#305 Lead Infinitely

The fastest way to weaken patient safety isn’t a missing checklist, it’s a team that stops trusting each other. We dig into “infinite anesthesia” and the next step, “leading infinitely,” a practical relational leadership approach designed to build psychological safety, empathy, humility, and civility in perioperative care.

We share why anesthesia professionals are uniquely positioned to lead across the full health system: we work at the intersection of surgeons, proceduralists, nurses, and hospital leaders, and we see how small culture signals impact big operational and safety outcomes. You’ll hear how trust-based teamwork can improve clinician well-being, strengthen system resilience, and support measurable gains in patient outcomes and retention.

We also break down the Lead Infinitely workshop series and what makes it different: teams learn together, practice concrete behaviors, and graduate with a strategic plan instead of a solo certificate. The conversation moves from training to scale, including why research, early wins, and credible champions matter if this work is going to spread beyond the OR and into onboarding, governance, and daily clinical practice.

If you want your workplace to feel safer, calmer, and more effective, listen now, share with a colleague, and subscribe so you don’t miss what’s next. After you listen, leave a review and tell us what leadership behavior you want to see more of on your team.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/305-lead-infinitely/

© 2026, The Anesthesia Patient Safety Foundation

Transcript

Why Leadership Must Be Human

SPEAKER_00 0:00

It's a message of empathy and compassion and psychological safety and leadership. It's a message of humility and not controlling others all the time, but sometimes getting low and lifting people up. It's a message of civility, right? The way that we treat each other at work matters and it matters tremendously. And I think these are universal messages that many people need to hear and need to discuss and need to wrestle with in their teams.

Sponsor Recognition And Support

Featured Article And How To Find It

Why Anesthesia Can Lead Systems

Alli 0:25

Hello and welcome back to the Anesthesia Patient Safety Podcast. I'm your host, Allie Bechtel. We are continuing the conversation about infinite anesthesia today. Infinite anesthesia is an approach to perioperative care that encompasses a mutually supportive workplace that maximizes patient care with every encounter in a way that appreciates every team member. Perioperative teams can embrace this culture of trust and teamwork that encourages all anesthesia professionals to see one another as respected fellow players in the infinite game of perioperative care with the pillars of intentional and respectful interprofessional dialogue, learning, and team building. We are going to learn more about this approach today and how you can lead infinitely at your institution. Before we dive further into the episode, we'd like to recognize Soul Ventum, a major corporate supporter of APSF. Soul Ventum has generously provided unrestricted support to further our vision that no one shall be harmed by anesthesia care. Thank you, Soul Ventum. We wouldn't be able to do all that we do without you. Our featured article is Leading Infinitely in Perioperative Care, an Anesthesia-led Relational Leadership Model by Matt Sharer and colleagues. This article is an APSF newsletter article published online February 1st, 2026. To follow along with us, head over to apSF.org and click on the newsletter heading. The first one down is APSF Newsletter Articles. Then you can scroll down until you get to our featured article, and I will include a link in the show notes as well. We have even more exclusive behind-the-scenes content from the authors. So let's take a listen now.

SPEAKER_02 2:18

I am Dr. Johan Beiste, Professor of Anesthasiology and Perioperative Medicine at the University of Alabama at Birmingham, where I'm present to serve as Executive Vice Chair for Operations and Integration.

Alli 2:33

I asked Johan why he feels so passionate about leading infinitely and what he hopes to see going forward. Here is his response.

SPEAKER_02 2:43

I am passionate because anesthesia teams uniquely sit at the intersection of virtually every specialist in the hospital. We see the full system in action. We function as team better than almost anyone. We have delivered near six sigma levels of safety through trust and collaboration. That experience makes it clear to me that the skills and relationships we cultivate aren't just for the OR. They can be used to transform how care is delivered across the full health system. Building trusting relational leadership is a practical level to improve patient safety, clinician well-being, and system resilience. And that's what the course is worth devoting myself to. I hope we scale this well beyond anesthesia into surgery, procedural specialties, hospital medicine, and also leadership, onboarding. So the infinite leadership mindset becomes a routine part of how teams are built and how change is managed. I want measurable improvements in patient outcomes, team performance, clinician retention, and most important, team culture, backed by research so institutions can justify investments. Ultimately, I want us to cross the cusp, move from pockets of early adopters to mainstream practice, where relational leadership is the norm, not the exception.

From Infinite Anesthesia To Workshops

Five Skills The Series Teaches

Scaling Beyond The Operating Room

Research And The Call To Action

Alli 4:13

Thank you so much to Johan for helping to kick off the show today. Now it's time to get back into the article to examine moving from infinite anesthesia to leading infinitely. Remember, infinite anesthesia embraces trust and teamwork where all anesthesia professionals see one another as respected fellow players in the infinite game of perioperative care. The authors tell us that this approach is inclusive and idealistic, but it may not be inclusive and idealistic enough for what we need in healthcare today. What do they mean by this? Well, since the authors proposed the idea of infinite anesthesia, hospitals across the United States and internationally reached out for more information and consultation. In the UK, an infinite game approach of a tiered system with levels of care based on surgical risk and clinical training has been proposed to help address the challenges of surgical wait lists. In the authors institution, the theories were put into practice with the development of a workshop series called Lead Infinitely. At first, the workshop series participants included nurse anesthetists, anesthesiologists, and perioperative nurses, but quickly expanded to include proceduralists and surgeons, with over 300 clinicians participating in the workshop series this year. The workshop series includes the following sessions: leading collectively, with the focus on teaming, collective intelligence, and mutual learning mindset. Leading with humility, with the focus on finding balance between professional will and personal humility. Leading with civility, which addresses the price of incivility and benefits of civility in healthcare teams. Leading with discovery, which involves managing change through the concepts of discovery-driven planning and idea flow. And finally, leading infinitely, which encompasses pursuing a just cause, building trusting teams, studying worthy rivals, preparing for existential flexibility, and demonstrating the courage to lead. This sounds like an amazing workshop series, which has seen steady growth at the author's institution and is gaining traction in hospitals around the United States as well. The goal for this workshop series is to bring frontline care teams together to educate on leadership and teamwork principles while also working to strengthen bonds and build respectful and trusting professional relationships. This is important work for improving workplace engagement, which can lead to improved employee retention. You cannot do this work alone, and teams attend the workshop together with group discussion and planning as important parts of every session. At the conclusion of the workshop series, participants don't just get individual certificates. Instead, teams graduate with a strategic plan to optimize patient care their teams deliver by forging stronger professional relationships to enhance team communication and performance. The demand is growing for this workshop series and education about leaning infinitely. And it has exploded to outside of the operating room to include surgical subspecialties, medical proceduralists, obstetricians and neonatologists, and hospital medicine physicians. As a result of this increased demand, a customized one-day workshop with any and or all of the original five topics has been created for departments in the author's institution. In addition, the School of Medicine Faculty Affairs leaders have recognized this series as important for all faculty in clinical and research domains and made it part of the onboarding process for new hires. Imagine joining an institution and learning that your new institution values leading infinitely with strong teamwork, communication, and respectful and trusting professional relationships right off the bat. Definitely a good way to start off on the right foot. The authors are also engaged in research to determine participants' perceptions of the course and its impact on daily practice and culture. Early reports from the participants' feedback describe the material as engaging, relevant, and helpful, and that the message is one that many need to hear. We are looking forward to learning more about this research going forward. The authors leave anesthesia professionals with a call to action. We need to take the foundation of infinite anesthesia and expand the scope to all healthcare teams with infinite leadership. Anesthesia leaders are uniquely positioned to lead infinitely because we can see the bigger picture of the healthcare system and we already embrace teamwork in our daily practice. The respectful, trusting, and inclusive anesthesia care team model is relevant beyond the operating room and across the healthcare system. We already have the foundation of wide-ranging relationships which provide access and credibility to improve efficiency, patient experience, quality care, and patient safety. The authors invite anesthesia leaders along with surgical and medical colleagues and healthcare system partners to join the Lead Infinite movement as active co-leaders to create and support mutually supportive workspaces that maximize patient care while appreciating every team member. This is a big opportunity. Are you ready to start leading infinitely? Before we wrap up for today, we are going to hear from the authors again. Let's take a listen.

SPEAKER_00 9:59

Hi, this is Matt Shear. I'd love to see the Lead Infinitely Workshop series become a movement. To do so, however, is going to require data. So that's what we're doing right now is some research into the workshop series and hope to be able to publish that in the near future. And then after that, I'd love to see the movement grow because I believe that the messages that are included in the workshop are universal. It's a message of empathy and compassion and psychological safety in leadership. It's a message of humility and not controlling others all the time, but sometimes getting low and lifting people up. It's a message of civility, right? The way that we treat each other at work matters and it matters tremendously. And I think these are universal messages that many people need to hear and need to discuss and need to wrestle with in their teams.

What Defines A Real Movement

Alli 10:44

I also caught up with Dr. Dan Berkowitz and asked him, what's next for this project? Here he is now.

SPEAKER_03 10:51

What I want to convey here is that what we are really experiencing and looking at with regard to leading infinitely and infinite anesthesia is not just a program, but a movement. And what is the difference between a program and a movement? Movements are really social and cultural phenomena that change people's beliefs, identities, and behaviors. And most importantly, they do that at scale. So what are those things that actually define or create a movement? Well, the first is having a clear, emotionally compelling why. Movements start with purposes that answers why. Why does this matter? They're not just technically better throughput, but morally and identity-wise really addressing a very important issue. They are simple, repeatable ideas or practices, and we can see that's part of the infinite anesthesia process. They have credible leaders and champions, and we can see that that's the case. They have early wins and evidence, concrete examples and data showing improvement that builds social proof, stories and rituals. We obviously are able to recount success stories, how we actually were able to create these highly functional teams from a situation in which there was a trust fracture between our team members. Networks and channels for diffusion. We have the opportunity for presentation of these ideas and this movement concept at conferences, grand rounds, presentations. And there is a structure for scale and sustainability, curricula and governance and measurement systems that actually enable us to determine the impact of the work that we do and momentum. Clearly, the work that we are doing has created momentum. And it is this momentum that actually really helps to define the fact that this is no longer just a project, but truly is a movement that will spread and hopefully will be incorporated and impacts healthcare and the healthcare environment in which we function incredibly.

Alli 13:29

Thank you so much to Matt, Dan, and Johan for contributing to the show today. We are so excited to see that Leading Infinitely has gained so much momentum that it's become a movement. And this movement has the potential to make a big difference in improving anesthesia patient safety going forward. If you want more information about Leading Infinitely, we hope that you will check out the University of Alabama at Birmingham Department of Anesthesiology and Perioperative Medicine Lead Infinitely website. I will include the link in the show notes. Here you will find more information about the workshop series, book recommendations, literature on the topic, and more information about bringing the workshop series to your clinical care team. We hope that you will check it out. If you have any questions or comments from today's show, please email us at podcast atapsf.org. Please keep in mind that the information in this show is provided for informational purposes only and does not constitute medical or legal advice. We hope that you will visit apSF.org for detailed information and check out the show notes for links to all the topics we discussed today. Thanks for joining us on the Anesthesia Patient Safety Podcast. If you found today's episode helpful, be sure to listen to past episodes, download your favorite, and share them with your colleagues and friends. We don't have an infinite number of episodes yet, but we do have over 300 and we are just getting started. Together, we can keep advancing patient safety in anesthesia care. See you next time. And until next time, stay vigilant so that no one shall be harmed by anesthesia care.