability policy.


• Develop medical records training.


• Establish and maintain a electronic medical recording and accountability system.


• Establish protocols for fee-estimates for profitability and legal purposes.


• For a bad outcome communicate with the client immediately.


• Have the attendant or treating doctor explain to the client important aspect of the procedure and deliver after-care instructions.


• Keep medical records up-to-date and readable.


• Obtain signed client consent forms.


• Provide anesthetic safety training.


• Spend communication time with receiving doctor when handing over a case.


• You can reduce liability by simply being less flexible or willing to cut corners with appropriate medical care.

• Measure the amount of malpractice insurance premium


• Legal and Accounting Fees Expense to Revenue Ratio


• Liability Insurance Expenses to Revenue Ratio


• Number of litigation cases


• Number of malpractice claims


• Number of Medically Reportable Complaints


• Number of Service Complaints

• Poor records and consent forms that lack the owner's authorization can lead to malpractice complaints.

• It's in every practice's interest to practice within the law and have a good professional reputation.

• Ensure consistency between practice policies and existing laws.

• Monitor and review signed client consent forms for every client that is recommended a medical protocol..

• Obtain signed client consent forms.


• Get owners release forms if declinining recommendation on chronic medication.


• Have the informed consent form initialed and signed regardless of outcome and document the exchange of aftercare information.


• Teach associates to develop prudent pre-service treatment plan estimates.

• Number of Service Complaints


• Number of Medically Reportable Complaints

• Pets’ and humans’ safety are the main concern of every vet clinic.

• Protect the health and safety of animals and humans

• Create a clean and safe work environment.

• Comply with all safety regulations within 3 months.

• Always lock the office and all entry points especially tight at night.


• Develop a nosocomial disease control program.


• Dispose of medical waste in puncture-proof containers.


• Dispose of sharp containers by placing smaller into the container provided by the hauler.


• Ensure appropriate programs to protect staff and practice from safety and other risk threats.


• Have a disaster plan scenario.


• Identify programs in quality standards like facility safety and reach commitments for outcome changes.


• Implement a DEA checklist to spot-check the controlled substance security and tracking system.


• Look for any strange parcels left behind.


• Place office furniture so that you can see who is coming and going.


• Promote Bite Awareness and National Dog Bite Prevention Week (late May)


• Provide anesthetic safety training.


• Provide emergency planning: in case of fire and fire drill, evaucation plan, utilities outages, boarding pet owners numbers etc.


• Stagger breaks and always have one person in open office.


• Use liquid soap rather than bar soap to cut down on bacterial transfer between handwashers.


• Validate radiation certification.

• Continuous Risk Assessment (11 items)


• Number of Medically Reportable Complaints


• Number of litigation cases

This is a problem that deals with clients or pets being at risk inside the hospital or clinic. Some examples that come to mind are: wet slippery floors; contruction obstacles, pets with behavioral problems and others. Contracting diseases from sick pets while in the clinic was not part of this problem. Any harm on animals and/or clients would affect our clinic’s reputation and clinic could be sued. Clinic staff will be also at risk of infection and/or injury if proper steps were not taken.

• Good communication is a necessary step for success at clinics.

• Good communication leads to increasing the number of satisfied customers and employees, it also decreases the cost of running the clinic.

• Decrease number of complaints/number of appointments ratio.

• Noticeably improve the level of communication in the clinic within 3 months.

• Avoid conflict between the Owners Perspective of a problem or solution with that of the Staff's; move forward together.


• Bad news should be delivered in person by the treating veterinarian immediately.


• Ensure adequacy, confidentiality, and availability of all patient/client care documentation.


• For a bad outcome communicate with the client immediately.


• Have the attendant or treating doctor explain to the client important aspect of the procedure and deliver after-care instructions.


• Have the informed consent form initialed and signed regardless of outcome and document the exchange of aftercare information.


• Implement a protocol to get your team to obtain informed consent, ensuring that the consent is actually informed.


• Keep medical records up-to-date and readable.


• Lack of trust results from lack of communication so improve communication to improve trust.


• Obtain signed client consent forms.


• Spend communication time with receiving doctor when handing over a case.

• Complaint Resolution Scale


• Complaint Responsiveness Scale (#366)


• Doctor to Client Communication Instrument


• Number of Service Complaints


• Organizational Communication Development Audit (56 items)


• Staff-Professional Two Way Communication Scale (0 item)

• Harmony between employees is a major path to success.

• Creat a work atmosphere that fosters compassion

• Keep communication real

• Create a trusting environment between employees and reassess in 3 months.

• Start afresh by unloading the negative(s) of the past.


• Lack of trust results from lack of communication so improve communication to improve trust.


• Telling the truth will lead to trust.


• Trust is mutual, give as much as you expect the level to be from others.


• Recognise that mistrust is a natural self-protection mechanism and hence trust will not be given easily.


• Measure performance daily by using a reliable measure that everyone trusts.


• Avoid conflict between the Owners Perspective of a problem or solution with that of the Staff's; move forward together.


• Direct sometimes negative office politics into a positive force through team building.


• Build and sustain team trust in the Leaders.


• Implement a protocol to get your team to obtain informed consent, ensuring that the consent is actually informed.


• Be truthful in explaining the whys of a decision, build honest images over time.


• Spend communication time with receiving doctor when handing over a case.

• Organizational Communication Development Audit (56 items)


• Organizational Trust Scale


• Staff-Professional Two Way Communication Scale (0 item)

• Unavailability of cash is a major deterrent against growth and sometimes survival of the clinic.

• Create an advanced, more competitive clinic.

• Push investing back in the clinic to increase long term profitability.

• Double the amount of cash kept in the clinic over the next 3 months..

• Always keep enough cash to support expenses for at least one month of operations.


• Invest in marketing your practice.


• When marketing the practice, focus on marketing strength and not on minimizing weakness.


• Invest in new equipment and decorations that would distinguish you from other clinics. For example, put a flat panel TV in your waiting room.


• Expand horizontally through investing in new animal related services such as grooming.


• If budget allows, hire a veterinary business consultant to more accurately identify growth possibilities.

• The amount of cash available to total costs.


• Net clients added after growth initiative was conducted.


• If a consultant was brought in then consulting fees to total revenue ratio.

• The well being of all animals and animal owners should be a main concern to all clinics

• Improving the quality of life in your community is the mission of every clinic.

• To perform as much afflordable free animal care for pet owners with limited funds who refuse care as possible.

• Increase your practice’s budget by 25% in six months to provide more free care in selected cases.

• Communicate a sense of urgency when treatments or procedures are needed and recommended.


• Conduct school tours to increase pet care awareness.


• Develop or provide a Rescue Fund for unaffordable pets.


• Encourage or promote Pet Insurance.


• Establish appropriate linkages with Advocacy Groups.


• Explain to owners their pets lifetime healthcare treatment needs and their importance even if they declines them.


• Provide adoption services through the practice.


• Create community awareness programs on the issues of animal suffering and diseases that could spread if services where not given to pets.


• Ask charity groups to recommend families that deserve free service and ask if you can install a donation box with a clear message explaining that the funds are to support treatment for animals in households that cannot afford service fees. Install a similar donation box in your clinic’s waiting room.

• Monitor the Net number of clients that continue to refuse service.


• Dollar amount of donations.

• Lack of payment on services provided by the clinic will reduce the clinic’s cashflows.

• A practice that provides high quality pet care needs to be finanically viable.

• Reduce the incidents of care with no pay.

• Reduce bad debts due to above by 50% over the next 3 months.

• Offer free service to those with limited funds through your local community organizations such as churches and use it as a marketing tool then for those that refuse to pay after accepting services, use the following strategies.


• Offer a discount for paying in full for services on the same day of receiving the bill.


• Interview new clients to profile them based on key traits, human-animal bond and financial strength.


• Increase the use of financing options such as payment schedules, bridge loans, and financing companies veterinary plans like Care Credit option.


• Provide credit only to established (more than 1 year old ) clients.


• To control accounts receivables send clients personalized statements with balances at 30, 60 and 90 days.


• Send clients with 60 days balance notice that the balance will handed over to a collection agency soon.


• Send clients with 90 days balance notice that the balance will handed over to a collection agency this next month, then do it.


• Collaborate with local businesses in the community in creating a non-creditworthy list of people that do not pay for services and goods, circulate the list between businesses in the community, make it public and demand payment upfront from those on the list.

• Accounts Receivable to Total Revenue Ratio


• Accounts Written Off


• Aged Accounts Receivable


• Cash flow


• Collected revenues per Transaction Total


• Frequency of use of Bill Collectors


• Pay-on-time Discount - Petowner


• Care Credit use.

• There is a lot to remember when delivering pet healthcare any many distractions in the clinic.

• Practice want to provide excellent care and a good experience for clients and their pets.


• Provide consistent quality medicine

• Empower team members and make them accountable for the knowledge for decisions.

• Benchmark: minimum number of clinic errors/week

• Assign strict and measurable accountability for both care and managerial outcomes.


• Determine alternative flow plan that enhances productivity and performance.


• Develop a program to independently improve the quality of services and care offered and provided to clients.


• Discuss identified programs in quality standards as in patient care and reach commitments for outcome changes.


• Educate staff members in every step of the process especially goal setting and planning to attain them.


• Implement a mentoring of less experienced associates to ensure a consistent medical care philosophy.


• Implement a quality improvement process within the practice, monitor and re-evaluate.


• Initiate methods to empower employees and make them accountable.


• Periodically conduct case reviews and critique on several levels to ensure consistency and continuity of patient care.


• Provide quality improvement reports on a regular basis.


• Redefine responsibilities so that there is exact expectations on day-to-day and priorities.


• Redefine responsibilities so that there is not too many assignments even for multi-tasking staff.


• Review quality assessment methodologies and initiate improvements.


• Slow down the pace of the practice, even in busy times, don't rush patients and pay adequate attention to them, despite schedule.


• Stock up the exam room(s) identically for efficiency.

• Continuous Improvement Scale (63 items)


• Continuous Quality Improvement Philosophy Scale (39 items)


• Number of errors in lab results average per week


• Number of error in clinic per week

• Highly emotional and unreasonable clients negatively affect your clinic’s performance.

• Reduce as many distractions as possible from the clinic.

• Handle highly emotional and unreasonable clientele well to increase loyalty and reduce distractions.

• Create a script of dealing with clientele to reduce client chances of acting unreasonably and test it out over 3 mo.

• Have the attendant or treating doctor explain to the client important aspect of the procedure and deliver after-care instructions.


• Have the informed consent form initialed and signed regardless of outcome and document the exchange of aftercare information.


• Accept or empathize with a Client's complaint before a justification, rationalization, excuse or explanation.


• Have a standardized method of dealing with complaints.


• Get rid of the high maintenance clients, if you have determined/proved that you can't afford them.


• Ask difficult or hard-to-please Clients to be more reasonable and understanding othewise they should have some other clinic provide them care.

• Complaint Resolution Scale


• Complaint Responsiveness Scale (#366)

• Adopting animals is one of the numerous noble deeds clinics do but could be at the cost of clinic's performance.

• Advocate for the pet

• Maximize the number of pets that could be adopted without hurting profitability.

• Adopt-out twice as many pets over the next 3 months as were adopted over the last 3 months.

• Support the "No Kill" movement, it is as important as adopting.


• Devote a certain percentage of profit to animal adoption and do not exceed it.


• Do not adopt animals from the same animal shelter, adopt them from as many shelters as possible to increase exposure.


• Publicize the adoption of new pets by publishing it in your newsletters, encouraging staff to talk passively about it to clients and in the community and ask the shelters to include the news in their newsletters if they have them.


• Offer a “support a pet” service for clients who cannot take care of extra pets in their homes by adopting a pet for them and taking care of it in return of paying the pet’s expenses.


• Provide adoption services through the practice.

• Percentage of increase in new clients after implementing the new pet adoption strategies.


• Percentage of increase in number of pets adopted by clinic and clients.

• Inventory control is a key factor in running a successful practice.

• Inventory control is key to every practice vision and mission statement

• Improve inventory management.

• Set the objective to the following benchmark: improve inventory management to free up capital with Inventory Turnover Ratio at 2.4

• Make a person responsible to check expired inventory every other week until the control of inventory is achieved.


• Make one person accountable and reward that person to reduce the expired material.


• Use local hospital pharmaceutical inventory for infrequently used items when needed in an emergency.


• Use research companies that track high volume inventory products and pay you to do so. They give you back data on your comparative cost and inventory levels. Currently, the only company that does this tracking is Vet informatics (www.vetinformatics.com).


• If you join Vet Informatics or if you are already a member of their program then have the designated inventory person track the reports they provide on their website. Ask him to control inventory according to the data they provide.

• Cost of Drugs


• Cost of Drugs and Medical Supplies To Revenue


• Cost of Food