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Learning important lessons
Dr. Simmons started his practice in 1982 and has seen it grow from a 760-square-foot storefront facility with two employees to a 15,000-square-foot free standing complex with five associates and 50+ support staff. The facility was built in 1985 and reconfigured five times since. Each time the hospital becomes more efficient and delivers more services. Today, the facility features a spectacular Pet Hotel and resort as well as a full service groomer and pet boutique.
This dizzying, 15-year upward spiral has taught Dr. Simmons some hard lessons. "When I first started my practice, there were just four of us. I was one of the gang, a buddy to my technicians and receptionists," he says. "After several months, I realized I was losing control of my practice. Then I made one of the toughest decisions I've ever had to make. I fired an excellent technician who also was a good friend. I set the tone that I'd be amicable outside the clinic in a personal setting, but inside the clinic I was in charge."
Now Dr. Simmons is learning to delegate responsibilities so he doesn't spend long hours and days off at the hospital. Through leveraging his staff, Dr. Simmons can go home at closing time and spend more time with his family.
Keeping pace with technology
When clients enter any of the hospital's seven exam rooms or separate dog and cat waiting areas, they're greeted by a television monitor showing continuous veterinary information, Like the slides projected in a theater before the movie begins, a photo-optic CD player shows pet care tips and quizzes.
But Dr. Simmons doesn't want clients to wait long. That's why there's a timer mounted outside each exam room door. When a client enters the room, the timer begins counting. An obnoxious alarm sounds five minutes later if a technician hasn't arrived.
Simmons Veterinary Clinic welcomes about 250 new clients a month. During the first visit, each pet is photographed with one of eight digital cameras. The client receives a laminated business card with the clinic's name, address, and phone and emergency numbers on the front and the pet's picture on the back. The digital photograph also is stored in the patient's computerized medical record. If the pet has lesions or other illnesses, the camera records magnified images so the doctors can keep a visual treatment history.
Dr. Simmons employs the power of 34 Windows NT workstations and a pair of 100-gigabyte servers with a 200-gigabyte real-time backup server. Besides a veterinary operating system, Dr. Simmons uses internal e-mail and a phone message system that's linked to client files.
Staff members also can open a customized appointment book in the exam room or on any of the 45 computers. A thumbnail storage system for expandable image files includes radiographs, ultrasound, lab work, and photographs. Images can be printed on a color laser printer for client education.
"My goal is to stop killing trees," says Dr. Simmons. "For the most part, we're a paperless practice, but we're still not completely weaned off the feeling of a file in our hands."
A full-time computer systems analyst trains staff, researches new and better ways to use all the high-tech gadgetry, and maintains the system. "Training is a never ending project," Dr. Simmons says.
A hospital team is working on a project to link computers with incoming phone calls. When the phone rings, the computer will automatically bring up the client's file on the receptionist's computer. A cordless headset will allow the receptionist freedom to move throughout the practice and minimize stiff necks.
The special procedures room looks more like a room at NASA than a veterinary hospital. Doctors perform ultrasonography, endos- copy, digital radiography, and other high-tech procedures. Endoscopy and ultrasound images are digitally captured and stored in the patient's file. Doctors can view the images along with X-rays without the hassle of tracking down an unused view box or misfiled film.
"For clients, seeing all this technology flash before them in an exam room may not have that much meaning," says Dr. Simmons. "But from the look on their faces, you know clients are confident you're providing their pet with the best possible care."
More than just computers
As you walk through the hospital, you realize there's more to this Practice of Excellence than just computers. Technicians in color-coordinated uniforms dart back and forth like bees in a hive. An in-house CBC/SMA blood machine is in constant use.
The pulse oximeter and ECG units in the dual surgery suite beep while surgeons perform procedures ranging from portosysternic shunts and anterior cruciate repairs to spays and declaws. Two dental procedure tables are ready for the next patients. Post- operative recovery wards lie just beyond sliding glass doors to enable patient monitoring without all the noise. Each recovery ward has hookups for ECG and IV infusion pumps, as well as automatic flush down toilet systems and high-volume exhaust fans on timers.
The facility has enough exhaust fans to exchange the building's entire air supply 10 times a day. "The electric bill jumped a notch or two, but the cost is worth it because upper respiratory incidences in my kennels and hospital are next to nil," Dr. Simmons says. Three industrial fans constantly circulate fresh air into the 34 covered outdoor exercise runs. Oscillating fans throughout the kennel and hospital minimize dead air pockets that can form with so many walls and doors.
"Maintaining an odor-free environment is extremely important," he says. "Where there's odor, something or somebody is not clean. I just don't tolerate that in my hospital."
Extras really matter
Although it has a separate entrance, exit, and air-conditioning system, the boarding kennel connects to the hospital through two doorways. Clients appreciate the facility's personal touches. Indoor dog kennels feature lockers for personal belongings.
Dr. Simmons takes the kennel seriously, not just as an add-on to the practice. "Kennel operation can be the demise of a veterinary practice, but it's not going to be the demise of mine," he vows. "In fact, it's one of our strongest assets."
A "Tender Loving Care" package offers boarders two 30-minute sessions of. supervised exercise in the training field next to the practice. Dogs can run, jump, and negotiate obstacle courses. "Even though charging for this activity increases the daily rate by 35 percent to 40 percent, almost half our clients choose the package," Dr. Simmons says.
The practice offers on-site Kindergarten, and advanced and agility training classes for dogs. Evening and weekend classes are held at the well-lit outdoor training facility. "As people drive by, they see a healthy, thriving practice in motion, and many have become long-time clients," Dr. Simmons says.
Cat condos are located in a sound-proof room with a thick glass panel so visitors can see but not disrupt the cats' quiet, comfy environment. The cat condos are 8-foot tri-level glass- mica units. A large sign on the entrance door warns that cats may be loose for playtime.
"The cats enjoy a couple hours of freedom," he says. "We're seeing more and more cat boarders. Word is out that cats don't seem stressed after their stay at our practice."
Clients also get online information about the practice and kennel from the clinic's Web site at www.simmonsvet.com. A complimentary coffee center, large walking path, and covered drop-off and pickup area are important finishing touches to each client visit.
No matter how carefully designed the building, how numerous the computers, how great the gigabytes, Dr. Simmons knows that a practice doesn't thrive without teamwork inside. Staff members, he says, are the clinic's heart and soul.
Dr. Simmons describes what happens when staff members care for clients. After he examined a tiny rat terrier, Dr. Simmons asked the client if she'd like a hospital tour while he watched her dog.
"Then a technician took the client on a tour," he explains. "I gently tucked the dog in my lab coat pocket. I was typing on the computer keyboard with this little dog in my pocket when they returned. The woman saw her dog in my warm pocket and shook her head as if to say 'unbelievable.' I took the little sleeping dog out of my pocket, handed it to her, and asked if she had a nice tour. She signed up for the six-week puppy course. She'll come back forever as long as she gets treated that way."
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