The Safety Playbook: Building Resilient Teams and Improving System Design

Alexandra Perreiter is the Director of Patient Safety at Sharp HealthCare, where she leads efforts to ensure care is safe, timely, evidence-based and centered around the needs of every patient. With roots in clinical pharmacy and years of experience inside hospital systems, she brings a grounded, practical approach to safety that connects policy with day-to-day care.

Since joining Sharp HealthCare in 2009, she has worked across departments to build a stronger safety culture. Early in her career at Sharp Memorial Hospital, she took the lead on the Medication Error Reduction Plan and chaired several committees focused on improving medication safety practices. Her ability to bridge clinical knowledge with systems thinking has made her a go-to leader for complex safety challenges.

Recognizing Dr. Perreiter’s systemsdriven mindset and commitment to human-centered care, this exclusive feature explores her journey in elevating patient safety at Sharp HealthCare.

Building Safety into the Culture: A Leadership Perspective

It started in the critical care unit. During my PGY-2 residency, I was surrounded by fast-paced decisions, constant handoffs and and situations where even the most skilled professionals couldn’t work in isolation. That’s when I realized safety isn’t about perfection; it’s about systems that support people, anticipate challenges and and make teamwork instinctive.

That realization reshaped my path. I immersed myself in medication safety, systems thinking and and just culture. What began as clinical training evolved into a mission to improve how healthcare functions for patients and those delivering care.

At Sharp HealthCare, that mission found room to grow. As a Safe Medication Practice Pharmacist, I led hospital-wide initiatives alongside frontline teams and leadership. These weren’t theoretical efforts; we were solving real problems together. That experience reinforced the value of listening, adapting and designing with the end user in mind.

As the work expanded, so did my view of safety. I understood it must be embedded throughout the care experience, not isolated in projects but woven into the culture. That perspective led me to my current role as Director of Patient Safety, where I now focus on advancing system-wide practices that elevate care, empower teams and make safety a shared foundation for everything we do.

Rethinking Safety Starts With the Right Questioning

Challenging the status quo is central to how I approach patient safety. While evidence-based practices remain essential, reaching zero harm takes more than following protocols. It calls for fresh thinking and innovation. Some of the most valuable insights often come from outside of health care.

I frequently look at high-risk industries like aviation, oil and gas and nuclear power, where systems are designed to support human performance under pressure. Tools like Usability Testing, Simulation, Human Factors and “Walk-Through Talk-Throughs” are helping us shift our focus from reactive fixes to proactive design, creating safer environments for patients and staff.

At Sharp HealthCare, this mindset is deeply embedded. Safety is one of our seven Pillars of Excellence, woven into everything from daily practice to strategic planning. Every team member, from frontline to leadership, receives training in High-Reliability Organizing, Just Culture and core patient safety principles. These efforts aren’t siloed; they’re integrated with our broader goals, backed by executive sponsorship and reinforced through Lean Six Sigma and regular Gemba walks that keep us grounded in the realities of care delivery, ensuring those closest to the work have the space and support to lead meaningful change.

Through A New Lens: AI, Adaptability And Resilience Shaping Safety 3.0 The Definition Of Safety Is Changing For Good Reasons.

That shift in thinking is what excites me most. At Sharp HealthCare, with frameworks like Safety II and Safety III as our inspiration, we are moving beyond failure-focused learning. Instead, we are beginning to study how teams succeed under pressure and how they adapt, communicate and deliver care despite complexity. This focus on resilience will help us build systems that support success, not just avoid harm.

Technology is also accelerating progress. Artificial intelligence is becoming a valuable ally that will help us detect safety risks earlier, make faster decisions and surface emerging threats. But while AI holds promise, our evolving safety culture gives it purpose.

Simulation is also driving change. More than a training tool, it allows us to uncover hidden risks, test team responses and refine how care is delivered. When combined with human factors engineering principles, like usability testing, we are better able to anticipate issues before they reach the bedside.

These trends are helping us redefine safety. We’re moving beyond “zero harm” as a finish line and embracing it as a dynamic capability, the ability to deliver safe care, even as conditions shift. That’s the future we’re building: where systems are designed with people in mind and every success story becomes a model for the next.

Safety by Design, Not By Default

When I think of regulatory compliance, I see it as the baseline or minimum safeguard put in place to protect patients. It creates structure and accountability, but it doesn’t define what exceptional care looks like. At Sharp HealthCare, we aim higher.

Our focus is on creating systems that do more than meet requirements. We foster an environment where innovation is encouraged, teams are empowered to test new ideas and proactive risk assessments guide how new technologies and practices are introduced into care. This mindset allows us to identify risks earlier, allowing us to shift our patient safety efforts towards a more proactive approach.

Wisdom from Experience: Change Your Perspective on Patient Safety.

There Are A Few Grounding Truths I Always Come Back To

Too often, patient safety gets mistaken for control. Early in your career, you might hear terms like “Standard Work” or want to control/define and/or script every aspect of the work at the frontlines. But real safety doesn’t come from rigid checklists. It comes from a shared mental mindset. When staff are given the tools, skills and freedom to adapt, they can respond effectively to the unpredictable nature of clinical care. That adaptability is where meaningful safety takes hold.

Another cornerstone is that safety is a daily habit, not a response to an incident. The most impactful work often happens quietly, long before a headline-making event. When we treat safety as something everyone owns and embed it into each interaction, handoff and workflow, we stop chasing harm and start preventing it. That proactive mindset is where real progress takes root.

Lastly, but perhaps most importantly, don’t silo yourself. Patient safety is deeply interconnected with everything that shapes the healthcare experience, including patient satisfaction, patient outcomes, team morale and even staff burnout. The more we collaborate across departments, the faster and more effectively we move forward. Aligning with others who care about these shared goals doesn’t dilute the mission; it strengthens it.