This session starts with a discussion of the various definitions of 'client retention,' including a variety of parameters one can measure with regard to retention. Attendees will define the aspects of client retention most critical to their own hospital, then explore the various factors that might affect retention. Taking this "evidence-based" approach to management will help you truly know what is going on with your practice and how your ideas are working.

Five tips for measuring and improving client retention
1. Define what you want to measure
2. Make the measurement, and evaluate your own trends year to year
3. Generate theories about how you could improve
4. Evaluate how you might verify those
5. Measure to verify whether your change was effective

Client retention is important always, but particularly in tough economic times. Unfortunately, many practices have not measured this item and have found themselves guessing about whether their retention is down. Measure and verify to find out what's going on in your hospital. Gut feeling is not a measurement.

The basic method of measuring client retention is:
          • Measure the number of your active clients during year 1
          • Of those, how many were active clients during year 2?
          • Year 2 divided by Year 1, times 100 = percent retention

The above equation is the 'standard' measurement that compares one year to another. It includes a major assumption, which is a shared definition of an 'active client.' One way to define 'active' is a client who has brought a pet in for an appointment at least once during the stated year. However, variation can occur if this definition includes any purchase by a client at all (e.g., for pet food), versus having the pet actually be seen by a doctor. Also, some practices may consider that a client who comes in only once every 18 months is still "Active," especially in hard-hit economic areas where clients may have put off services for a short time.

Other practices may want to know the percentage of their clients who have truly "bonded" to the practice, and that definition varies among practices. For example, a practice may want to know the percentage of clients who actually bring their pet in at least twice a year, and to find out whether or how that improves year by year. An equation of a similar format to the above can be created to make this measurement year by year.

      2. Make the measurement, and evaluate your own trends year to year

What's typical? That's the problem... we don't know. Start measuring now, and then you will have numbers for comparison year by year.

      3. Generate theories about how you could improve

Once you have measured, what do you do? Behavior drives numbers... but, how? What behavior could this number reflect? How can you verify that? Brainstorm all the possible factors with your team, then figure out how you can verify whether those items have an actual impact. Client retention could be influenced by the type of reminder system used; by doctor-client rapport and trust; or by the ability of the doctor and team to communicate the importance of recommended health care.

      4. Evaluate how you might verify those ideas

One idea is to have the client services team make the "next appointment" with every client upon check-out. This could increase the percentage of clients that return at the recommended time for recommended exams or diagnostic testing. If you implement such a strategy, you want to know if it is having the intended impact. To evaluate that, you must have "before" and "after" measurements.

      5. Measure to verify whether your change was effective

You had a great idea of how to improve retention, and it was implemented. You have a "good" gut feeling... but how do you know that it worked? Measure and verify.

In summary, the recession provides an opportunity. Gather data to create goals. Evaluate how behavior influences data. Follow trends and outcomes, and continue through good times and bad.

Resources

Client Satisfaction Pays: Quality Service for Practice Success. 2^nd Ed, AAHA Press 2009. Carin A. Smith, DVM http://www.aahanet.org/

Team Satisfaction Pays: Organizational Development for Practice Success. Smith Veterinary Consulting, 2008. Carin A. Smith, DVM http://www.smithvet.com/