Communicating through Adverse Events

The ability to communicate effectively is an essential skill regardless of where your veterinary degree takes you. In clinical practice, communication within the team as well as with the animal owner or caretaker can often directly impact treatment efficacy and patient outcomes. Some of the most challenging communications will come when there has been an adverse event. Adverse events may result from an inherent risk or a medical or surgical error, such as inappropriate medication dosing or administration, or even a patient death. Below are key steps to consider when handling an adverse event whether as a student or when you are the lead veterinarian on the team.

  • Be honest and explain to the owner or caretaker what has happened. The attending veterinarian should contact the owner as soon as reasonably possible to inform them of the adverse event whether caused by an error or an inherent risk. By advising the owner in a timely fashion, they can make decisions as to how to proceed with guidance for the best care possible in the situation.
  • Explain why this has happened, if known. It is acceptable to inform the owner that an error was made in calculating a dose or that a patient was injured during handling. If the injury is the result of an inherent risk, explain the details of the case to the best of your ability.
  • Explain what will happen next, including the care steps recommended if the patient is still alive. Discuss all next steps and gain consent.
  • Always recommend what is in the best interest of the patient. After an adverse event occurs, it is essential to offer and recommend the treatment and care that provides for the best potential outcome for the patient. In some cases, this may include hospitalization, fluid therapy, blood transfusions, etc. If ongoing care is indicated, offer referral to an emergency care center or boarded specialist as appropriate. Explain as completely as possible the care that will and may be needed.
  • Explain what you will learn from this event. If an error has been made, how will you and your team work to prevent it from happening again in the future? In some cases, this may be the recognition of staff training needs, continuing education or changes in screening procedures or standard operating procedures.
  • Express empathy. Without being overly apologetic, demonstrate empathy for the injury or loss of the patient. Allow clients a moment or two to process the news and in order to not sound disingenuous, make an effort to use expressive body language.
  • In the event of a medical or surgical error, contact your insurance carrier. By reporting a claim immediately, the details will still be fresh in your mind. When a known error has occurred, the insurance provider can offer guidance for the reimbursement of fees for ongoing care at emergency or referral centers.

Ultimately, all veterinarians work to provide the best care for their patients. Despite our best efforts though, we may still lose patients either through an error or inherent risks. In the event of an injury or loss sustained during treatment, effective communication with the owner/client is the best way to navigate these upsetting situations and ensure the best outcome for you, your patient, and your client.