Case Study: NorthStar VETS
NorthStar VETS is a cutting-edge veterinary emergency trauma and specialty center, one that excels with its technician training program even as the team constantly seeks to improve it.
Hospital administrator Brie D. Messier, MBA, nursing supervisor Rose Pierson, CVT, and Deon Spencer, CVT, professional development coordinator, discussed NorthStar VETS’ technician training program as well as a few of their current procedures.
Bird’s Eye View of NorthStar VETS: Veterinary Emergency Trauma & Specialty Center
• 1st AAHA Accredited Referral Practice in NJ (2010)
• Open 24 hours a day, 7 days a week, 365 days a year
• Voted 2012 Best Specialty/Referral Hospital Design Award Winner by
• Specialty services: Neurology, Avian and Exotics
– 55 technicians and assistants
– 1 hospital administrator
– 1 professional development coordinator
– 1 office manager
– 8 emergency clinicians
– 18 specialists
The Technician Training Program: Where It Begins
Hiring at NorthStar VETS is a three step process. Phase I begins with Rose Pierson, who carefully screens written applications. Phase II is an in-person meeting with Rose and either Brie or Joan Fischer, office manager. “Everyone says they love animals,” notes Brie, “but…we have to dig deeper.” Phase III consists of a working interview, which involves an experienced technician or supervisor working directly with the candidate. Although veterinarians are not involved in the working interview, the process usually suggests whether the candidate will be a good match with the veterinarians on staff as well as with clients.
Rose says, “Our hospital’s philosophy is to teach—if they’re a good fit, we can teach them everything they need to know.”
Creating Well-Rounded Technicians
Having “floating” technicians stationed throughout the hospital departments helps create technicians who are well-rounded. In addition, extensive cross-training avoids the need to station employees in one place because no one has been trained to replace them.
Management evaluates schedules and makes decisions on who is cross-trained, such as placing a technician in ICU on a day when it isn’t busy so that he or she can learn additional skills. Supplemental personnel or staff can be rotated if too many people are concentrated in one area—taking into account any unexpected circumstances.
If managers receive feedback that a particular arrangement is not working, they change it—and they readily admit that many schedules have been modified to maximize efficiency.
Technician and Assistant Levels
Technicians and assistants are grouped by level based on experience and clinical responsibilities. From the moment a technician walks through the hospital door, he or she has a clear outline of what skills are needed to be promoted.
When testing for a higher level, technicians and assistants perform the new duties under the supervision of a senior technician. For the final exam, mastery of those same skills must be demonstrated. The hospital’s organizational chart accommodates the constant updating of employees’ changing levels, which are designated by the color of scrubs: assistants wear grey scrubs and technicians wear navy blue (with doctors in light blue), so that in emergencies the right people can be pulled in immediately.
The goal is to ensure that technicians and assistants don’t become static, both in carrying out their duties and in fostering genuine enthusiasm and interest in doing the best quality work possible.
Examples of levels:
Level 1 assistant: Knows basic normal values (TPR, MM); how to properly clean cages and restrain large dogs; understands common terminology and ISO protocol
Level 1 technician: Able to place cephalic, medial, and lateral saphenous catheters; knows how to properly obtain a blood pressure via Doppler; can triage emergencies appropriately
Level 2 technician: Able to effectively monitor all noncritical patients under anesthesia; can properly document all controlled drugs; is comfortable handling exotic species
Level 3 technician: Can monitor all critical patients under anesthesia; able to place nasal oxygen lines; able to obtain a blood gas aseptically
Six CE (continuing education) credits are required to be promoted to the next level. Staff are given time to accomplish both the tests and CE credits, as the level system is designed to encourage technicians to start a dual career path. CE is offered at different times and days—crucial flexibility for staff in such a big hospital.
Every other month mandatory CE is offered for technicians. In February, it focused on interpreting ECGs. Staff learned to read the difference between VTach and VFib.
Dual Career Path
Brie, Rose, and Deon all agree that they “don’t want people [just] clocking in and clocking out.” A greater engagement is asked of every technician to truly invest in his or her professional future, which the hospital supports by creating dual career paths.
A broad range of opportunities besides management are available for technicians to pursue. They can specialize in critical care, acupuncture, subspecialties like anesthesia, or if they’re interested in finance and marketing, they can go back to school to earn a certification or degree of their choice. Brie explains, “We create a flexible schedule, reimbursement, and merit raises, depending on which certifications or degrees have been obtained.”
A Learning Culture
A culture of learning is not just encouraged but ensured with the help of managers and doctors alike, who support technicians’ professional career development.
Doctors frequently hold impromptu lectures on conditions like Cushing’s syndrome and Addison’s disease; “pop-up education” allows technicians to learn during live surgeries and procedures.
Receptionists are encouraged to attend CE as well. It permits a better understanding of the medical ailments of patients and allows insight into their colleagues’ roles.
In this culture, people aren’t afraid to say, “I’m sorry, I don’t know how to do that.” This creates an environment in which all staff is learning every day.
A prevailing attitude is that no one should be surprised during a performance review. Feedback is given regularly on the floor or immediately after a situation occurs in which all employees (regardless of their scrubs’ color) are expected to participate.
Brie indicates, “We have open communication as part of our mission, which can be difficult and scary. But we try to give employees the tools they need to solve problems on their own. We’re also vocal about who did a great job, because it’s important for people to say ‘I saw how what you did made a difference.’ ”
In the past, feedback was also provided biannually during performance evaluations with 360 degree reviews. Currently (as is consistent with a culture of constant improvement) the hospital is adjusting to an annual process that is “a little less taxing.”
Looking to the Future
“We’re not perfect in everything we do,” offers Brie, “but we’re striving every day to get there.” | EVT