As an early-career clinician working in medication safety, I observed a recurring challenge among older adults receiving care: long medication lists, high-risk drugs, and preventable harm that affected comfort, cognition, mobility, and confidence. Many older patients and their families were unsure why certain medications were continued, while clinicians lacked a unified, structured process to safely reduce unnecessary medicines. This gap inspired me to design and lead a deprescribing initiative focused on improving safety and restoring quality of life for older adults.

Tangible Impact

The project targeted individuals with polypharmacy and high anticholinergic burden. Using evidence-informed tools, each patient received a pharmacist-led review followed by shared decision-making discussions between the clinician, patient, and family.

Within the first year:

-The average number of chronic medications decreased by over one-third, with no negative clinical impact.
-High-risk anticholinergic and sedative medications were safely deprescribed, resulting in measurable reductions in anticholinergic burden scores.
-Patients experienced fewer medication-related symptoms such as dizziness, confusion, constipation, and daytime sedation.
-Families reported improvements in mood, alertness, participation in daily activities, and overall well-being.

These outcomes were supported by before–after medication counts, burden score trends, clinical observations, and patient stories—demonstrating clear and meaningful improvement in safety and experience.

Collaboration Across Boundaries

Although the idea originated within pharmacy, the project became a model of interdisciplinary cooperation. Physicians collaborated to prioritize medication changes and validate clinical decisions. Nurses monitored symptoms, reinforced counselling, and ensured continuity. Quality and patient-experience teams guided measurement and data collection.

Families played a central role—often providing insight into day-to-day function and contributing to decisions. This cross-disciplinary partnership helped transform deprescribing from an individual effort into a shared, team-driven standard of care.

Inspiration & Leadership as a Rising Star

This project began not as a formal mandate, but as a vision to create safer, more dignified care for older adults. As a young leader, I initiated the pathway, piloted it with a small group of patients, and built trust through transparency, communication, and early wins.

I developed tools, delivered micro-learning sessions, facilitated case discussions, and supported colleagues to adopt deprescribing principles confidently. By leading from the frontline, I demonstrated that meaningful change can begin with curiosity, persistence, and the courage to challenge old habits.

The project’s success reflects a leadership philosophy grounded in empathy, evidence, and collaborative influence—key qualities the Rising Star category celebrates.

Sustainability & Learning

To ensure long-lasting improvement, the deprescribing pathway was embedded into routine practice through:

A standardized deprescribing checklist used during medication reviews.

Quick-reference guides and visual tools available to clinicians.

Micro-learning modules repeated for new staff members.

Regular case-based learning huddles to share successes and challenges.

Simple dashboards tracking high-risk medications and deprescribing trends monthly.

Over time, the model spread organically to other clinics caring for older adults, demonstrating scalability, adaptability, and sustainability.

Equity & Inclusion

Older adults—especially those with limited health literacy, cognitive challenges, or communication barriers—are often left out of decisions about their medications. The project specifically aimed to amplify these voices.

We designed plain-language tools, culturally and linguistically accessible materials, and visual supports to explain deprescribing concepts. Patients and caregivers were invited to express fears, priorities, and expectations, turning a potentially intimidating process into an empowering one.

By reframing deprescribing as “making your medicines fit your life” rather than withdrawing care, we promoted trust, autonomy, and emotional safety.

Reflection & Lessons Learned

Not every deprescribing attempt proceeded smoothly. Some patients felt anxious about stopping long-used medications, and a few required slower tapering or reintroduction of a drug. These challenges taught us to strengthen anticipatory guidance, improve safety-netting instructions, and refine follow-up intervals.

The most important lesson was that deprescribing is as much an emotional process as a clinical one. It requires empathy, patience, and a willingness to listen. The project reinforced that sustainable improvement grows from transparency, humility, and continuous learning—not perfection.

This initiative proved that early-career leaders can ignite significant change by observing unmet needs, mobilizing collaboration, and keeping the patient’s lived experience at the center of every decision.

From One Rose Among Tulips to Transforming Healthcare: Building Equity from Experience

As a first-generation doctor and daughter of Iraqi refugee parents, I turned the vulnerability of witnessing inequity in patient care and the broader healthcare environment—where marginalized groups repeatedly face unequal opportunities—into a national movement for inclusive, equitable healthcare.

I am a medical doctor, PhD researcher, and Healthcare Leadership Academy Fellow advancing equity and systemic leadership in healthcare. I work across research, education, clinical practice, national policy, and community partnerships to embed inclusion into the core of healthcare systems.

Tangible Impact: structural improvement in care, outcomes, and learning:

In 2024, I founded LUMCDiversity, a rapidly growing network of more than 100 clinicians, nurses, researchers, residents, and students committed to equitable healthcare and medical education. Through this platform, I have delivered over 500 workshops on implicit bias, cultural humility, anti-racism, and inclusive communication. These sessions are now structurally integrated into departmental teaching programmes at the Leiden University Medical Center (LUMC), strengthening clinical communication, diagnostic accuracy, and equitable care delivery.

Through the LUMC Impulse Team for Education, Diversity & Inclusion, I co-led the redesign of the medical curriculum for more than 1,000 students. We embedded equity, social determinants of health, and culturally responsive care into core teaching, supported by a €100,000 institutional grant from the Vice Dean. I also established a structured mentorship programme for first-generation students, students from lower socio-economic backgrounds, and students with migration backgrounds—significantly improving retention, confidence, and equitable access to opportunities.

My PhD research focuses on social determinants of health in inflammatory bowel disease (IBD). It is the first project in the Netherlands to integrate validated racism and discrimination questionnaires and link these experiences to inflammation, disease flares, treatment adherence, and quality of life. This work provides clinicians with new insights into how structural inequities influence chronic disease trajectories and patient outcomes.

Collaboration: leading change across institutions, sectors, and communities

As Vice Chair of CODING—the national collective for diversity and inclusion in Dutch medicine—I collaborate with medical schools, specialty training boards, hospitals, and national education committees to strengthen fairness in selection, supervision, and learning environments. I also work closely with key national partners, including the Ministry of Health, Welfare and Sport (VWS), Pharos (the Dutch Centre of Expertise on Health Inequalities), and several regional and municipal health organisations. Together, we develop evidence-based interventions, physician training programmes, and policy frameworks aimed at reducing health inequities and improving communication across diverse patient populations.

I contributed to the creation of a national diversity database to support data-driven policy decisions and institutional accountability across the Dutch medical education system. Beyond academia, I co-developed a 5VWO outreach programme for secondary school students from underrepresented backgrounds. This initiative directly addresses the “leaky pipeline” in medical education and was featured in an NPO/Omroep ZWART documentary, expanding its public impact and creating a scalable model for widening participation. In addition, as a BIG Navigator, I support international physicians entering the Dutch healthcare system, reducing barriers in licensing processes and strengthening diversity within clinical teams.

Inspiration and Leadership: transforming culture through authenticity and representation

My leadership is grounded in authenticity, humility, and the belief that representation is a catalyst for systemic change. During medical school, I often felt like “a rose among tulips”—visible but not fully belonging. This experience now fuels my mission to ensure future generations, especially first-generation and bicultural students, never doubt their place in medicine.

In 2024, I received the Mr. K.J. Cath Award, Leiden University’s highest honour for societal impact. I was recognised for translating lived experience into structural institutional change across clinical culture, education redesign, and research. Through national interviews, documentaries, keynotes, workshops, and mentorship, I encourage students and early-career clinicians to embrace leadership as both possible and necessary.

Sustainability and Learning: ensuring change lasts and spreads

My work is built on a sustainable framework of data, narratives, and policy. Research and national datasets guide decision-making; lived experiences from patients and students inform design; and policy advocacy ensures changes become embedded in institutional structures rather than dependent on individuals. This framework drives curriculum reform, leadership development, and organisational strategy. Other Dutch academic medical centers have begun adopting elements of LUMCDiversity, demonstrating national scalability.

Equity, Inclusion, and Reflection: elevating voices seldom heard

I center the experiences of patients facing language barriers, families shaped by migration, first-generation students, international doctors, and trainees experiencing inequitable access to opportunities. My work aims to ensure that health outcomes and career progression are shaped by potential rather than background.

I believe meaningful improvement requires vulnerability and reflection. A defining moment was delivering tragic news to a Yemeni family without an interpreter—an experience that revealed how inequity manifests in urgent, intimate clinical encounters. Sharing such lessons openly accelerates collective learning and strengthens the culture of care. It also crystallised a core insight for me: authentic leadership comes from integrating lived experience with professional responsibility, turning vulnerability into a force for sustainable, inclusive change.

Ninar AlJerf (18 yrs.) represents a new generation of healthcare improvers whose leadership emerges not from position or privilege, but from evidence, equity, and an unwavering commitment to safety and quality in resource-constrained settings. As an early-career medical student and published researcher working at the intersection of public health, nutrition, digital technology, and community systems in Syria, Ninar has already demonstrated tangible and measurable impact on healthcare quality, patient safety, and health equity—locally and globally.

Ninar’s work is grounded in a systems-based understanding of safety: that health outcomes are inseparable from food systems, digital access, education, and social vulnerability. This perspective is reflected in her peer-reviewed research, including first-author publications in Discover Food, Human Ecology, Journal of Anthropological Archaeology, and BMC Nutrition. These studies translate directly into quality and safety improvement by addressing preventable risks—malnutrition, dietary misinformation, inequitable access to care, and culturally misaligned interventions—that disproportionately affect underserved populations.

One of Ninar’s most impactful contributions is her 2025 study on digital technology to advance global health in urban Syria, which systematically assessed nutrition interventions and unmet needs using mixed methods. The study identified critical gaps in patient education, continuity of care, and data-driven decision-making, particularly among adolescents and women. Findings from this work informed the development of low-cost, digitally supported nutrition education frameworks designed for fragile health systems, demonstrating a clear pathway from research to safer, more effective care delivery.

Beyond academia, Ninar operationalizes improvement through collaborative, community-embedded leadership. Since 2021, she has served as Coordinator of Projects for Smart Kids and Juniors under the Syrian Ministry of Education, where she designs, implements, and evaluates educational programs that directly influence child well-being and safety. Her work includes training educators, managing project budgets, and assessing outcomes related to learning performance and psychosocial health—key upstream determinants of patient safety. Internal program evaluations showed improved student engagement and knowledge retention, reinforcing the sustainability of these interventions.

Equity and inclusion are central to Ninar’s improvement philosophy. Through her leadership with Ataa Humanitarian Relief Association, she co-coordinates programs supporting widows and divorced women—groups often excluded from formal health systems. These initiatives integrate health awareness, nutrition literacy, and psychosocial support, reducing barriers to care and amplifying voices that are rarely represented in quality improvement discourse. Community feedback consistently highlights increased confidence, improved household nutrition practices, and strengthened trust in health-related information.
Ninar’s commitment to safety extends across the lifespan. Earlier volunteer work delivering nutritionally appropriate meals to elderly residents emphasized dignity, dietary adequacy, and risk reduction for vulnerable populations. This experience shaped her later research on dietary patterns and chronic disease risk, reinforcing the importance of patient-centred, context-sensitive interventions.

A defining strength of Ninar’s work is learning through reflection. Conducting improvement initiatives in an environment marked by economic constraints, infrastructural instability, and limited digital access required continuous adaptation. Early digital interventions faced challenges related to connectivity and health literacy. Rather than abandoning these efforts, Ninar refined the tools, simplified content, and engaged local educators and families as co-designers. This iterative learning process strengthened adoption and ensured that improvements were not only effective but sustainable.

Ninar also demonstrates leadership through knowledge dissemination. With an h-index of 3 and 86 citations at an early career stage, her work informs global discussions on nutrition safety, sustainable food systems, and personalized health. Importantly, she bridges historical, environmental, and biomedical perspectives, showing how ancient dietary resilience can inform modern safety strategies—an innovative approach that broadens how quality improvement is conceptualized.

Testimonials from educators and community partners describe Ninar as “methodical, empathetic, and impact-driven,” noting her ability to translate complex evidence into actionable practice. Teachers involved in Ministry of Education projects report improved confidence in delivering health-related content, while community organizations cite her clarity, ethical sensitivity, and collaborative spirit.
In summary, Ninar AlJerf exemplifies the essence of a Rising Star in quality and safety: she delivers measurable impact, works across disciplines and communities, centres equity, sustains improvement through learning, and leads with humility and evidence. At a time when healthcare systems require bold yet grounded innovation, Ninar’s work signals not only early promise, but lasting influence on the future of safe, equitable care.

I am Dr. Zenebe Tella, a medical doctor at Alamata General Hospital in Ethiopia. As an early‑career clinician, I have dedicated my work to improving the quality and safety of care in resource‑limited settings. My journey reflects the belief that leadership can emerge from the frontline, where bold ideas and collaboration transform patient outcomes.

Tangible Impact
During the COVID‑19 pandemic, I led a community resilience programme that integrated triage, health education, and infection‑prevention practices. This initiative reduced delays in diagnosis and improved adherence to public health measures, contributing to a measurable decline in community transmission. In parallel, I coordinated MDR‑TB and HIV services, introducing mentorship and structured reporting systems. These changes increased treatment completion rates and improved continuity of care. By embedding strong documentation practices, we enhanced accountability and ensured safer patient management.

Collaboration
Collaboration was the cornerstone of these achievements. I worked with nurses, laboratory staff, community health workers, and local leaders to design culturally sensitive outreach. Partnerships with regional health offices and NGOs secured essential supplies and training. Patients and families were engaged as co‑producers of care, shaping education materials and reinforcing adherence. By bridging hospital, community, and government structures, we created shared responsibility for improvement.

Inspiration and Leadership
As a young physician, I recognized that leadership is not defined by title but by action. I championed infection‑prevention protocols that became hospital‑wide standards, mentored junior colleagues in clinical documentation, and advocated for equitable access to services. My leadership style is rooted in humility and resilience: leading by example, listening to others, and demonstrating that even early‑career professionals can spark systemic change.

Sustainability and Learning
To ensure improvements lasted, we embedded continuous learning into our programmes. Monthly workshops reinforced infection‑prevention practices and updated staff on evolving guidelines. Documentation systems were standardized, enabling consistent reporting and accountability. Community education was designed to be locally owned, with leaders and volunteers continuing outreach beyond the initial project. These structures ensured that improvements were not temporary fixes but sustainable practices that could spread to other facilities.

Equity and Inclusion
Equity was central to our work. We prioritized outreach to remote villages, where access to TB and HIV services was limited. Women and youth were engaged as peer educators, amplifying voices often unheard in health decision‑making. By co‑producing initiatives with patients and communities, we ensured that interventions reflected lived realities and addressed barriers to care. This inclusive approach strengthened trust and improved uptake of services.

Reflection
Our journey was not without challenges. Resource constraints, misinformation, and stigma threatened progress. We learned that building trust through transparency and consistent communication was as important as clinical interventions. Flexibility was key: adapting education materials to local languages and cultural contexts made them more effective. We also recognized the importance of documenting not just successes but lessons learned, so that others could build on our experience. The greatest reflection is that improvement is a collective endeavor — no single actor can achieve it alone.

Conclusion
This project demonstrates how frontline leadership, collaboration, and equity can transform health outcomes even in resource‑limited settings. By combining outbreak response with integrated care, we achieved measurable improvements in safety, outcomes, and patient experience. As an early‑career physician, I am proud to share this story as part of the Rising Star category, representing the resilience and innovation of healthcare professionals in Ethiopia.

I am an early-career healthcare operator and strategist focused on closing a persistent gap in quality and safety improvement: the disconnect between evidence, strategy, and real-world health system decision-making. My work demonstrates how meaningful improvement can be led without formal authority by building practical, sustainable systems that translate insight into action.

The problem
Before this initiative, quality and safety insights were often fragmented, inaccessible, or overly academic. Frontline operators and early-career professionals rarely had platforms to share improvement work, and health system leaders lacked concise, operationally relevant synthesis to support decisions. As a result, valuable learning frequently failed to spread or influence practice.

The intervention
In response, I founded and led an independent improvement platform designed to translate quality, safety, and operational evidence into clear, actionable guidance for healthcare leaders and practitioners. The work intentionally bridges disciplines, bringing together clinicians, administrators, researchers, and early-career professionals to share improvement insights in a format designed for real-world use.

I built the platform’s structure from the ground up, including governance, editorial standards, review processes, and dissemination systems. Importantly, this work was led without institutional backing, formal authority, or significant financial resources, relying instead on collaboration, clarity, and consistency.

Tangible impact
Within two years, this initiative has reached more than 10,000 healthcare leaders, clinicians, and operators monthly. It has supported contributions from dozens of professionals across institutions and has become a repeatable mechanism for sharing practical improvement knowledge related to clinical growth, patient access, operational efficiency, and care delivery.

In parallel, my operational role within a large academic health system allowed me to directly apply and test these insights. I supported multidisciplinary clinical expansion efforts, coordinated across surgical, administrative, and marketing teams, and translated operational data into executive-ready recommendations. This bidirectional flow—practice informing shared learning and shared learning informing practice—strengthened impact and relevance.

Collaboration across boundaries
Collaboration is central to this work. Contributors span clinical, administrative, academic, and early-career roles, often crossing organizational and professional boundaries. By creating a structured but accessible platform, the initiative enables collaboration among individuals who would not typically engage in shared quality and safety improvement efforts.

Leadership and inspiration
As an early-career leader without positional power, my leadership has focused on enabling others. I designed systems that allow contributors to safely share work, many for the first time, and to see their improvement efforts taken seriously by decision-makers. This approach demonstrates that leadership in quality and safety does not require senior titles, only accountability and follow-through.

Sustainability and learning
Sustainability was a deliberate design choice. Rather than one-off outputs, I built repeatable processes for contribution, review, dissemination, and feedback. Early iterations of the work were overly academic and insufficiently practical. Incorporating feedback from clinicians and operators led to clearer language, improved formats, and significantly higher engagement. This learning reinforced that improvement must be both rigorous and accessible to endure.

Equity and inclusion
Equity is addressed by expanding who gets to participate in improvement conversations. The platform intentionally values lived operational experience alongside traditional credentials, elevating voices from early-career professionals and frontline practitioners who are often underrepresented in quality and safety discourse.

Reflection
This work demonstrates how early-career professionals can drive measurable, sustainable improvement by building bridges—between evidence and action, between disciplines, and between voices that are often unheard. As a Rising Star, I continue to refine how structured communication, collaboration, and humility can accelerate improvement at scale.

I am an early career anesthesiologist at GRAACC, a tertiary pediatric oncology center in São Paulo, Brazil, caring for children whose physiology, resilience, and evidence base differ fundamentally from those of otherwise healthy pediatric patients. Too often, I saw children with cancer arrive for surgery after excessively prolonged fasting—thirsty, distressed, dehydrated, and physiologically compromised before anesthesia even began. In this vulnerable population, chemotherapy- and radiotherapy-related nausea, vomiting, and altered gastrointestinal motility amplify the effects of prolonged fasting. However, perioperative fasting practices continue to rely largely on data from healthy children, applying a one-size-fits-all approach that does not fit all.

From a quality and safety perspective, prolonged fasting is not a minor inconvenience but a driver of avoidable harm. Dehydration and relative hypovolemia increase hemodynamic instability at induction, contribute to hypoglycemia, and make venous access more difficult. For children, this means more needle attempts and greater distress than for adults. For families, this means watching their children suffer unnecessarily. For the system, this means procedural delays, inefficient operating room flow, and avoidable use of invasive interventions. This is the point at which quality, safety, experience, and efficiency intersect.

Through an Institute for Healthcare Improvement (IHI) quality and safety course, I was challenged to identify a problem that truly mattered to patients and their families and to lead improvement from the bedside. Although I did not hold formal authority, I recognized that prolonged fasting had become a hidden driver of harm—through dehydration, metabolic instability, and procedural complexity—affecting the entire perioperative pathway, from preoperative experience to intraoperative stability and postoperative recovery. By bringing together frontline clinicians, families, and data, I led the change without a title.

In response, I led the development of GRAACC-FAST, a targeted quality improvement initiative designed specifically for pediatric oncology patients. The protocol integrates two low-cost, scalable interventions with a high impact. First, standardized preoperative carbohydrate loading with a maltodextrin-based clear drink was permitted up to two hours before anesthesia to promote hydration and metabolic stability. Second, bedside point-of-care gastric ultrasound (POCUS) enables clinicians to assess actual gastric content and safely individualize fasting decisions in a population where assumptions are unsafe.

Using the Model for Improvement and iterative Plan–Do–Study–Act cycles, we implemented GRAACC-FAST in children undergoing elective surgery. Families received clear and consistent guidance and became active partners in their care. Multidisciplinary teams adopted a concise fasting pathway in a busy, resource-constrained environment. At the bedside, anesthesiologists trained in gastric POCUS guided real-time decisions to proceed, delay, or adapt the anesthetic plan based on physiology rather than rigid rules.

The benefits were immediate and visible at all levels. Children arrived calmer, better hydrated, more hemodynamically stable, and with more reliable venous access, resulting in fewer needle attempts and a less traumatic start to surgery. Families reported reduced anxiety and greater trust in the care process after the intervention. Clinicians experienced smoother induction and fewer last-minute workarounds. For the system, this translated into fewer delays, less waste, and more reliable operating room flow, with clear gains in efficiency alongside improved safety and experience.

Within weeks, run charts demonstrated a sustained reduction in fasting times compared with the historical average of approximately 11 hours. Importantly, these improvements were achieved without any aspiration events or major safety concerns, reinforcing that hydration supported by gastric POCUS enhances safety rather than compromising it.

Equity underpins this study. Many children treated at GRAACC come from socioeconomically vulnerable backgrounds and endure repeated hospitalizations and invasive procedures. Reducing unnecessary dehydration and venepuncture is a small intervention with an outsized impact, restoring dignity for children, confidence for families, and reliability for the system.

GRAACC-FAST has already changed Brazilian culture. Fasting is no longer viewed as a fixed rule but as a clinical decision informed by patient physiology and supported by bedside imaging. For me, this project represents what quality and safety leadership looks like in practice: leading without formal authority, connecting quality to safety, experience, and efficiency, and using simple, replicable tools—hydration protocols and gastric POCUS—to deliver measurable, human-centered improvement for children with cancer.