Introduction
Animal companions are important and dear to the owners and thus, deserve much care. Individuals have for a long time adopted pets as part of their lives to the extent they treat them like family members. This has allowed many resources to be invested in the animals’ medicine, care, and practice. Despite the efforts made to improve the field of veterinary medicine and practice, the number of deaths reported every year as a result of failure of a provider to be keen during treatment is alarming. With each passing year, the frequency of reported cases rises to a level it is becoming harder for pet owners worldwide to trust that their animals will be safe in the hands of a veterinarian.
There are individuals who have attributed the rising number of reported cases to the immaturity or inexperience of some of the providers since some of them are in their internship training programs and thus, still learning. This is a valid point but still does not encourage a pet owner since there is a possibility that a minor error, as seems to one person, can lead to drastic consequences. Even if it is not death, a mistake can lead permanent disability of a pet. The image of a hospital or clinic after such an incident can be tarnished, which may result in them not receiving any business, thus closure. Additionally, the event can lead to an emotional breakdown on the part of the individual who feels like they are guilty and responsible for what happened.
To solve the issues, it is important that everyone in the field of patient care for animals participates in the process of developing intervention methods that can help alleviate the situation. For instance, the use of checklists has been known to reduce the occurrence of errors in other fields and sectors, for example, aviation. In veterinary medicine and practice, they will help to ensure that the patient safety is upheld by reducing the likelihood of mistakes. This will enable the field to continue growing and moving in the right direction. Technological advancements also play a role in the development of the area. Cloud technology has allowed files about the medical information of patients to remain safe and easily accessible. This paper highlights the importance of the implementation of checklists and how they enhance patient safety, challenges affecting the field of veterinary medicine and practice, and technological advancements.
Discussion
Importance of Checklists and their impact on Patient Safety Within Veterinary Hospitals
The utilization of surgical safety checklists preserves many lives and reduces complications. Common misinformation concerning the checklists mentioned above is that they consume much time. However, they are more straightforward to implement and quickly improve the workflow while reducing stress. They are regularly used in other industries, for example, the aviation industry. There, they help in ensuring safety as well as the removal of human errors. Failure by a pilot to use one is regarded as a violation of flight protocol as well as a flight error. In the evolved world, almost fifty percent of harmful incidents that impact human patients are associated with surgical care, showing that bettering safety with the mentioned tools has the probability of having a significant influence on the safety of a patient.
Surgical checklists are quickly becoming a common practice in health care with the intention of reducing the rate at which complications occur. Utilizing a standard surgical checklist that involves anesthesia, ICU personnel as well as the surgical team, a system evolved that greatly reduced the rate of surgical complications at the international level in eight hospitals globally. The mortality rate experienced a dip from almost two percent to less than one percent with the application of checklist. The inpatient complication cases reduced too from eleven percent to seven percent. Checklists create three stop points that enable communication between members of the surgical team, that is, before anesthesia, skin incision as well as recovery.
The first step of this process is known as sign-in, whereby before induction of anesthesia, team members confirm the surgical site, patient identity as well as danger of losing blood. Other items assessed include whether the pulse oximeter is on as well as working, any identified allergies, and the danger of aspiration. The next step is a time-out just before performing the incision. Here, the whole team, including the observers and visitors in the OR, go through the introduction. The following are confirmed: roles, site, patient identity as well as procedure. The surgeon then examines vital and unanticipated steps, the anesthesiologist assesses issues, and the nursing personnel evaluates the equipment issues.
Confirmation of antibiotic administration as well as that the necessary imaging is displayed is as well conducted at the second step. At completion, another step known as time out is performed. At this stage of the process, the sponge, needle as well as instrument count is checked, specimens labelled, equipment concerns addressed, or relevant procedures before recovery are assessed aloud. Even though the items on the list are all reminders and tasks that qualified personnel to understand must be done, the checklist serves the purpose of reducing the rate of complication by guaranteeing that all details are kept in mind. It also leads to better communication between members of the team and a culture shift that highlights the importance of communication as well as working in unison to offer the best probable outcome.
There are challenges facing the implementation of checklists, for instance, surgical in practice. It is essential to recall that it has to be user-friendly. One can easily be tempted to add much data to a checklist to make it all-encompassing for a patient’s whole stay. An individual should resist this enticement and focus on vital information to guarantee the safety of a patient. For instance, confirming a surgical site, procedure as well as identity is important. There are things that are not needed on the list, for example, trimming the nails of a patient. It needs to be changed to fit someone’s practice, however, it must be quick and only consume thirty to sixty seconds to finish.
A checklist should contain items that are information that is conveyed between a surgeon, nurses, or anesthetist routinely. The aim of it is to ensure that the data is efficiently shared as well as those essential items are remembered since humans can forget or think that it is someone else’s responsibility. A typical instance is the administration of perioperative antibiotics (Ballantyne, 2018, p.292). Despite a surgeon being tasked with the role of ordering antibiotics, administering is the work of an anesthetist. The proper utilization of timely prophylactic antibiotics is a significantly critical part of avoiding surgical site infections. However, the timing importance is often ignored (Ballantyne, 2018, p.293). They need to be issued twenty to thirty minutes before the surgery starts for maximum effectiveness.
The checklist needs to be simple as well as widely applicable to various types of surgical procedures. Resistance to implementing a checklist is common, particularly from a surgeon. Some of them claim that they feel that they have already done a great job or that the suggestion the surgery site requires confirmation or that the count of instruments or sponge is an ideal idea is insulting to their expertise and experience. The reality is that every human is prone to making mistakes. A wrong site or patient having surgery is a stressful event for the team to experience, and even though it may seldom occur, it is good to avoid. For instance, forgetting a sponge in a cavity can cause a devastating impact on a patient’s quality of life. When attempting to implement a checklist in one’s practice, it is essential that they begin small and work closely with surgeons that are interested in participating. At times, this is what it takes to develop buy-in from other team members and surgeons.
Common Mistakes Within the Veterinary Profession
Even though every individual has made mistakes from time to time, it certainly does not feel right. The issue is in a fast-paced area, for instance, in veterinary medicine, errors can be inevitable. This can lead vets to feel guilty, dejected, or anxious. More serious slipups, almost fifteen percent of errors, resulting in patient harm and can lead to an individual leaving the practice completely. While the majority of vets feel that it is the right report as well as share errors, there are some that do not appear confident concerning the sector’s attitude towards committing mistakes. This leads to attempts to understand the circumstances that lead to the faults and which are most common. When a vet makes a mistake, there are few main reasons why it may have happened.
In research examining the causes as well as the types of veterinary faults, experts discovered that eighty percent of errors could be attributed to owner interference, cognitive limitations, and a lack of skill. Other causes include productivity issues, failure in communication as well as leadership. Cognitive limitations are commonly related to clinicians (Bailey et al., 2019). Lack of concentration usually leads to surgical faults, for example, forgetting equipment inside a patient, and medical slipups, for instance, not administering oxygen during a surgical procedure. Other cognitive errors types result in failures of short-term or long-haul memory, diagnostic tunnel vision as well as confirmation bias. Issues related to the owner’s interference could not be blamed on vets themselves. Poor outcomes are mainly due to an owner’s refusal to accept suggestions. Poor recommendations from younger vets as well as nurses are also a major cause of these errors.
Some of the common mistakes within a veterinary profession include surgical errors involving drugs and diagnostic faults. Blunders during a surgical procedure account for around fifty percent of all faults that happen in practice and are committed mostly by individuals on an internship training program. One review of about seventy thousand cases revealed that close to forty percent of negative incidents could be connected to operations. Of such occurrences, the most were from orthopedics and general surgery. Poor communication has been linked to forty-three percent of mistakes in a surgical room. Moreover, failure in leadership regarding neglecting the responsibility of promoting patient safety by ignoring checklists has also been associated with these blunders. An intern is more prone to faults when there is no supervision, especially since they do not have adequate experience in the field.
Of all the non-surgical mistakes, drug-associated errors are the most prevalent. Incidents relating to drugs account for fifteen percent of negative occurrences in veterinary medicine and practice, analgesics, as well as hypoglycaemic agents, are responsible for eighty-six percent of avoidable events. One research exploring hospital procedures discovered that fifty-four percent of mistakes involved a drug-relation case. Mainly, such incidents happened as a result of poor administration procedures, that is, offering the wrong dosage or drug to a patient. Medication faults appear to happen when there is unclear labeling, drug dosage devices are poorly designed, veterinary professionals, utilize error-susceptible symbols, or improper disposal.
Diagnostic mistakes are commonly made in veterinary medicine and practice. This is especially a reality for graduate vets who do not have enough experience and, thus, are more likely to commit mistakes. They commonly ignore doing conducting the needed diagnostic tests and therefore lead to poor judgment. A more experienced professional may have a cognitive bias which may result in similar faults. This type of bias happens when someone utilizes psychological shortcuts in their decision-making. They may neglect apparent symptoms in patients and instead choose to conduct inappropriate tests that result in misdiagnosis.
Patient Safety and Its Significance Within the Veterinary Practice
A medical care provider, regardless of their country of work, strives to offer a safe surrounding for the patient, nonetheless, human errors are unavoidable. Medical errors have been described to be acts of commission or omission in planning or execution that lead or may result in an unplanned outcome. Such events are well-known as a major cause of mortality as well as morbidity in hospitals. Recently, they have been approximated to be among the top killers in the U.S. Apart from harming the patients and potentially causing them to succumb, the errors may result in significant monetary losses and have an adverse effect on the wellness of the medical care provider. In spite of human errors being unavoidable, a system can be designed to reduce the frequency as well as decrease the effect on a patient. The first step would be to identify them regardless of whether they cause harm to an individual or not.
By assessing records of reported cases, one can conduct root cause analysis to understand the leading factors to the event and, therefore, develop intervention methods to limit the rate of them happening in the future. Numerous techniques have been used to note down the faults, including voluntary incident reporting system, medical record review, and direct observation of patient care. A study was conducted to demonstrate such issues happen more often in veterinary hospitals with an estimate of five per one thousand visits (Aziz et al., 2018, p.4). The number of reports per one visit was higher in the SAP, however, due to the study’s nature, the researchers failed to reach to conclusions about the true prevalence of errors (Aziz et al., 2018, p.8). A voluntary reporting system underestimates the occurrence of these incidents, and the number of cases reported may reflect more about the reporting behaviors or practice of hospital staff and not the frequency of the events. Therefore, instead of claiming that the SAP had a higher rate of occurrence of faults that involved patient safety, it appears most probably that the personnel is simply more aggressive.
In many instances, the cases reported failed to prove harm on a patient, which is a pattern that resembles one witnessed with voluntary reporting in people’ hospitals. Nevertheless, the majority of those incidents have the capacity to result in significant mortality or morbidity. Investigating every incident is important when designing an intervention with the purpose of reducing errors. In the research, the SAP recorded a lower rate of negative events as compared to an SAU or LAU. This shows that faults in this field may be less probably to be noticed before reaching the patient as well as possibly cause harm. Experts claim that it is common for a teaching hospital to have a significant number of students, new house officers as well as junior personnel. This is a group of individuals who do not comprehend the safety policies well in addition to having less experience with various aspects of the patient care as well as case management. Hence, in such settings, the blunders may be a major cause behind harm to clients.
Similarly, such incidents have been demonstrated in the United States in human hospitals with a rise in serious faults seen with new medical residents’ intake. Nevertheless, as a result of the voluntary nature of the research, the smaller part of negative incidents at the SAP may as well be a reflection of aggressiveness in personnel reporting non-severe cases. This may result from a higher portion of the personnel at the SAP being more experienced with the error reporting systems than at the teaching hospitals. At the latter, there are new house officers as well as students. The rate of severe faults resulting in death or long-term harm was low, at less than two percent of told incidents.
Nonetheless, while they continue to be uncommon, those mistakes can have severe effects. It is essential to identify the harm to a patient, emotional bearing on a client, the damage to a medical institution’s image, as well as psychological wellness of individuals who feel guilty for the incidents. Errors in medical care have appeared to contribute to significant emotional burnout on the part of the providers. Veterinarians have reported an adverse impact on confidence as well as mental wellbeing after a serious event of mistakes. Most of the blunders are preventable if a proper system is introduced to minimize the risk. This shows the significance of raising the awareness as well as research into these errors in veterinary medicine and practice, as well as the implementation of a reporting system and committees to assess available data.
It is important that a hospital has a system in place that allows a veterinarian to feel comfortable admitting faults as well as guide them through reporting to a client. Human doctors have the responsibility to reveal such an incident to the patient and how it is discussed has a major effect on the client’s emotional response to the event. Similar is probable for someone whose pet has suffered harm as a result of a medical error. A survey conducted on patient safety discovered that mistakes associated with drugs were the most reported type in numerous hospitals (Assefa and Abunna, 2018). The findings are supported by published assessments of such incidents whereby this type of blunders was the most disclosed.
The type of errors mentioned above is most likely to happen due to failure of administering drugs at the prescribed time. All hospitals have their own policies as well as procedures for ordering, approving, and administration of treatments. These variations impact how the types of faults are committed. In human health care institutions, a successful intervention might include digitalized doctor order entry, dosage reduction system, barcoded medication delivery system, pharmacist, and periodic, yet routinely, training. The protocols have been demonstrated to minimize the mistakes in numerous trials as well as meta-analyses. Communication faults are also high among the top reported types of errors. For a piece of information to be conveyed with efficacy, it is important for one to understand where, when as well as how to accomplish that task.
Challenges Facing Veterinary Medicine and Practice
Being a professional in the care of animals is rewarding in various ways, however, one faces challenges that may result in them quitting, for instance, remaining relevant despite the ever-changing practice norms. The career primarily meant offering treatment as well as care to unwell animals until several years ago. Nevertheless, in this era, a pet owner approaches much more than simple medical care. They anticipate a service-centered approach as well as outcomes, necessitating renewed or transformed approach towards the perception of animal health. Single veterinary clinics that once exited in particular localities are now found alongside multispecialty referrals, mobile clinics, and large hospital chains. Development in the field also means the need for improved collaboration with labs for the purpose of diagnosis.
When one fails to stay ahead with the changes, their practice can soon suffer due to irrelevance. A veterinary PM software tailors one’s knowledge and skills to meet the growing, new-age demand by aligning daily operations. Thus, eliminating redundancy as well as limiting dependence on human intervention for everyday functioning. For example, the program can aid an individual in collaborating with speciality clinics or bigger hospitals to offer or get referrals. Inbuilt techniques can assist them in retrieving reports on diagnosis directly from the lab without the need to consume much treatment time. It can as well make it possible for them to accept payment through numerous means from the clients.
Another challenge facing the practice is managing pricing as well as cash flow. The former is a vital part that enables veterinary medicine and practice. Any procedure that someone performs in their clinic requires to be priced reasonably so that the customer cannot be disgruntled or negatively impacts the individual. Cash flow is another issue in the field, as suggested by (Armitage‐Chan and May, 2018, p.68). Almost all professionals in the area go through lean durations in some form. However, with software, both phenomena can be improved (Armitage‐Chan and May, 2018, p.68). Most solutions for managing clinics provide reports on expenditure categories, income from most-availed processes, most paying treatments, among others. This allows an individual to tailor the prices to enable satisfying returns. Additionally, the system helps one to learn the patterns as well as plan ahead to provide a special offer in order to attract more clients during a low season.
The third challenge is responding or reacting to rivals in the same field. The digital era means an increase in competitiveness which projects through rivalry. It may not necessarily come from a similar clinic but also a pet store mobile clinic as well as online diagnoses. A tech-savvy pet owner now relies majorly on peer reviews, social media, and web presence to learn the best care choice for their animals. This has made it compulsory for veterinary practices, whether large or small, to have a data-rich, user-friendly website along with a great social media presence.
These features add credibility to the practice as well as also present the clients the chance to write good things about one’s service that can ear attention among other people. Defeating the competition is easier when a veterinarian has software to manage all of his work activities. These programs come with inbuilt mechanisms that give one a step ahead of the other by helping them market their clinic via the internet. Most solutions also aid in building an individual connection with a patient or pet and their owner by enabling the functionality of greetings birthday wishes, among others.
The fourth challenge is dealing with one’s employees, which makes the practice difficult. Staff members at a front desk and technicians in a clinic play an important role in the practice’s success. Peak hours can be tiresome not only for the veterinary but the other individuals too. During the rushed duration, the employees are usually asked to switch constantly between numerous tasks such as registration, patient calls, admission, medicine, or equipment retrieval (Davidow, 2021, p.1111). The greater the manual input in each of the tasks, the more the chance of an error happening. Personnel who are handling several responsibilities may quickly neglect one or more, which might result in mistakes later, for instance, a missed appointment, incorrect bill, or overlapping schedule. This is when the importance of having management software is realized. Various tools as well as modules contained in the program help in the automation of activities such as sending reminders scheduling a meeting, among others. Such systems can also be developed to optimize workflow associated with managing inventory, processing bills as well as pet admissions.
The other challenge is handling pet owners who are proving to be difficult. On the one hand, dealing with a client with care can ensure that whenever they need veterinary services, they seek the individual. On the other hand, an angry or disgruntled customer is unlikely to come back (Curth, 2018). When a care provider bears bad news concerning their animal friends, a pet owner can quickly become unmanageable. In this regard, veterinary management software can be useful (Cray et al., 2018, p.1052). Such a program allows one to teach the customers regarding the need for preventive medicine as well as routine veterinary wellbeing checkups via the utilization of inbuilt communication modules. Moreover, a good program also offers information about certain clients on long-standing pet owners most significant payers, among others. Reports such as those can be utilized to run loyalty tests. Rewarding loyal clients gain the attention of the customer base, however, it enables marketing techniques, for instance, word of mouth, which attract more customers.
The other challenge is learning all along since the practice is always evolving. It is important that one remains updated concerning the treatment options, surgical procedures, and therapies. Attending conferences, seminars, or short-time training programs can offer someone’s practice a boost like not before. Similar outcomes can be reached by listening to podcasts and watching videos by an acknowledged member of the veterinary field. The software can also be a source of such data as well as the latest news from the area of practice.
How Changing Technology is Helping Veterinary Medicine and Practice
Advancements in technology have aided the quality of life of both humans as well as animals. The area of veterinary medicine has experienced significant transformations enabling the practitioners to make quicker diagnoses, more correct prognoses, and eventually, save animal lives. The utilization of technology has also ensured good results for the pets and their owners (Bondad‐Reantaso et al., 2021, p.1473). Over the last ten years, the field has witnessed several changes regarding diagnosis, care as well as treatment. Magnetic resonance imaging, laparoscopy, and ultrasound scans that were utilized only on people are now helping to treat pets and other animals. Digital radiographs are replacing x-ray films for digital communication, effective treatment, and detailed evaluation. Others include digital dental x-rays as well as advanced oral surgery instruments allowing veterinarians to improve oral wellness in pets. Latest inventions address medical issues in animals within clinics for the purpose of prevention as well as better care.
Some of the technological innovations that have helped improve veterinary medicine and practice include wearable devices, 3D printing, and minimally invasive surgical procedures. Increasingly, animal wearables are being utilized to monitor their wellness (Dunfield et al., 2018, p.790). The gadgets that capture critical statistics such as heart rate, body temperature, pH levels, and respiration rate help maintain a track of the pet’s wellbeing on an endless basis. Such tools also better diagnoses as well as lead to quicker, better, and more correct treatment.
3D printing is much beneficial in surgical procedures for pets and other animals as well. The technology enables a veterinarian with information about internal bone as well as muscle structures of the animal that is scheduled for operation. It promotes rapid prototyping that aids in creating animal bone models from the data collected using digitized tomography scans. Such developments are a boon too for the owners since they assist in their education concerning their animal companion’s physiology and anatomy. This technology is also significantly applied to produce custom-tailored prosthetics for the animals, which is a tough task to accomplish.
A surgical procedure through minimally invasive methods can now be conducted on near any part of the pet’s body, including the heart as well as other internal organs. The technology extremely minimizes post-surgery recovery time for a pet as well as helps them to go back to their normal selves fast. Other developments in the field include surgical monitoring gadgets, microchip fracture detection for broken bones, corrective laser eye surgeries, and an oral pill camera that obtains internal images when swallowed.
Advancement in technology has helped not only veterinary medicine but also the practice. The computer programs, despite not being new to the market, have gotten a boost, with most software vendors transitioning to the cloud (Benis, 2018, p.269). One of the benefits of this is the ease of accessibility. When a piece of data, as well as medical records, get backed up in the cloud, a veterinarian can retrieve them without a struggle, for instance, in just a button click using any internet-enabled gadget. This becomes immensely critical when the records need to be available instantly or during a case of emergency.
Another benefit is improved collaboration since caring for animal companions needs teamwork. A digitized medical record stored in the cloud allows every team member to access and work on the newer information even when they are in different time zones. Latest computer programs allow hospitals and clinics to access outcomes directly from diagnostic labs, hence reducing the time needed for treatment significantly and making life easier for the owners. Such sharing of data via the internet also betters treatment effectiveness and minimizes the likelihood of medical errors.
Another benefit is the safety offered by the cloud storage method. Files stored in a cloud-based veterinary practice management computer program are saved, backed-up as well as restored to another off-site location. This prevents theft or ruin as a result of calamities or hardware crashes. Lastly, cloud technology is cost-effective (Belshaw et al., 2018, p.7). Software or programs in this technology save veterinarians the effort, time, and money spent on program installations, servers, on-site consultants, or updates. The majority of the systems provide flexible pricing plans fitting for the needs and magnitude of the practice. Improved web marketing, computer software systems, and advanced medical technologies are driving the international veterinary services market. Therefore, the adoption of the latest technologies in the field becomes indispensable to veterinarians, hospitals, and clinics aiming to better their practice.
Conclusion
The use of checklists is a practice that has been popularized and much encouraged in fields that involve human lives. For instance, as mentioned earlier, the aviation industry utilizes them. A pilot is not allowed to take off without going through the whole process, and it is considered a violation of protocol. This makes it difficult for accidents to occur as they can be fatal and risk the lives of people. It is not different from the field of veterinary medicine and practice. The life of a pet is at stake, which means that it is important that a care provider follows all the procedures needed to reduce the occurrence of errors.
Checklists such as those used for surgical safety protect lives and limit the frequency of complications. Since more hospitals adopted them, mortality rate has been reduced by a large margin. This is important since it helps the field to grow. Pet owners view their animal companions as close, similar to family members. Understanding this, the veterinarians need to ensure that therefore need to act in the same way they would be treating people. Cases of negligence have tarnished the image of some hospitals, which has also threatened the status of patient care in the entire field. Disgruntled customers or clients have aired their grievances using various means, including social media, and led to insecurity among other pet owners.
To continue restoring the trust and faith individuals had in the practice, veterinarians have embraced the use of technology, for instance, wearable devices, 3D printing, and minimally invasive surgical procedures. These help improve the efficiency of treatment options reducing the likelihood of destroying life. Additionally, cloud storage has enabled the safety of medical records, which in the past suffered the fate of damage after a calamity or theft after hardware went missing. The paper has generally shown that checklists are essential in veterinary practice, and also technological advancements have ensured continuous growth of animal care.
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