The role of communication in mistakes

The consequences of poor communication in veterinary practice 

Something goes wrong. A mistake is made. A complaint is lodged or potentially a claim is filed. But the impact of poor communication can have a far wider impact, both short and long term:  

• Negative client experiences and low levels of satisfaction  
• Poor patient outcomes  
• Reduced ability to deliver safe and effective care  
• Frustration and low levels of job satisfaction 

At the VDS, we know how important a role communication in veterinary practice plays in cases of litigation and complaints. It is the job of our Claims team to support VDS members in these situations. Their experience and know-how is integral to the way in which we support and develop resources for our members, including the development and delivery of veterinary communication training which our training team have been doing for over 20 years.  

Poor communication leads to poor outcomes – Where’s the evidence? 

Our claims experience provides a solid evidence base of the amount and types of communication problems experienced in veterinary practice.  

Recent research¹, undertaken by Elly Russell of VDS Training, looked at 100 closed VDS cases of alleged professional negligence. Elly’s research examined not just how often communication in veterinary practice played a part but also the different types of communication problems encountered.  

The study found that in 80% of cases, communication had some sort of contributory role to play in the complaint.  

In many claims and complaints, it’s often the case that there isn’t an identifiable clinical error, and that patient care has in fact been adequate. Instead, the issue is often exacerbated by a communication problem. A lack of dialogue, differing expectations, confusion and upset caused by a simple misunderstanding are all examples of communication issues unearthed by Elly’s research.  

Mistakes and complaints 

Knowing that a client is unhappy with the way we’ve taken care of their animal can be difficult to hear. We want to do a great job and we tend to set pretty high expectations for ourselves!  

A key distinction to make here is whether a communication problem contributed towards the complaint, or did it play a role in the mistake actually happening in the first place. For example, a miscommunication error resulting in a mistake with bad consequences for a patient (e.g. a double dose of medication), versus a communication failure where everything goes fine clinically with the animal, but your client feels that things weren’t explained to them properly and they leave lacking understanding and feeling dissatisfied.  

Interestingly, according to Elly’s research, communication errors as a result of the failure to transfer information between team members, are more likely to lead to a mistake. Whereas incidents where a client does not feel they have been listened to, whether or not that involves a mistake, are more likely to lead to a complaint.  

Fixing poor communication in veterinary practice 

So how does the profession continue to learn, adapt and change its ways of working to mitigate poor communication in practice? Whilst there may be some truth in the fact that some of us are innately better at communication than others, communication skills can be learned, practised and developed. Improving your non-clinical skills is a lifelong process.  

As well as verbal and nonverbal communication skills in veterinary practice, consideration needs to be given to all the other ways in which your team shares information on a daily basis… Ops boards, theatre sheets, clinical notes, post-it notes passed to reception. These also form part of the wider picture and small changes to these components can lead to communications improvement. Some of the issues that we might think about less often when discussing communication in veterinary practice are:  

• The physical environment – conducting rounds in a noisy room, the phone interrupting conversations, lack of privacy when discussing treatment issues with a client  
• Time limitations – getting everyone in a room together when colleagues work varying shift patterns, particularly with a very large team.  

Time for a team talk 

For communication in veterinary practice to work effectively across the whole practice, it requires your whole team to be communicating well. Everyone will have an impact. 

Here are some starting points to think about for your team:  

• Stay curious - ask and, importantly, listen to other peoples’ opinions to build an awareness of what is going on with your clients and colleagues.  
• Start to consider effective communication as something achieved by the whole team rather than individuals. 
• Find what works for your team – it’s not a one size fits all solution so what works for one might not for another! A great starting point is an in-practice culture survey from the VDS Training team to measure, review and discuss the culture of your team. 
• If something isn’t working, consider not just the verbal communication that takes place, but the system and environmental factors – are these optimal for your team?
• Be collectively reflective as a team – talk about what’s working and what’s not working 
• Sign up to VetSafe, the Society’s confidential significant event reporting system, to explore incidents and near misses, and identify where communication may have contributed.  
• Consider veterinary communication training, CPD and vet practice support for the whole team – explore what’s on offer from VDS Training on their website or call to discuss how they can help your practice work on their communication as a team.  

Notes  

VDS Training Services Limited (trading as VDS Training) is a wholly owned subsidiary of The Veterinary Defence Society Limited.  

Note 1: Russell, E, Mossop, L, Forbes, E, Oxtoby, C. Uncovering the ‘messy details’ of veterinary communication: An analysis of communication problems in cases of alleged professional negligence. Vet Rec. 2022; 00e1068. https://doi.org/10.1002/vetr.1068