• Comprehensive resource presenting information on patient safety theory and methodology in a practical and engaging format

    Veterinary Patient Safety is an engaging guide to understanding patient safety and the tools necessary for improving patient outcomes. The book is based on the fundamentals of safety science, introducing both theory, methodology and practical applications of key principals. The book follows the development of patient safety and accident theory, using real-world examples, published veterinary medical literature, as well as insights from human healthcare and other industries such as aviation.

    By understanding the reasons why accidents, errors, and morbidity and mortality associated with veterinary medicine might occur, readers learn how to implement changes to improve patient safety and outcomes. The author addresses the most common incidents in veterinary medicine, such as misdiagnosis, medication, equipment and communication errors, and includes many different how-to guides to perform patient safety investigations. Analysis techniques, such as the critical incident technique, Human Factors Analysis Classification System, Systems Analysis and The Five Whys, are explained. Critiques on theories, methodology and published studies are used to demonstrate the strengths and weaknesses of methods and analysis techniques. The importance of local investigations and the lack of a one-size-fits all approach is emphasized, alongside the importance of fostering safety culture including the debriefing following major incidents or complications.

    Veterinary Patient Safety includes information on:

    • Current data on the degree of harm occurring through unsafe care
    • Key concepts and safety theory
    • Human fallibility and the importance of non-technical skills
    • Organizational culture, covering incivility and its effect on team performance, the concept of blame and ways to assess culture
    • Reporting and learning methods, including incident reporting, debriefs, interviews, surveys, case review and trigger tools, and process evaluation
    • Explanatory analysis methods and how they can be applied to veterinary safety investigations
    • Patient safety improvement tools, including checklists and cognitive aids, simulation and teamwork building, briefings and debriefings, and debiasing strategies
    • Legal and ethical aspects of patient safety, including error disclosure, litigation, non-maleficence and the veterinary professional’s “new accountability”

    Veterinary Patient Safety is an excellent holistic resource on the subject for general veterinary practitioners, veterinary specialists, veterinary students, veterinary nurses and veterinary managers.

  • Preface ii

    Acknowledgements

    Introduction v

    Chapter 1. The language of (patient) safety 1

    Chapter 2. A Brief History of Healthcare associated Harm and Patient Safety 11

    Chapter 3. Modern Prevalence and Impact of Healthcare Associated Harm 23

    Chapter 4. Why are patients harmed by healthcare? Theories, concepts and models 73

    Chapter 5. Human performance and error; 147

    Chapter 6. Organisational, professional and safety cultures; 249

    Chapter 7. Dealing with the nonclinical aftermath of an incident or error; 311

    Chapter 8. Methods of assessment and measurement in patient safety 356

    Chapter 9. Analysis Techniques for Patient Safety Investigations 568

    Chapter 10. Patient Safety Interventions 713

    Chapter 11. Feedback and closing the loop: Quality Improvement Cycles 890

    Chapter 12. Ethics in Patient Safety Investigations; 902

    Chapter 13. Suggested unified approach for veterinary healthcare; 940

    Appendix I. Glossary of terms; 980

    Appendix II: List of veterinary clinical practice guidelines 989

    Anesthesia and Analgesia; 989

    Emergency and Critical Care (including transfusion medicine) 991

    Cardiology; 992

    Dentistry; 993

    Dermatology 994

    Internal medicine; 996

    Neurology; 1011

    Oncology; 1012

    General practice; 1012

    Equine; 1017

    Appendix III. Case studies; 1023

    Case Study 1: Improving Compliance with a Checklist 1023

    Situation 1023

    Background; 1023

    Assessment & Analysis; 1024

    Recommendations 1025

    Case study 2: Improving Reliability and Safety in an Intensive Care Unit 1027

    Situation 1027

    Background; 1027

    Assessment & Analysis; 1028

    Recommendations 1029

    Case study 3: Improving the Safety of Infused Medications 1032

    Situation 1032

    Background; 1032

    Assessment & Analysis; 1033

    Recommendations 1034

    Case Study 4: Introducing an Incident Reporting System 1037

    Situation 1037

    Background; 1037

    Assessment & Analysis; 1039

    Recommendations 1041

    Case study 5: Improving the Safety of Overnight Care 1043

    Situation 1043

    Background; 1043

    Assessment & Analysis; 1044

    Recommendations 1047

    Case Study 6: Reducing Wound Complications and Surgical Site Infections 1049

    Situation 1049

    Background; 1049

    Assessment & Analysis; 1052

    Recommendations 1053

  • Matthew McMillan

    Has been a veterinarian for over twenty years, is a Diplomate of the European College of Veterinary Anaesthesia and Analgesia, an EBVS® and RCVS recognised Specialist in Anaesthesia and Analgesia, and a Fellow of the Royal College of Veterinary Surgeons. He is currently Head of Anaesthesiology at Ludwig-Maximilians-University of Munich in Germany. He is co-author of Errors in Veterinary Anesthesia (Wiley) Cognitive Aids for Anaesthesia in Small Animal Practice (BSAVA) and was the Chair of the Association of Veterinary Anaesthetist working party who developed the AVA’s Safe Anaesthesia Checklist.

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