Introduction Post – Sarah Brewer

I’m attending the Academy for Emerging Leaders in Patient Safety because I believe our health care system has a duty to provide patients with safe, high-quality care. However, fulfilling this obligation requires a radical culture shift, and it is my goal to contribute to this critical cultural change.

My interest in quality improvement and patient safety stems from my experience as a child of someone who experienced a medical mistake. In the early 2000s, my mother’s surgeon made an error that led her to experience extreme, debilitating pain. The surgeon refused to believe my mother’s account of her symptoms post-surgery. In the following months, she consulted with other surgeons in our local area, but she came up against the ‘wall of silence’; these other surgeons refused to discuss her symptoms or the specifics of her operation, and they became offended when she asked if it was possible that something had gone wrong during her procedure. It took two years for my mother to find a surgeon who believed her, validated her experience, and fixed the mistake.

This experience had an enormous impact on me and my life. Years later, as a freshman in college, I began researching the history and literature on women’s treatment in the medical system. I quickly changed the focus of my studies to medical anthropology. The stories I read echoed my own frustration and anger with the culture of medicine, and I wanted to document and amplify patients’ experiences with disease and healthcare to advocate for serious change. After graduation, I realized that if I was going to affect real change in the system, I needed a deeper understanding of healthcare delivery on the ground. I volunteered in various healthcare settings including a community clinic, palliative care, and surgery units. I gained an appreciation for the complexity of healthcare and the good intent of most care providers. I came to understand culture change a little differently – it required less ‘rooting out the bad actors’ than I once envisioned, and a lot more team science, flattened hierarchies, and the ability to speak up without repercussion.

In 2020, I completed my Master of Public Health degree and shortly thereafter began working in clinical and translational research at an academic medical center. I have the privilege of working with interdisciplinary teams on projects typically focused on identifying ways to make translation of evidence-based practices more efficient, improving workforce development, and enhancing research support services based on feedback from clinician researchers and research participants. I find working in health research is particularly conducive to thinking through two ‘culture shift’ questions that have been woven throughout my career development: First, how can we ensure evidence-based practices are effectively and efficiently disseminated in clinical practice, and what elements or changes are key to overcoming various levels of resistance? Second, in what ways can we make care more patient-centered and validate patient experiences, and in the process improve quality and safety?

I hope to have the opportunity at AELPS to gain further insight into these, and many other, questions with you all.