Adults learn when there is a "teachable moment". Effective trainers develop teachable moments by capitalizing on "discoveries" within the daily operational flow of the zone. As previously described, there are four different adult learning types, and they must each be addressed differently.

 Role players are only one type.

 Data/fact-heavy explanations are only desired by one group.

 Examples of similar success stories are needed by the third group.

 Active and timely hands-on application is needed by the fourth group.

The leadership skill "effective teaching" is diagramed in Appendix B, Building The Successful Veterinary Practice: Leadership Tools, and has been provided in the VCI® Signature Series Monographs Staff Orientation & Training, Leadership Action Planner, and Leadership Principles & Skills, and is shown on the Leadership Pocket Card published by Catanzaro & Associates, Inc.(VCI®). A list of VCI® pocket cards is provided below.

When Veterinary Consulting International® initiates a year-long consultation, it is a "change process" that requires total commitment by leadership and staff. The initial four-day visit allows us a diagnostic insight to the practice, finding the strengths within the team, and provides the beginning of the programs and systems efforts. Then it is up to the practice team and leadership to make the words in the transition plan come to life. If we Always do what we have Always done, we are always going to Get what we have always Gotten (A²=G²). Change takes both time and commitment by the leaders and followers.

Life on the veterinary healthcare delivery team will never be the same, following a conversion to team-based veterinary healthcare delivery. The core belief is that by building on strengths, those of the staff, as well as primary providers, greater contact, more client-centered awareness, and impassioned patient advocacy will emerge. Staff members are identified as "ready" to become zone coordinators, program managers, and even coordinators/managers in development, to be discussed in the following chapter.

We must realize that regardless of the dreams and talents of the leadership in any practice, the difference will be made by each staff member. A savvy veterinary healthcare delivery team recognizes early that each staff member is at a different starting point on this new journey, and changes must start with where they are to get to the new level in the future.

The governance, administrator, coordinators, managers, and trainers need to understand the stages of learning and change (see Figure 5.2, in Building The Successful Veterinary Practice: Innovation & Creativity):

 Most people are clueless and comfortable before the consult visit. They didn't know what they didn't know. Complacency was the state of mind. It's a "Ho-hum, we've always done it that way", relaxed attitude. The need each person has is to discover the rationale for learning and clear direction with the detailed instructions. This is the "Forming Stage" in group development (see Appendix B, Building The Successful Veterinary Practice: Leadership Skills).

 Soon after the exit staff meeting, some of the team will be clued in and uncomfortable. They now know what they didn't know. All at once they become aware and feel awkward. This is the "Storming Stage" of group development (see Appendix B, Building The Successful Veterinary Practice: Leadership Skills).The leaders must use persuasion and coaching techniques, with the healthcare team in each zone, while balancing the needs of the group and the needs of the individual. Stages of resistance will become very visible within the healthcare delivery teams.

 First stage of resistance (uninformed and happy) equals excuses:

 Team members need readiness to learn, not just training.

 "What's in it for them" is needed.

 They need to understand the "why" of change.

 Second stage of resistance ("I told you so") equals fear of failure:

 Team members need the opportunity to make mistakes.

 Celebrate the attempt.

 "What can we do better next time?" is the question.

 Believe it or not, all teams make it through the Storming Stage and into the Norming Stage, where they become awkward, but trying. The zone teams are aware of the learning process and feel nervous about making mistakes. The practice leader needs to give coordinators space during this stage, to turn "attempts" into learning situations. The leadership will experience glimmers of hope and cautious optimism. The practice leadership needs to set the example, and allow zone teams to practice what they are learning. Feedback and mentoring are key elements to this stage.

 The light at the end of the tunnel comes into view as we near the Performing Stage (see Appendix B, Building The Successful Veterinary Practice: Leadership Skills). Since this is where people exceed the expectations of their leadership, they appear to be proud and accomplished. They know the zone team has arrived, when the team feels sure and secure. They sound positive and creative. Each zone is easily showing pride and achievement.

Coordinators now need for their leaders to consult with them before changes are initiated. It is a total healthcare team effort now. Everyone now realizes it is OK to let go of the old ways and unilaterally take on new opportunities for innovation.