We need to talk about error: causes and types of error in veterinary practice

Abstract

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.

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

“…In human healthcare, similar findings relating to nurses being more prone to rate pain higher, or more willing to administer pain relief are seen, 41,42 This study also demonstrated the relevance of interprofessional working, especially communication, for quality of care and patient safety via the identification of errors. 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.…”

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.…”

Improving safety through changes to the practice culture

“…Finally, it is well-established that a significant cause of complaints in veterinary practice is poor communication (McGrath and Little 2010, Oxtoby and others 2015). This also applies to inter- and intra-professional working in practice: it can be extremely rare for the whole staff to be together, or working in the same teams; a 24-hour service implies different shift patterns or working in branch practices.…”