Veterinary care is about more than clinical knowledge and technical skills - it’s about thinking critically, learning from experience, and supporting the wellbeing of patients, clients, and the whole team. This guidance uses current evidence and regulatory expectations to support veterinary teams in embedding safety-focused practices such as near-miss reporting, morbidity and mortality (M&M) rounds, and Schwartz rounds into everyday clinical work. It aligns with the Veterinary Council of New Zealand’s CPD framework and draws on insights from multiple professions and recent veterinary research.

The Vet Council's CPD framework requires veterinarians to plan, participate in, and reflect on learning activities that go beyond clinical knowledge and technical skills. Critical reasoning - how you think, analyse, and make decisions- is a core area of competence.

This includes:

Errors, sometimes called misadventures, are acts of omission (didn’t do) or commission (did do but shouldn’t have) that could or did lead to unintended outcomes. Near misses are incidents that could have caused harm but did not; adverse events result in actual harm. Reporting these events is essential for learning and prevention.

Common veterinary errors include drug errors, communication failures, and treatment-related incidents. In a teaching hospital study, oversight, drug, iatrogenic, and staff-related errors were most frequent. Barriers to reporting include fear of blame, lack of systems, and emotional distress. A non-punitive, confidential reporting culture is vital to encourage openness and improvement.

M&M rounds are structured, confidential forums to discuss complications, errors, and near misses. They support root cause analysis, team learning, and emotional processing. Cases typically include deaths, 'never events'¹, safety incidents, and near misses. Discussions use tools like SBAR² (Situation-Background-Assessment-Recommendation (Pang et al. 2018)) and fishbone diagrams³ (also known as cause and effect, Ishikawa, or Fishikawa diagrams (Pang et al. 2018)) to identify contributing factors and generate recommendations. Regular M&M rounds help build a culture of safety and continuous improvement.

Schwartz rounds provide a structured space for veterinary teams to discuss the emotional and ethical challenges of their work. They focus on sharing experiences, supporting wellbeing, and fostering compassion. These rounds help normalise emotions, reduce moral injury, and build team resilience. They are inclusive, non-blaming, and complement M&M rounds by addressing the human impact of clinical work.

A safety culture includes openness, trust, learning, and system-level thinking. Errors are often due to system factors, not individual failings. Leadership plays a key role in creating a non-blame environment where staff feel safe to speak up. Approachable leaders, structured communication, and team-based problem solving are essential. Supporting 'second victims', e.g. clinicians affected by errors, is part of a just culture.

CPD plans should cover all aspects of competence, including reasoning, communication, and wellbeing. Embedding these insights into CPD activities and team discussions strengthens clinical reasoning and improves patient safety.

[1] “Never Events” are serious, preventable incidents in healthcare that result in patient harm or death and should not occur if proper safety protocols are followed

²SBAR is a structured communication tool that helps teams discuss cases clearly and consistently. It stands for: Situation, Background, Assessment, Recommendation, see Pang et al 2018 for more information.

³A fishbone diagram is a visual tool used to explore the possible causes of an event by grouping them into categories like people, process, or equipment. It helps teams identify contributing factors in a structured, non-blaming way. See Pang et al. 2018 for more information.