Building a Culture of Safety Across Healthcare Teams with Dr. William Scharf

Summary

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Becker’s Healthcare Podcast: Building a Culture of Safety Across Healthcare Teams with Dr. William Scharf

Guest: Dr. William Scharf, Executive Clinical Director of Quality and Safety, Advent Health
Host: Erica Carbajal
Date: March 25, 2026
Duration: ~12 minutes

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Episode Overview

In this episode, Dr. William Scharf discusses Advent Health’s strategies to build and sustain a robust culture of safety across healthcare teams. He shares actionable approaches for continuous quality improvement, the need for high reliability at the unit level, and the critical importance of psychological safety for all staff, not just clinicians. Dr. Scharf emphasizes systemic solutions, inclusive leadership, and cross-functional teamwork as foundational to patient and staff safety.

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Key Discussion Points & Insights

Dr. Scharf’s Background & Philosophy (00:22–01:41)

• Personal Journey: Dr. Scharf describes how the 1999 publication "To Err Is Human" reshaped his approach to patient safety.
  • Quote: “Most error is not caused by bad people. It’s caused by bad systems.” – Dr. Scharf [00:57]
• Motivation: The recognition that systemic flaws, rather than individual failings, drive most errors set the stage for his career-long immersion in patient safety leadership.

Major Patient Safety Goal at Advent Health (02:09–03:52)

• Patient Safety Academy: Upon joining Advent Health, Dr. Scharf inherited a unique program devoted to educating leaders in patient safety science.
  • Three-day immersive courses for clinical and operational leaders build foundational knowledge in safety science.
  • Quote: “We cannot have our good leaders just finessing and doing what they think is best. They need to have a good foundation in science.” – Dr. Scharf [02:39]
• Signature Safety Seminar: Mobile, condensed seminars delivered onsite at Advent Health facilities focus on hands-on education: learning, leadership, knowledge, and data management.
  • Overwhelming positive reception and expansion to multiple hospitals.
  • Memorable Moment: Dr. Scharf mentions traveling to North Georgia for an upcoming seminar, reflecting his commitment to being on the ground. [03:40]

Building and Sustaining a Safety Culture (04:39–06:35)

• Advent Health’s “North Star” Goal: Aspire to be the safest healthcare organization in the country.
  • Quote: “Culture just outweighs policies, technology, and protocols.” – Dr. Scharf [04:56]
• Recognizing the Challenge:
  • Culture change is difficult and slow, requiring sustained leadership focus.
  • Leaders must self-reflect: Do staff feel safe reporting errors? Are concerns addressed or ignored? Is collaboration prioritized over silos?
    • Quote: “Are your frontline leaders trust that their concerns are being addressed, or does it go into some black box?” – Dr. Scharf [05:12]
• High Reliability Organization/Unit Culture:
  • Implementation of real-time data sharing with electronic displays (e.g., 55-inch monitors) to promote transparency and daily debriefings at the unit level.
  • Focus on community-building within each unit because “at the end of the day that’s where care is delivered.” [06:31]

Closing the Feedback Loop & Ensuring Psychological Safety (06:35–07:33)

• Process Example: Staff concerns are actively addressed to avoid “black box” outcomes—emphasizing the need to close the loop and sustain engagement.
• Whole Person Care: Commitment to a faith-based culture and brand promise, including service standards like “keep me safe.”
  • Emphasis on psychological safety and a “just culture,” where all staff are empowered and protected to speak up about safety.

Addressing Survey Findings & Leadership-Frontline Disconnect (07:33–09:24)

• Survey Results Response: Dr. Scharf reacts to a recent Press Ganey report showing 47% of healthcare workers report low safety culture perception, despite overall post-pandemic improvement.
  • Recognizes a persistent, normal gap between leadership intentions and frontline experiences; the goal is to avoid a “really large gap.”
  • Advent Health uses annual safety culture surveys to proactively identify and address these disconnects.
  • Quote: “There is always a gap between leadership and what the frontline staff is perceiving… But what we don’t want to see is a really large gap.” – Dr. Scharf [08:38]

Cross-Functional Safety: Whole Team Inclusion (09:24–11:21)

• Everyone’s Responsibility: Safety culture is not just for clinicians; HR, Environmental Services, Spiritual Care, and others are integral.
  • HR has a seat at the table during safety seminars and academies to support psychological safety initiatives.
  • Patient feedback often singles out non-clinical staff (e.g., environmental services, transporters) for their positive safety impact.
    • Quote/Proverb: “You don’t have to be Monet to make an impression.” – Dr. Scharf [10:34]
  • Interventions include inviting transporters and other non-clinical staff into daily huddles at high-reliability unit cultures, ensuring all staff feel valued and included.

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Notable Quotes

• “Most error is not caused by bad people. It’s caused by bad systems.” – Dr. William Scharf [00:57]
• “We cannot have our good leaders just finessing and doing what they think is best. They need to have a good foundation in science.” – Dr. William Scharf [02:39]
• “Culture just outweighs policies, technology, and protocols.” – Dr. William Scharf [04:56]
• “Are your frontline leaders trust that their concerns are being addressed, or does it go into some black box?” – Dr. William Scharf [05:12]
• “There is always a gap between leadership and what the frontline staff is perceiving… But what we don’t want to see is a really large gap.” – Dr. William Scharf [08:38]
• “You don’t have to be Monet to make an impression.” – Dr. William Scharf [10:34]

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Important Timestamps

• 00:22: Dr. Scharf’s Background and Early Influences in Patient Safety
• 02:09: Advent Health’s Patient Safety Academy & Signature Safety Seminar
• 04:39: Building Culture as the Foundation for Safety and Quality
• 06:35: Strategies for Closing the Feedback Loop and Ensuring Psychological Safety
• 07:33: Leadership-Frontline Disconnect and Data-Driven Culture Enhancement
• 09:24: Inclusion of All Teams and the Role of Cross-Functional Partnerships

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Memorable Moments

• Dr. Scharf’s commitment to hands-on education, personally traveling to hospitals to lead safety seminars. [03:40]
• The practical inclusion of non-clinical team members in daily safety huddles, recognizing their impact on patient experience and safety. [10:34]

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Tone & Takeaways

• Dr. Scharf’s tone is candid, practical, and grounded in both empathy and scientific rigor.
• The episode delivers actionable insights for healthcare leaders: invest in education, prioritize psychological safety, systematically close feedback loops, and support a culture that includes every staff member.

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Transcript

[A]

Hi, everyone. You're listening to the Becker's Healthcare Podcast. I'm Erica Carbajal, and thank you so much for tuning into this episode where we're joined by Dr. William Scharf, executive Clinical Director of Quality and Safety for Advent Health. Dr. Scharf, thanks in advance for taking the time.

[B]

Thanks so much, Erica. Glad to be joining today.

[A]

Yeah, we're excited to have you. Welcome, welcome. Well, Dr. Scharf, to start us off, do you mind sharing a little bit about your background in healthcare and your current role at Advent Health with our audience?

[B]

Sure. I'm a surgeon by training. I went to the University of Illinois for medical school and started there for residency and completed surgical studies at the Ohio State University before being in practice in downstate Illinois for a number of years. My life significantly changed in 1999 to air is Human came out. The imagery at that time was that there were roughly 45,000 to 100,000 lives being lost each year from medical error. But the real thing that impacted me is that there were a couple of visionaries at the organization that I was at that started a patient safety collaborative. And the thing that resonated with me was that most error is not caused by bad people. It's caused by bad systems. And so I immersed myself in just almost everything that I could with patient safety. And sometimes life throws you curve balls. And I'm here at Advent Health with just an absolutely wonderful organization with a sense of purpose.

[A]

Yeah, absolutely. And I know Advent Health is doing a ton in terms of just creating those systems that you mentioned and those processes that really focus on prevention and fostering that culture of safety. So excited to hear about that. Dr. Scharf, what is one major patient safety goal that your team at Advent Health is focused on for 2026? And maybe what operational changes are you working toward to achieve some real progress?

[B]

Well, I can just say is that historically, when I came, I inherited a newly found Patient Safety Academy. I don't really think that many healthcare organizations have their own Patient Safety academy or something therein. And since that time. Well, let me just unpack this a little bit. Is that our Patient Safety Academy, we bring in our clinical and operational leaders across all of Admet Health for a three day course because you really need to understand what are the fundamental parts of patient safety science. We cannot have our good leaders just finessing and doing what they think is best. They need to have a good foundation in science. And. And what's happened over the course of years is that there was so much success out of The Patient Safety Academy is that others have said. Dr. Sharf and some of my other members of my team. What can we do to bring you to our places so that perhaps we can have a condensed version so that you could talk to our managers and unit leaders? To that end, we have created what we call the Signature Safety Seminar. What we will do is our team will jump on a plane or drive to one of our hospitals and we'll have a condensed version that teaches learning, knowledge, leadership and data management. So it's a great experience. It's actually been an overwhelming success. And just as a side note is that later today I'm going to hop on a plane and go to some of our hospitals in North Georgia to speak tomorrow at our Signature Safety Seminar. Wow.

[A]

Yeah. No talk about getting on the ground and really teaching this and driving this forward. That's great. What a great initiative. Dr. Scharf, one of the things that comes through often, a theme, if you will, that we hear a lot from quality and safety leaders, is that a lot of teams can and are good at initiatives. They can follow initiative, make progress in terms of quality and safety. But what really the differentiator is really the organizations that can drive continuous quality improvement. That differentiator comes down to culture. So from your perspective, what leadership behaviors or operational practices actually do build that kind of safety culture daily that's needed across frontline teams?

[B]

Excellent question. And Erica, if you don't mind, I'd like to unpack this just a little bit. I'd like to first say, is that Advent Health, we aspire to be the safest healthcare organization in the country. That's our North Star goal, plain and simple. That's where we want to be. To that end, we recognize that culture just outweighs policies, technology and protocols. And here's where it becomes challenging. First of all, changing culture takes a very long time. And secondly, it is hard, hard, hard. And so leaders really need to be asking themselves some questions. Do your staff feel safe to report errors without fear of punishment? Are leaders responding constructively or defensively? Are your frontline leaders trust that their concerns are being addressed, or does it go into some black box? And do your teams collaborate or do they operate in silos? That's where we have invested really heavily in what we call high reliability organization, unit culture. It's where we have a team that goes to each of our hospitals and addresses. Actually, let me just step back. They'll go to our hospitals. They have a 55 inch plasma monitor that connects electronically across the hospital, across the system. And what we do is that that creates a complete data source. But that's not the whole purpose. The whole purpose is creating a sense of community and having frontline debriefings every day for each of those units. Because at the end of the day that's where care is delivered. It's at the unit.

[A]

Yeah, that's interesting. In the point you raised too, about, you know, when concerns are addressed or brought up, not having them go into a black box, but really important for staff to feel like the loop was closed, if you will. So can you share, can you expand on that a little bit and maybe share an example of what those processes look like in terms of being able to follow up on concerns that are raised, you know, at scale across such a large organization?

[B]

Well, yes, first and foremost it begins with what we call whole person care. It's our brand promise that we deliver to our staff and to our, our patients. And it begins with a faith based culture. It we have a set of service standards, one of them which is keep me safe. And the recognition is that we have to drive down the fundamentals of psychologic safety and creating a just culture.

[A]

Yeah, absolutely. Thanks, Dr. Sharp. I wanted to ask too, just around a recent press Ganey report that we covered and it had found that nearly half of healthcare workers, I believe it was about 47%, reported low perceptions of safety culture, even though overall scores had improved post pandemic. So overall, what's your reaction to those findings and where do you think perhaps the biggest disconnect still exists between leadership's intentions and then frontline staff's actual experience of safety culture?

[B]

Well, I would say first and foremost when I hear this, it does make me sad. It does not have to be that way at most of our places. I say most of our places because there are some of our advent health hospitals that we have acquired and that are on a pathway which we call acquisition to excellence, nonetheless, is that we have an annual safety culture survey that we look at really closely and create strategies and tactics around how to enhance our culture. Now what I'm getting towards and that is that when we look at each of our hospitals is that there is always a gap, a gap between leadership and what the frontline staff is proceeding. And that's normal. I mean, that's a recognition that there will always be a gap. But what we don't want to see is a really large gap. And if we have a particular unit or particular areas that start to have a gap, then we're going to intervene and we're going to try to provide these hospitals with tactics that they can, that are actionable, that they can use to help with their teams. And so that that gap does not exist.

[A]

Yeah, definitely sounds like it's really critical to continue to check in on that annually and even more often to be able to identify where the gaps are and where they might be growing. Dr. Scharf, I know that you've spoken a lot about the importance of safety as everyone's responsibility as well, not just clinicians, but also ranging from teams like environmental Services, hr, Spiritual care. So can you share an example where from the bedside maybe where that cross functional approach has actually made a difference in safety or quality outcomes.

[B]

Before I dwell into that answer, Erica, I just want to say that one of the things that we recognized very early on and that is that HR has to have a seat at the table. And so when we do our signature safety seminar and patient safety academies, we actually invite HR because they're critical in helping support our work towards psychologic safety. Now, to answer your question a little bit more fully, and that is that it's always been fascinating to me is that when we see comments that patients have reported about some of the best experiences that they have had, some of the areas they will call out environmental service individuals who come in and claim that their room daily or the transporters. And there's an old proverb or saying that is that you don't have to be Monet to make an impression. And so one of the things that we will do is that we'll look at the results from our safety culture. And if we see that there's a gap, you know, the transporters do not feel whole or valued, is that we're going to try to intervene such that they can be part of the daily huddles that are at the high reliability unit cultures.

[A]

Yeah, that's great. And I think that's a really standout example of including transporters in those daily huddles. And also what you mentioned about HR and kind of threading that needle of how they actually do fit in in terms of the psychological safety and cultivating that across the teams. Well, Dr. Scharf, thank you so much for joining us on the podcast today. Taking time out of, away from the high stakes work that I know you're leading to share your insights with our audience.

[B]

Thank you so much, Erica. It's been a pleasure. And thank you for all the work that you're doing with Beckers. Have a great day.

[A]

You too. Take care. We'll stay in touch.