Patient safety research in human medicine has identified the causes and common types of medical error and subsequently informed the development of interventions which mitigate harm, such as the WHO's safe surgery checklist. There is no such evidence available to the veterinary profession. This study therefore aims to identify the causes and types of errors in veterinary practice, and presents an evidence based system for their classification. Causes of error were identified from retrospective record review of 678 claims to the profession's leading indemnity insurer and nine focus groups (average N per group=8) with vets, nurses and support staff were performed using critical incident technique. Reason's (2000) Swiss cheese model of error was used to inform the interpretation of the data. Types of error were extracted from 2978 claims records reported between the years 2009 and 2013. The major classes of error causation were identified with mistakes involving surgery the most common type of error. The results were triangulated with findings from the medical literature and highlight the importance of cognitive limitations, deficiencies in non-technical skills and a systems approach to veterinary error.

Significant event reporting is an important concept for patient safety in human medicine, but substantial barriers to the discussion and reporting of adverse events have been identified. This study explored the factors that influence the discussion and reporting of significant events among veterinary surgeons and nurses. Purposive sampling was used to generate participants for six focus groups consisting of a range of veterinary professionals of different ages and roles (mean N per group=9). Thematic analysis of the discussions identified three main themes: the effect of culture, the influence of organisational systems and the emotional effect of error. Fear, lack of time or understanding and organisational concerns were identified as barriers, while the effect of feedback, opportunity for learning and structure of a reporting system facilitated error reporting. Professional attitudes and culture emerged as both a positive and negative influence on the discussion of error. The results were triangulated against the findings in the medical literature and highlight common themes in clinician’s concerns regarding the discussion of professional error. The results of this study have been used to inform the development of the ‘VetSafe’ tool, a web-based central error reporting system.

Background: UK veterinary practitioners are reported to be fearful of client complaints, but their experiences have not been formally captured. Understanding how complaints impact veterinary practitioners is key to mitigating detrimental consequences. Methods: A qualitative exploration of how UK veterinary practitioners experience and respond to adverse events was conducted. Data were collected via focus groups and interviews, which were transcribed and simultaneously analysed. Coding and theme development were inductive rather than restricted by preconceived theories. Results: Twelve focus groups and 15 individual interviews took place. One theme identified focused on the impact of client complaints. Practitioners experienced unintentional distraction and disengagement from clinical work, as well as employing defensive strategies as a direct result of complaints. The vexatious nature of some complainants was highlighted, along with concerns about practice and regulatory complaint management, lack of appropriate support, discriminatory behaviours and the influence of 'trial by media'. Conclusions: Client complaints present a threat to practitioner mental health and workforce sustainability, as well as having implications for patient safety. Mitigating these effects is a complex and multifaceted undertaking, but fairness, transparency and timeliness of practice and regulatory complaint investigation must be prioritised, along with provision of tailored support for those facing complaints.

Objectives To investigate staff attitudes to the use of a surgical safety checklist in a small animal operating room and to gain insight into barriers to use. Materials and Methods A questionnaire was designed and used to assess attitudes of 36 operating room personnel to the checklist. The checklist was retrospectively audited on 984 patients over an 8‐month period to investigate compliance. Results Responses were obtained from 100% of operating room personnel. Attitudes to the checklist were positive, with 83.4% agreeing that it improved teamwork and 100% agreed that the checklist improved patient safety, reduced error and was best practice. Most personnel (94%) believed that a completed checklist was used for every procedure. Several barriers were highlighted, including issues of hierarchy and team‐working and lack of training. 984 checklists were used during the study period with 83 (8.4%) being fully completed. Clinical Significance Surgical safety checklists have potential to improve patient safety in veterinary operating rooms. However, appropriate design and implementation are critical and surgeons should endeavour to support checklist use.

Background: Veterinary healthcare can be a complex process and may lead to unwanted, potentially harmful patient safety incidents as a consequence, negatively impacting both the practice team and client satisfaction. The aim of this study was to identify how such incidents impact cats and dogs by analysing reports gathered in a large-scale voluntary incident reporting system. Methods: Descriptive statistical analysis was used to study a total of 2155 incident reports, submitted by 130 practices on mainland Europe. Results: Incidents caused harm in more than 40% of reports. Medicationrelated incidents were the most frequent type of incident recorded (40%). Treatment-related incidents were the most common type of incident causing patient harm (55%). Anaesthesia-related incidents were the most severe type of incident, resulting in patient death in 18% of these reports. Most incidents were reported from hospital wards, and a significantly higher proportion of cats were harmed by incidents compared to dogs. Conclusion:This study demonstrates that patients are regularly harmed by incidents, with medication-related incidents being most common. In depth understanding of incident data can help develop interventions to reduce the risk of incident recurrence.