Blame and shame in the veterinary profession: barriers and facilitators to reporting significant events

Abstract

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.

Significant event reporting in veterinary practice

“…A paper by Oxtoby and colleagues, summarised on p 501 of this issue of Vet Record, has provided a novel understanding of the barriers and facilitators to the reporting of signiicant events in the veterinary profession. 29 They found three main themes that inluence the reporting of signiicant events: the efect of culture, the inluence of organisational systems and the emotional efect of error. They have thus provided the evidence base for a paradigm shit in attitudes towards error in the veterinary profession.…”

“…learning one. 29 With the growing awareness of the problems of mental health within the profession, this culture shit is vital and urgent. This change will ultimately beneit the profession as a whole, our colleagues as individuals and the animals that are entrusted into our care.…”

“…In their paper, Oxtoby and colleagues concluded that a national veterinary signiicant event reporting system should be a simple online tool, accessible to all, with readily available feedback and support and hosted by an organisation independent from the regulator (ie, not the Royal College of Veterinary Surgeons). 29 The results of this study have been used to inform the development of the Veterinary Defence Society's VetSafe tool, 31 which is designed to fulil the requirements outlined above. This is a bespoke and conidential online system that allows veterinary practitioners and veterinary nurses to record signiicant events in their practices.…”

“…It could be suggested that the profession is currently mired in a culture of blame and shame 29,30 . As discussed by Oxtoby and colleagues, the profession needs to change its culture from one of blame and shame to a just and learning one 29 .…”

“…It could be suggested that the profession is currently mired in a culture of blame and shame 29,30 . As discussed by Oxtoby and colleagues, the profession needs to change its culture from one of blame and shame to a just and learning one 29 . With the growing awareness of the problems of mental health within the profession, this culture shift is vital and urgent.…”