Once pet-specific care has been considered for a practice and clients are "on board" with the philosophy, it is important to consider how the veterinary team can best deliver this level of care and embed the concepts in the practice workstream. The "rooming" process provides the perfect opportunity for the technician/nurse on a pet's care team to review with the client the aspects of their pet's care plan that are anticipated for that visit and to ask the client if they have any questions about the diagnostics, treatments, or other anticipated aspects of their pet's visit. Forward booking of appointments, procedures, and other visits is an easy and effective way to increase the likelihood that the clients will actually show up for the care that their pets need and benefit from. Pet-specific care allows specific competencies to be developed which can lead to career fulfillment regardless of the career ladders available in a particular practice. To keep the very best employees, and for them to remain challenged and motivated, staff development must be part of the practice's core strategies. Pet-specific care focuses heavily on prevention, early detection, evidence-based treatment and attention to closing compliance gaps, and practices need systems in place so that implementation is as close to seamless as possible. Core competencies are important in staff development, because they can be tiered and considered in terms of reward-based compensation. The individual development plan is an agreement between the organization and the employee and both must be involved in its creation. Staff who feel empowered and competent are better able to engage clients and advance pet care initiatives. Staff should be encouraged to develop competencies needed by the practice. Accountability is a critical attribute in the functioning of a veterinary hospital. For a hospital to function at its best, especially when delivering pet-specific care, every employee must not only be accountable for their own duties but also deliver on implied promises to all stakeholders regarding the mission and vision of the practice. The challenge with veterinary hospitals is to make accountability a scalable attribute. Accountability is important for the organization in general because without it, bad leaders drive out good staff and it is very easy for even high-producing teams to be reduced to mediocrity. Veterinarians are often hesitant about empowering employees, for fear that they will overstep their authority or discount goods and services to clients, but there is no evidence to support such fears. Alignment is critical for a variety of reasons, not the least of which is that without alignment, it is impossible to deliver on a unified mission and vision to pet owners. Every hospital has its own reasons to harness alignment, and yet hospital goals are not difficult to enumerate. Accountability is a critical attribute in the functioning of a veterinary hospital. As was mentioned from the very start, running an efficient and effective veterinary hospital doesn't happen by accident — it takes planning. In a well-designed strategic plan, there is a division of duty between the management team and the hospital staff who will be implementing the changes. Pet-specific care relies on the successful interaction and collaboration of all hospital team members. Alignment begins with effective leadership. Including team members in strategic planning efforts, and sharing metrics that allow them to see the impact of their actions, help assure alignment around best practices. Emotional Intelligence (EI), also referred to as Emotional Quotient, has become a popular topic but its roots can be traced back over 100 years. EI is important in the workplace, but its relationship to actual intelligence has been disputed. The mixed model of EI focuses on the skills and competencies that drive leadership performance. These skills are: self-awareness, self-regulation, social skills, empathy, and motivation. There are several tests for the mixed model, including the Emotional Competency Inventory, the Emotional and Social Competency Inventory, and the Emotional Intelligence Appraisal; 360° assessments are also considered measures of this mixed model. For most veterinary practices, the primary method of assessing EI will likely be to increase self-awareness with the use of self-tests, or 360° evaluations which look at the interactions of individuals with other stakeholders. Effective nursing leadership is associated with a culture of high-quality care and continuous improvement. The increasing complexity of veterinary healthcare makes it difficult for one member of staff to lead alone. The ability and willingness to delegate and share leadership responsibilities is a valuable skill that can streamline a leader's workload and empower employees, raising levels of job satisfaction and motivation. The requirement every nurse has to ensure their knowledge and skills are up to date is a fundamental leadership behavior, for nurses must be self-aware and self-critical and seek out the relevant training to facilitate their professional development. The democratic open approach of transformational leadership can be a barrier to effective working as it can be difficult to make rapid decisions when every member of a large team requires consultation. Nursing care plans are the written records of nursing care intended for a patient. They can support holistic approaches, pet-specific care, continuity of care, and clinical governance. Implicit care planning may come naturally to veterinary nurses, but there are several advantages to explicitly planning patient care and creating a detailed nursing care plan. One of the most useful tools in planning nursing care is the nursing process. This is a cyclical, continuous process of assessment, planning, implementation, and evaluation. Planning the nursing care of a patient is a two-stage process. First, goals of care should be set. The second part of the planning process is preparation. Patient goals need to be planned with the support and consent of pet owners. The evaluation stage is key to the nursing process and supports the continuum of care. Care plans can also be a valuable tool for retrospective clinical audit to support clinical governance. Care bundles are used within human-centered healthcare to facilitate the use of strong evidence-based practice to improve clinical outcomes. Evidence from human-centered healthcare demonstrates the positive impact of care bundles when applied to the management of chronic disease. One of the most important principles of patient safety in healthcare is the empowerment of all staff members to speak out if they have concerns about safety. The use of care bundles can contribute to an improvement in patient safety. A robust care bundle can be a useful tool to measure care and support clinical governance. Recruiting enthusiastic and knowledgeable members of the team to support the implementation of the care bundle can be invaluable. Robust and detailed education with theoretical concepts and simulation practice will result in a team ready and able to take full advantage of the use of the care bundle. Procedure manuals and reference manuals are helpful management tools in any size or type of veterinary practice. They serve as a convenient reference tool to ensure that standards of care and standard guidelines are in place. The practice should make a master list of all of the types of manuals they need. The number of manuals will depend on the size, scope, and complexity of the practice. While each manual should have a specific project manager, the more people involved in the creation and review of the manual, the better the final product will be. Manuals should be reviewed and updated as needed each year. Each update should result in a new revision date. Electronic manuals are easier to create, distribute, and maintain than hard-copy manuals, but at least one of each manual should be maintained in hard copy so it is available during network, internet, or power failures. Patient and procedure logs play a vital role in any practice and work best in conjunction with well-designed and well prepared procedure manuals. Logs are created in response to specific disasters that the practice leadership hopes to prevent from recurring, so the information gathering can be quick and easy. Logs exist to support quality assurance and compliance. They also help the practice leadership identify trends quickly. Logs help the practice manage product recalls in an efficient manner. Logs can help identify team members who need additional training, or are not fully compliant with practice policies. Computer automation does not negate the need for logs and manual auditing. In many cases, the use of software increases the number of errors and omissions within a specific process. The frequency of checking the log against the computer varies from practice to practice. In every aspect of veterinary medicine, the accurate recording of health assessment, recognition of lesions and therapy provided generates a useful medical record. While often underused in some practices, becoming familiar with the terminology and their application is important for the practice team to be able to effectively communicate and record dental conditions, treatment, and instructions for our patients and clients, to provide optimal oral care. A SOAP style of medical record can be utilized with areas to record radiographic assessment, physical findings, assessment, and treatment provided. The most efficient way to denote these findings is "four-handed charting" with one person probing the teeth to determine periodontal pockets, GR (RE), missing teeth, etc. and calling out the measurements as a second person records the findings on the dental chart. Every person who owns or works around animals is considered to have assumed the risks of being potentially injured – whether from an animal's kick, bite, scratch, or even an infectious zoonotic disease resulting from an animal's secondary sources. Even though a veterinarian's liability or an animal owner's liability might be at issue when injuries or damages occur to people and property, this chapter discusses ways to prevent or minimize being injured by animals at the workplace. In addition to being the legal duty and responsibility of the veterinary practice owner, ensuring a safe working environment for employees is essential. Employees working at a veterinary facility are considered to have knowingly assumed the risks that might arise from animal-related injuries. Unlike employees, clients do not necessarily assume all risks of injuries from their own animals or other animals when visiting a veterinary facility. Animal hospice, a philosophy of care that addresses the end of life care of the pet, as well as the needs of the human caregiver, is an evolving movement that harnesses the skills and abilities of an interdisciplinary team (IDT). While some of the IDT team members might be in employee relationships, most people working in animal hospice today are small businesses or volunteers that form a referral network to care for hospice families. Palliative care can occur at all stages of life, but is especially important at end of life. It is patient-focused care to improve quality of life (QOL). The hospice philosophy does not preclude euthanasia, but it does take an approach to palliative care and assessing QOL that often delays euthanasia significantly without significant suffering. Medical errors are infrequently discussed in veterinary practice. Few reports in the current literature describe their incidence; however, they do occur and they have the potential to cause harm, if not death, to our patients. More patients die annually from preventable medical errors than automobile accidents. Medical errors result from either cognitive limitations or system failures. The former refers to deficiencies of the individual, whereas the latter reflects the deficiencies of the work environment. Medical errors should be disclosed to the veterinary team and the client, and considered as teachable moments rather than badges of shame. Several communication models help veterinary teams to discuss medical errors with clients, including the acronym TEAM: "T" stands for truth, teamwork, and transparency; "E" stands for empathy; "A" stands for apology and accountability; and "M" stands for management. Consistency in practice communication with clients is a constant battle. Communication styles differ from person to person, as does emotional intelligence, and with that comes differences in how people hear and retain information. There are some basic aspects of communication that should be taken into consideration: verbal, nonverbal, and preverbal. A better approach that will resound clearly with a client is to talk about the "why" first. As technology continues to advance, it will be important to adapt to client expectations. Currently, social media is dominating marketing communication, but there are still many clients who like postcard reminders. Telemedicine is another growing platform to convert phone conversations to healthcare for clients who are not able/willing to come into the clinic. The golden rule of effective communication is: speak to others the way they want to be spoken to. Compassion fatigue and burnout are common occupational stressors in veterinary practice. Compassion fatigue and burnout have an impact on more than just the individual experiencing them. The field of veterinary medicine attracts individuals who are passionate about animal care and have high levels of compassion and empathy. Compassion fatigue and burnout can negatively affect patient care and the overall performance of a veterinary practice. Compassion fatigue results from emotional and physical depletion from continual exposure to, and the relief of, others' suffering. Burnout results from chronic exposure to a stressful work environment. There are three dimensions to burnout: emotional exhaustion, low sense of personal achievement, and cynicism. Effectively managing compassion fatigue and burnout is essential to preserving the mental, emotional, and physical health of veterinary professionals. Organizational solutions for compassion fatigue and burnout involve maintaining an even balance between job demands and job resources. Compromise fatigue is an insidious disorder experienced by many who work in the animal health field. Early in their careers, most animal healthcare workers focus on desirable outcomes, and the best evidence-based ways to achieve them. Compromise fatigue should be considered an occupational hazard in the companion animal healthcare marketplace. Compromise fatigue should be expected, since inevitably veterinary care of companion animals must be responsive to the pet owner's ability to pay. Since compromise fatigue is often associated with the financial constraints of pet owners, reasonable expectations of pet care expenses should be communicated to pet owners early and often, as well as the particular healthcare risk factors for the individual pet. Risk management strategies should be discussed with pet owners at the very first office visit. Compromise fatigue can be mitigated somewhat by having proactive discussions with pet owners regarding financial risk management, before problems occur. Canine atopic dermatitis is a common and often frustrating disorder to manage for both pet owners and veterinarians. Most atopic pets do have a genetic predisposition to develop allergies, and the clinical presentation is often characteristic, but that is typically where the simple part ends. Pet owners can often predict the costs of such things as feeding, grooming, and boarding, but the costs of veterinary care are often much harder to predict. Atopic dermatitis can be attributable to the complex interactions of many different genes, and the heritability of the condition is estimated to be quite high. Pets with atopic dermatitis tend to develop recurrent bacterial and yeast infections and so when pets develop such issues, it is important to routinely assess with cytology. Pet-specific care can make allergy management a much more positive experience for clients, patients, and the entire hospital team. Periodontal disease (PD) is one of the most commonly encountered diseases in our canine and feline patients. Some features of veterinary practices that promote good compliance when it comes to dentistry include educating the whole team on the benefits of a dental procedure, including front office staff, assistants and nurses/technicians, and veterinarians. The whole team can also be educated on common concerns that clients have, specifically in regard to anesthesia. Every pet should have quality oral and dental care throughout its life stages, with an oral examination at every visit, professional care at regular intervals, and effective home care. Brachycephalic dogs and cats are also at higher risk of periodontal and dental disease due to crowded and rotated teeth. Strategies for scheduling and dental team workflow can be quite complicated. Managing unexpected challenges is a common problem in dental practice. Degenerative Joint Disease (DJD) and osteoarthritis (OA) are present in many more dogs and cats, including young animals, than generally appreciated. Contrary to conventional concepts, OA is not a disease strictly of older dogs or cats. At least 20% of all dogs are likely affected by OA, and probably many more, and most are diagnosed between 8 and 13 years old; 60% of all cats and 90% of cats over the age of 10 have radiographic DJD changes. Several clinical metrology instruments are validated for assessment and scoring of OA in dogs, including the Canine Brief Pain Inventory and Liverpool Osteoarthritis in Dogs. A response to nonsteroidal antiinflammatory drug therapy will reinforce the diagnosis of OA and create the space for client acceptance of a more detailed plan. The pathophysiology of OA in dogs is often conformational, and exacerbated by common risk factors. The most successful way to provide effective and consistent pain relief for veterinary patients is to approach pain management as a team. The first step in building an effective pain management team is educating the team about animal pain with the goal of ensuring that every team member fervently believes that animals do feel pain and that pain can negatively impact that animal's health, behavior, and welfare. The next steps include assigning specific roles for each team member, providing the training and education that the team member requires to fulfill their role and emphasizing that every team member must constantly strive to meet the practice's goal of relieving pain in every single patient. As with human nurses, the veterinary nurse is generally the primary "voice," or advocate, of the patient. The pet owner should be motivated to work with the veterinary team to ensure that the pet is not experiencing pain, either acute or chronic. Two common causes of infectious diseases that impact populations of cats globally are feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV). Repeat testing is also encouraged following exposure to cats that are either known to be infected or have unknown retroviral status. When a cat is exposed to FeLV, viral particles are first found in lymph tissue near the site of exposure. The presence of the p27 protein can be detected at this time through enzyme-linked immunosorbent assay (ELISA) testing. An ELISA is typically used in-house to test for p27 antigen. Feline leukemia virus and FIV have global presences when it comes to feline infectious disease. Any initial consultation about FeLV and FIV should explore patient- and household-specific risk factors. Recurrent pyoderma is a common and often frustrating disorder to manage for both pet owners and veterinarians. Pyodermas are typically characterized by their depth, or by their particular characteristics. Intermediate pyodermas involve deeper penetration of bacteria, and most often result in folliculitis and perifolliculitis. Deep pyodermas involve yet deeper structures in the dermis and panniculus, including furunculosis, cellulitis, abscesses, and fistulating diseases. The concept of recurrent pyoderma, once again, is that the condition responds entirely to antimicrobial therapy, only to relapse at some point after therapy has been stopped. The most common underlying cause for recurrent pyoderma is allergy, and atopic dermatitis accounts for a majority of cases. Antimicrobial resistance is a significant issue in healthcare and must be taken seriously. Veterinary healthcare teams should practice good infection control with each case of pyoderma, and this includes appropriate hand washing, cleansing, and disinfection. Otitis externa is a common and often frustrating disorder to manage for both pet owners and veterinarians. The management of ear disorders is frustrating for both veterinarian and pet owner. Undiagnosed rupture of the eardrum is very common in chronic otitis externa. To successfully treat ear canal problems, it is important to first understand some of the structures involved. Culture and susceptibility testing is useful when systemic therapy is being considered, but it is important to realize that because microbes are so plentiful in the ear canal, selection of causative microbes is not always assured, depending on sampling technique and laboratory factors. Any process that disturbs the ear canal's barrier function will predispose to otitis externa. The best approach to managing the pet with otitis externa is to suspect from the outset that the problem is secondary to some underlying problem. Most cases of otitis externa can be managed without the use of systemic antibiotics. Obesity in the pet population has reached epidemic proportions in many industrialized countries. The primary treatment for obesity is reduced caloric intake and increased physical activity. Weight management in pets, including obesity prevention and treatment, is a challenge for the veterinary healthcare team and pet owners. The best approach for weight management in pets is a team approach, where all team members are saying the same thing and are part of the weight management program supporting the pet owner and patient. The healthcare team should assess every patient that comes into the hospital, every time they come into the hospital, to establish nutritional needs and feeding goals. The veterinary assistant or credentialed technician/nurse should be leading the nutritional history. Effective follow-up and regular monitoring by the entire veterinary team are crucial parts of a successful weight loss program. A successful weight management program is in the best interest of the pets. Glaucoma is a group of ocular diseases that exhibit increased levels of intraocular pressure (IOP) that are detrimental to the maintenance of vision and health of the eye. Primary glaucoma is typically thought to occur in dogs with a genetic predisposition for anatomical differences which cause an inadequate outflow of aqueous, thereby leading to an increase in IOP. Secondary glaucoma is typically thought to be a result of a decrease of aqueous outflow with an increase in IOP in eyes with open angles. Most feline patients that develop glaucoma do so from chronic uveitis. Various treatments exist for glaucoma, but the team should understand that there is never a cure for glaucoma. Surgical therapies for glaucoma are utilized to prevent vision loss and maintain controlled IOPs. Surgical therapies can be grouped into categories such as vision-sparing procedures versus comfort-restoring procedures. Diabetes mellitus (DM) is frequently diagnosed in companion animal practice. A team approach to medical management of DM is essential. Effective therapy requires commitment to care by both the client and the veterinary team. Obesity is a well-established risk factor for the development of DM. An appropriate time to initiate a conversation about risk factors for DM is when patients present as kittens and puppies for wellness visits. Wellness visits are an excellent opportunity for client education concerning content areas that are essential to pet health. The typical protocol for treatment of DM involves insulin therapy and dietary management. Both arms of therapy target the patient's circulating blood glucose concentration, with the hope of keeping this below the renal threshold for as long as possible. Monitoring the diabetic patient is an essential part of medical management so that clinical signs are controlled without hypoglycemic episodes. Patients with cancer may have numerous co-morbidities, requiring doctors across multiple disciplines to be involved in their care. Regular meetings of the multidisciplinary team (MDT) allow for collective discussion of the patient's case, assuring that all members are aware of the patient's treatment plan and that all the patient's needs are being met. A solution to the standard process of patient care is the implementation of a MDT. An MDT is a group of clinicians and paraprofessionals that include the primary care team as well as specialists across multiple disciplines that collectively coordinate their care of a cancer patient. An effective MDT requires a selected individual to assume a leadership role. The principles and importance of an MDT approach to patient care are essential to impart to those entering the veterinary profession.

Being a client-centered hospital is somewhat different from being a service-oriented hospital. The goal of providing excellent client service is to make clients happy and build client loyalty. Client-centered teams strive to enhance client engagement, build trust, and develop partnerships with clients so they are part of the decision-making process for their pet's healthcare. Client-centered hospitals develop a culture dedicated to helping pet owners at all times and creating an exceptional client experience. Giving compliments is an easy way to enhance client engagement. One of the best compliments is to praise clients for how well they take care of their pet. In client-centered hospitals, teams work together to meet the needs of pet owners and create an exceptional client service experience. Practices need systems and standards to ensure pet owners have a positive client experience every time they visit the hospital. Workplace management is about balancing the needs of those receiving care through the hospital with those providing the care. The business model for veterinary practices in the United States is one of many small primary care hospitals serving communities. The premise of open-book management is that organizational business information shared with employees not only helps them to do their jobs better, but helps them understand their role in the company and the company's ultimate success. The care of pets is changing profoundly, especially with the introduction of pet-specific care, and the ability of veterinary hospitals to change along with it will ultimately determine the success or failure of many veterinary hospitals. The care of pets is changing profoundly, especially with the introduction of pet-specific care, and the ability of veterinary hospitals to change along with it will ultimately determine the success or failure of many veterinary hospitals. Change follows a process that is predictable and can be executed successfully on a consistent basis, but it is not intuitive or generally practiced due to our expectations of how change should happen. As people are thinking about moving to pet-specific care, there will be myriad behavioral changes that are needed for the humans in practice and even the clients. Change first begins in the human brain with an insight about something that needs to be different. The next component of human change is involvement. Focus is the act of putting energy and more thought into the path through the change that we think might work. Change follows a pretty clear pattern in humans but if we understand it and support each of the components of change, we greatly increase our chances of leading a successful change in our practice, no matter what it is. The last component of sustainable change is environment. Clients' expectations (sometimes unrealistic expectations) of veterinary medical services can be the source of significant misunderstandings, potentially resulting in lawsuits, internet shaming, or veterinary board complaints. It is important to minimize misunderstandings and complaints from clients – while maximizing communications and viable defenses against such claims – by using informed consents from clients regarding veterinary medical treatment of their animals. Three differentiating factors include consent for treatment can only be provided by the patient's owner/guardian, being informed about costs is an integral part of the client's/owner's consent, and the patient does not have legally recognized "rights of consent." When drafting consent-for-treatment documents, the wording of the form should be easily understood by any reasonable person with average intelligence. Several states have enacted mandatory informed consent statutes as part of their veterinary practice acts. Social media offers veterinary practices a variety of ways to connect with their clients. Facebook is the most commonly used social media platform, both for general users and for the veterinary industry. Boasting nearly 1.8 billion daily active users, the platform is used by about 70% of veterinary practices. Instagram is rapidly growing among users in the general population and in the veterinary community. Lesser utilized platforms in the veterinary industry include Twitter, YouTube, LinkedIn, Snapchat, and Pinterest. Video content gives clientele a look at the "real people" behind the medicine and patient care at practice– something no one else can replicate. Social media presents arguably the best and most affordable type of advertising in the modern world. Call-to-action buttons, available on Facebook and Instagram business accounts, provide clickable links to key information and conversion opportunities. Veterinary medical practices are facing many of the same increasing challenges as other business operations in trying to deter access to, and exposure of, confidential and proprietary information. It is important that veterinary practices explore methods and reasons for ensuring the confidentiality of proprietary business information as well as protecting uniquely identifiable information of private individuals and businesses. Protecting privacy rights and confidentiality of information should be a business's priority without a time limit – whether during employment, after business hours, and even after employment has ended. Protecting proprietary and confidential interests relies upon legal, ethical, and moral foundations. Maintaining confidentiality and privacy in a workplace can be extremely challenging for employers, especially in this age of electronic and technological advances. Puppy classes and kitten classes are invaluable services that can be offered by a clinic to their community—if they are done well. The puppies and kittens are given a safe environment for socializing. During the classes, the owners are becoming comfortable with the clinic and staff. Puppy classes are typically run by a veterinary nurse or technician, sometimes with a local dog trainer. Kitten classes are generally run by a veterinary nurse or technician. All clinics can run a puppy or kitten class if resources are allocated for this. Puppy and kitten classes need dedicated time. Kitten classes are different from puppy classes. Species differences and the developmental stage of the kittens mean that some things undertaken in puppy classes are not suitable for kitten classes. Puppies and kittens who attend the classes become familiar with the clinic, which reduces their stress levels at subsequent visits. Veterinary healthcare providers are obligated by the Veterinarian's Oath to act as stewards of the animal kingdom. Cost of veterinary care is rising as scientific advancements increase the diagnostic and therapeutic tools available to healthcare providers. As diagnostic testing and treatment options expand, so too does the cost of care. Each test expands the arsenal of what healthcare providers can test for, and each test gives the clinician a better understanding of the patient's individual circumstances. In order for veterinary practices to survive, they must receive payment for services rendered. Options for financing care include the following: establishing wellness plans within individual veterinary practices, offering in-house payment plans, accepting third-party payments, and promoting PHI. Practices need to look beyond traditional methods of payment and implement financing strategies that assist clients with patient care expenses. Implementing pet-specific care can be much easier and more effective when medical goals are supported by data and information. Practice management software (PMS), also known as a pet information management system or "PIMS," facilitates the process of storing, retrieving, and using the data and information. Early detection is a key principle of pet-specific care. Surveillance networks are being developed that will seek to leverage PIMS data. There are a few stakeholders who can benefit from the data and information PIMS makes available with pet-specific care. Many PIMS systems can store or integrate data from external sources such as diagnostic equipment, laboratory results, wearables, mobile apps, client communication systems, and more. Analytics and informatics are two discrete disciplines which are integral to making veterinary data productive for multiple stakeholders including doctors and staff, practices, suppliers, researchers/academics, and the animal health industry as a whole. A core concept in pet-specific care is evidence-based medicine. This inherently lends itself to analytics and informatics at multiple levels. Data points associated with early detection of conditions, reactions, diseases, etc. will be defined and redefined on an almost continuous basis. In the context of pet-specific care, interoperability is even more challenging. The very nature of "personalizing" medicine requires very detailed and specific data points. Privacy is defined as the appropriate availability of data and information. Security is more aligned to the protection of data within digital systems. Ethics revolves around appropriate uses of data and information by stakeholders who are entitled to use it. Client safety is of the utmost importance in all areas of veterinary medicine – not just the veterinary clinic or hospital, but also in the home and community. Client safety encompasses an understanding of animal psychology and awareness of how the environment may impact this, as well as an appreciation of special circumstances, such as administration of medications, zoonotic diseases, and emergency situations, among others. Undoubtedly, all veterinarians and veterinary hospitals will, at some point, treat an emergency patient. Many of these situations have the potential to put owners at risk of injury as they try to help their pet or transport them to the hospital. Many animals will require oral medications at home at some point. Ideally, a patient willingly takes their medications in a small treat. Patients being treated with chemotherapeutic medications may excrete these drugs in their urine or feces, resulting in cytotoxic or genotoxic waste. Patient safety within the veterinary environment is threatened by the increasing complexity of healthcare combined with emerging disease profiles, financial pressures, and pharmaceutical resistance. Prioritizing a philosophy of patient safety is probably one of the most important measures a veterinary healthcare team can implement to keep animals safe in the clinical environment. As well as facilitating and supporting the reporting of patient safety incidents, team leaders need to demonstrate that they are able to perform thorough impartial, no blame investigations. Embracing client complaints is another paradigm shift that will support patient safety. It has been said that near-misses are "the gold dust of patient safety." Such incidents provide a highly valuable substrate for learning. Human-centered healthcare has learned valuable lessons on safety from other complex and risky industries. Implementation of pet-specific care inherently involves storage and retrieval of data and information, whether paper-based, digital, or both. Protecting client personal data is not only a best practice, in many places it is required by law. It is therefore important to define "confidential" information, assess existing systems and processes that store or use the information, and make improvements as necessary. Personally identifiable information, often called "PII," is any single piece of data or collection of data that enables identification of an individual. It is well known that PII should be kept secure, but PII is not the only type of data that should be kept confidential. Pet medical records, the confidentiality of which may or may not be protected by law, should be secured as well. This chapter provides some best practices for keeping client and patient information secure. In veterinary hospitals, microbial control is best accomplished with sanitation, disinfection, and sterilization. Disinfection is crucial to prevent the spread of infectious disease, especially in the veterinary hospital. Information on disinfectants for specific animal disease agents can be obtained from regulatory animal health agencies. Disinfectants utilized in veterinary hospitals should bear the approval statement of the Environmental Protection Agency in the USA or a similar agency in other countries. Be sure that all members of the veterinary team understand and follow the label instructions. Veterinary team members should also review the protocol itself. Ensure the team is using the correct disinfectant and using it properly. As cleaning and disinfecting protocols become part of a veterinary hospital's culture, the healthcare team will be more confident when admitting and treating patients, including those with infectious diseases, while minimizing the risk of exposure to other patients, the healthcare team, and pet owners.