Summary
- Patient safety isn’t just a human health care concern; it extends across species. In veterinary medicine, safety culture and quality improvement are still emerging — and one veterinarian is leading the way.
Dr. Lydia Love, DVM, DACVAA, CPPS, is the first veterinarian to earn the Certified Professional in Patient Safety (CPPS)™ credential. In this interview, Dr. Love shares what inspired her to pursue CPPS, how safety science is taking root in veterinary practice, and what both fields can learn from each other.
What sparked your interest in CPPS certification?
The discussion surrounding patient safety culture and quality improvement in veterinary medicine didn’t start until the early 2010s, but I was introduced to it through my residency training and popular culture: Atul Gawande's The Checklist Manifesto, Peter Provenost and Eric Vohr’s Safe Patients, Smart Hospitals, and Lucian Leape's Error in Medicine.
As a veterinary anesthesiologist, my residency training was in anesthesia of all species except humans. Anesthesiologists are natural proponents of patient safety because of the work we perform. Although my patients have fur, scales, or feathers, they are still patients to whom we administer cardiorespiratory toxins, which carries the potential for harm we are responsible for mitigating.
My first clinical experience in patient safety application was introducing checklists into the practice I worked at, and I quickly realized that implementing checklists alone is insufficient to transform and sustain safety. CPPS allowed me to formalize competencies I had an interest in and expand my scope of knowledge. As someone who was mostly self-trained in the field, I had not been exposed to aspects like performance measurement and analysis. Earning my CPPS credential has provided me opportunities within my organization to have meaningful conversations and spread the word about patient safety principles.
What is the current state of patient safety culture in veterinary medicine?
Patient safety culture is nascent but growing. Most veterinary practitioners are now familiar with tools like checklists and reporting systems, though the principles of patient safety and quality improvement are not fully integrated into practice. There is not yet a shared language of safety and quality in the industry.
Though dedicated patient safety roles are rare in the veterinary field, skills like teamwork, communication, rebounding from errors, and responding to adverse events are broadly applicable and serve to improve both care outcomes and practitioner well-being. As a Clinical Associate Professor, I’ve been able to incorporate those ideas into our curriculum for veterinary students, so they are exposed to these tools early in their careers. As they enter practice, I hope this results in the normalization of safety culture and science into our profession.
How does patient safety differ between animal and human health care?
Safety also involves the physical and psychological safety of the caregiving team, not just the patients. In human medicine, this may present as workplace violence. In veterinary medicine, our patients more often present a physical danger to us — caring for a large animal like a cow or horse, or even an uncooperative cat, for example. How we mitigate this risk is the same as in human medicine: formalizing communication and creating a shared mental model using tools like huddles, briefs, and debriefs before, during, and after a high-risk event.
Traditionally we’ve had a very hierarchical client-doctor relationship, and I think this is starting to change. Like pediatrics, where a child’s guardian must advocate for them, a client must advocate for their animal. Owners are starting to become more involved in care decisions. If my loved one experienced a medical emergency, I could be with them in the hospital and participate in their care, but the physical space of a veterinary hospital is typically not designed to make that possible, so a client has fewer opportunities to be directly involved and advocate for their animal.
Finally, access to care and equity of care differ quite a bit in animal health care. For example, in veterinary medicine, economic euthanasia is an acceptable health care outcome, and veterinary care may be rendered to animals used for food. There is a mindset shift regarding what a positive outcome looks like to ensure we are providing quality care to every animal that enters our practice.
Where are the most urgent opportunities to improve veterinary safety systems?
We need to shift from a mindset of blame and shame when things go wrong to a review of the systems that fail us. While some teams put this into practice, it isn’t the norm. This blame-and-shame culture discourages reporting of adverse events, and with few formalized safety reporting systems in place, opportunities to change the systems that cause harm are greatly reduced.
Accreditation for veterinary hospitals in the United States is not required — only about 15 percent of hospitals become accredited through the American Animal Hospital Association. Each state has laws about what services can be performed by a clinic, and the scope of practice, but reporting regulations are essentially nonexistent, so the benchmarks are as well.
What can human health care learn from veterinary medicine?
The veterinary field is excellent at looking at the patient as a whole system, rather than a group of various functions. Most veterinary care occurs with a single provider, rather than many specialists as we see in human health care. While of course there are benefits to the specialist model of care, having a single care provider for the entirety of the animal’s life offers huge benefits in terms of centering the whole patient. I can understand the animal and owner’s entire situation — from economic issues and emotional concerns to care preferences and history — in a holistic way.
Closing Thoughts
Dr. Love’s journey underscores a powerful truth: patient safety principles transcend species. By earning the CPPS credential, she not only formalized her expertise but also opened doors for veterinary medicine to join a global movement working toward safer care. As safety culture grows in veterinary practice, CPPS offers a framework for building systems that protect patients, whether they walk on two legs or four. For professionals committed to advancing safety, CPPS is more than a certification; it’s a catalyst for change.
Learn more about CPPS and how it can advance safety in your organization here.
Zoë Mahoney is a Project Manager and Credentialing Specialist at IHI.
Editor’s note: This interview has been edited for length and clarity.
Photo by Freepik
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