Errors in veterinary practice: preliminary lessons for building better veterinary teams

Abstract

Case studies in two typical UK veterinary practices were undertaken to explore teamwork, including interprofessional working. Each study involved one week of whole team observation based on practice locations (reception, operating theatre), one week of shadowing six focus individuals (veterinary surgeons, veterinary nurses and administrators) and a final week consisting of semistructured interviews regarding teamwork. Errors emerged as a finding of the study. The definition of errors was inclusive, pertaining to inputs or omitted actions with potential adverse outcomes for patients, clients or the practice. The 40 identified instances could be grouped into clinical errors (dosing/drugs, surgical preparation, lack of follow-up), lost item errors, and most frequently, communication errors (records, procedures, missing face-to-face communication, mistakes within face-to-face communication). The qualitative nature of the study allowed the underlying cause of the errors to be explored. In addition to some individual mistakes, system faults were identified as a major cause of errors. Observed examples and interviews demonstrated several challenges to interprofessional teamworking which may cause errors, including: lack of time, part-time staff leading to frequent handovers, branch differences and individual veterinary surgeon work preferences. Lessons are drawn for building better veterinary teams and implications for Disciplinary Proceedings considered.

Challenges facing the veterinary profession in Ireland: 1. clinical veterinary services

“…In fact, lack of clients’ trust due to poor communication has been described as one of the most pervasive problems in veterinary practice [16]. Moreover, improved communication can help prevent errors in veterinary practice [17], and a UK disciplinary case on emergency out-of-hours care [18] illustrates the importance of appropriate communication, if, and when, conflicting interests arise. In order to meet their clients’ expectations, veterinarians need to learn how to effectively communicate the value (i.e., service, goods) they are delivering [19].…”

The case of veterinary interprofessional practice: From one health to a world of its own

“…Errors relating to challenges of the system, rather than an individual's mistake, are increasingly recognised in healthcare 43 and are beginning to be researched in the veterinary field, 44 as explored in a further publication from this overarching study. 31 Case studies are an ideal approach to investigate interprofessional working in veterinary practices. The benefits of case studies include researching a phenomenon which has multiple variables of interest, in depth 23 and through a variety of lenses.…”

“…As the topic of errors is substantial in its own right, the results regarding error and blame are explored in depth in an article within a veterinary specific journal. 31 In summary, the 40 instances identified as an error mainly related to communication mistakes -both interprofessional and intraprofessional.…”

Duty hours restriction for our surgical trainees: An ethical obligation or a bad idea?

“…The vast majority of these new graduates reported working without supervision. Other studies of the incidence of errors in veterinary medicine are focused on specific aspects of practice, such as adverse events after dispensing errors, insurance claims, or observational studies in general practice . Similar to human healthcare, these studies show that systematic and communication errors are the most common causes of adverse events in veterinary medicine.…”