No matter who you are or what career path you’ve chosen,
everyone has made an error at work at one point or another. While some mistakes
may not seem as dire in other professional settings—missing an appointment, sending
an email to the wrong recipient, losing your temper when faced with a
challenging situation—errors in the medical field can come with heavy
consequences.
Losing your temper or getting into a heated argument with a
client, for example, can result in a veterinary license board complaint. Making
a mistake during treatment can lead to expensive emergency care or even the death
of a patient. Sending an email containing confidential information to the wrong
recipient can become a data and privacy breach that results in legal action. These
and other errors can be compounded when social media and negative reviews are
added to the mix.
Because veterinarians and their teams face such potentially
high risks, it’s critical to know how to respond when an error happens. We’ve
previously addressed what veterinarians should do if a medical error (real or
alleged) is made, but the ripple effect of some mistakes travels far beyond pacifying
a client or reaching out to your malpractice policy carrier for aid. What about
the emotional toll on you and your staff? An error—especially a significant
one—can be a blow to the professional self-esteem of the person who committed it
as well as the overall morale of the team.
In this article, we explore ways that veterinary staff can
navigate errors as a cohesive unit and grow from them.
The nature of veterinary clinics lends itself to group-mediated error.
In the typical practice setting, veterinary care is a group
effort that begins with the front desk staff and culminates in treatment
provided by the veterinarian and technical support staff. Frequently, a medical
mistake made by one employee has implications in the professional lives of
their team members, and miscommunication between various players is often the
root cause of errors. Consider the following scenario:
A nine-month-old F Yorkshire
Terrier is brought in for deciduous tooth extraction. The veterinarian and
technicians are busy with an emergency, so the receptionist sets the patient up
in a cage prior to surgery. The owner is not asked to sign a consent form. And
the receptionist does not update the cage card, which states the patient is to
be spayed. Once the emergency is stable, the veterinarian and her team complete
the surgery, performing the procedure indicated on the patient’s cage card. When
the client returns to pick up the dog, they are irate to discover she had been
spayed, claiming she was going to be bred and they have lost money due to the
loss of future litters. They leave with the dog, refusing to pay, and later
leave nasty reviews online.
As this example demonstrates, mistakes made by one clinic
employee can directly affect their fellow team members and the practice at
large. This observation isn’t intended to scare veterinarians into thinking
they can never make a mistake. That’s not realistic. Instead, it illustrates
the necessity of facing errors together, as a unit, since the fast-paced nature
of veterinary medicine rarely results in mistakes that only affect one
employee.
Working together after treatment-related errors creates
better long-term outcomes.
The steps below outline a healthy, team-centric approach to
addressing mistakes made in the workplace. Note that this process should only
be followed after the individuals directly involved in the error have had
a chance to decompress and settle their emotions. Depending on the severity of
the mistake and its consequences, the time needed for the employee to regain
their composure might range from a few hours to a few days. Use your best
judgment to determine when to hold your all-staff meeting.
- Create a plan ahead of time. Before a mistake happens, the entire practice staff should know the process that occurs in the wake of a misstep. A team that understands that all mistakes will be calmly and professionally addressed as a group will recover from errors faster than a team that does not have a process in place. Knowing that all mistakes will be approached as a team helps shift staff from a reactive, blame-casting mindset into a problem-solving mindset.
- Encourage calm discussion. A neutral party—ideally, a team member who wasn’t directly involved in the mistake—should lead the discussion and guide the staff through a series of pre-set questions. No matter how frustrated everyone might feel, the meeting should open with a reminder that everyone should remain calm and professional. Devise a system to ensure people don’t interrupt or talk over each other and stick to it firmly.
- Don’t make assumptions. Each team member should be given the opportunity to describe the events as they happened. This process allows the team to create a more detailed picture of what led to the incident and is essential to identifying ways to avoid a similar error in the future. Additionally, the team member who caused the mistake should be given the opportunity to take ownership and offer apologies, if appropriate.
- Identify the crux of the problem. Examine the details of the mistake critically. Did some part of your current process lead to this error, such as poorly organized supplies or badly marked exam rooms? Was the error the result of a hectic schedule or a lack of communication between team members? All mistakes have a root cause, even if that cause is something as simple as, “Our workload was extremely busy today. I was frazzled and not thinking clearly.”
- Create a plan to reduce the likelihood of the mistake occurring again. Whether it’s reexamining the way materials are stored in the practice, improving team communication, or issuing reminders to slow down and double-check your work on hectic days, look for ways to reduce the likelihood of the mistake being repeated. All team members should be allowed to suggest potential solutions, and the meeting leader should encourage staff to bring ideas to their attention after the meeting.
- Create a plan to contain or minimize the fall out. Work together to determine the best way to handle consequences of the mistake. In the scenario above, an appropriate response might include following up with the client to explain the mistake and offer an apology. It is also an opportunity to explain new protocols that have been put into place to prevent a similar error from happening again. Be cautious when responding to criticism online or in another “public” forum, however. For tips on addressing negative online reviews or social media posts, visit the AVMA’s Reputation Management Toolkit.
- Conclude with a reminder that everyone is trying their hardest and everyone is human. Before everyone heads home for the day or returns to work, end the meeting on a positive note (if appropriate). Thank everyone for their contributions to the discussion and remind them that if they have feedback to submit in the days following the meeting, they’re encouraged to do so. Demonstrate gratitude for the team-centric approach and offer the employees who committed the mistake any supportive resources that they might require.
Try these tips to regulate your emotions in the wake of an error.
If you find yourself stressed or upset in the wake of an
error, consider the following options to help get your emotions under control:
- Take a short walk.
- Spend a quiet moment alone in the practice’s breakroom, restroom, or another private space. Take deep, soothing breaths.
- Text or call a friend or loved one.
- Pull a trusted fellow employee aside and talk things through.
- Speak to a medical professional, if necessary. Not sure where to turn for help? Refer to the AVMA’s State Wellbeing Programs for Veterinary Professionals.
If after taking these steps you still feel frazzled and
unable to work, speak to your supervisor immediately. Working in a bad
headspace may lead to additional errors. It is better to request a longer break
to appropriately gather yourself than to push through and potentially harm a
patient. If taking a break is simply not possible, repeat the emotional
regulation steps as often as you can, triple-check your work, and be sure to decompress
after you’ve left the practice for the day.