Jill Bixler, M.D., Clinical Assistant Professor; Associate Chief for Faculty Affairs; Service Chief; and Department Lead for Quality and Safety, is working to create a comprehensive culture of safety for everyone in the U-M Department of Ophthalmology, including faculty, staff, and trainees. “The department is adopting new approaches to ensure both physical and emotional safety for faculty, staff, and especially trainees,” says Dr. Bixler. “Traditionally, medical safety initiatives have focused on preventing medical errors and surgical issues, but now the department is also prioritizing the physical and emotional safety of all Kellogg faculty, staff, and trainees. The ultimate goal is for residents to know they are not alone, and that they are not expected to accept inappropriate behavior.” As part of the initiative, the department holds annual Safety Grand Rounds, which in 2025 featured contributions from the U-M Office of Equity, Civil Rights, and Title IX (ECRT), focusing on addressing harassment and unprofessional behavior, which often stems from the hierarchical nature of medical training. There are also quarterly Safety Pre-Grand Rounds, as well as frequent discussions and protocols surrounding patient safety, which are determined by the needs of the department. “We are modeling the program after the Department of Neurology’s initiative, giving residents access to a dedicated faculty member—not a formal part of the administration—to foster a safe space for reporting concerns without fear of retaliation,” she says. “We want to make sure residents have someone who is not part of the program’s administration, to make it as safe a place as possible for the residents.” The program includes meetings with second-year (PGY2) and fourth-year (PGY4) residents to discuss reporting mechanisms, professional expectations, and to ensure they know they have the right to a safe, respectful workplace. “An introduction to safety takes place at orientation, but true understanding comes from watching all interactions and having that behavior modeled by the Kellogg team,” says Dr. Bixler. “As an example, when residents raised concerns about being alone with patients in remote parts of the ER, the department swiftly collaborated with the ER team to change protocols so that residents were no longer alone with patients. Within a few weeks, we had implemented a new protocol for how ophthalmology ER patients would be seen.”