Patient safety events cause harm across a variety of veterinary care settings: a global retrospective analysis

Objective To describe the characteristics of voluntarily reported patient safety events (PSEs) in primary care, specialty, and emergency veterinary facilities in the US and Europe. Methods This was an observational study that retrospectively analyzed PSE data reported electronically from 2,284 veterinary facilities across 5 veterinary multisite practice networks between January 1, 2021, and December 31, 2022. We reported PSE rates/1,000 patient visits with 95% CIs and used chi 2 tests to examine differences in incident type, patient outcomes, and species between primary care and/or emergency practices. Using data from one of the networks, we compared event reporting rates, as well as major-harm and death rates, among species relative to patient visits, reporting incidence rate ratios and 95% CIs. Results A total of 64,404 PSEs were included in the analysis. Sixty-five percent were submitted by primary care facilities, and 30% were submitted by specialty and/or emergency facilities. Most reported events were classified as causing no harm or were "near misses" (73%; n = 47,040), whereas 6.1% (3,925) of all incidents were deemed to cause major harm or patient death. Patient care and handling and medication-related incidents were the most common categories of reported events, whereas anesthesia/sedation events were most common among those resulting in either major harm or death of a patient. Compared to dogs, cats had significantly more reported events relative to the overall patient visit population. Both cats and exotic species, including small mammalian companion species, birds, and reptiles, were more likely to experience events resulting in death or major harm compared to dogs. Conclusions Patient safety events occur in a variety of veterinary care settings. Patient safety events having a higher impact on patients, including those resulting in major harm or patient death, make up a small percentage of all reported events. The most common PSEs reported were related to medication use and patient care and handling. Cats may be at increased risk of experiencing PSEs, and cats and exotic species may suffer more severe harm when they occur. Clinical Relevance Errors in veterinary healthcare occurred at a predictable rate. Veterinary practices of all types should collect data on the PSEs occurring in their facilities to identify opportunities to improve the safety of their patients.