Safe by design: Making the right thing the easy thing

If a workaround becomes the norm, that isn’t a training issue; it's a system design failure."

This focus on safety-by-design has been central to Yvette Khozam’s work as a digital leader.

It has been recognised with three shortlists at the HSJ Digital Awards 2026: Yvette for Digital Leader of the Year, and the West London NHS Trust team for Outstanding Achievement in EPR Implementation and Optimisation, and Improving Mental Health through Digital. She emphasises that the impact came from multidisciplinary teamwork and that DHLP gave her the practical operating model to lead it: decision rights, risk controls, and benefits tracking that stood up under pressure.

As a clinical informatics leader who has led digital deployments across settings ranging from older adult wards to high-secure mental health, she sees workarounds as design feedback: an opportunity to make the safe path the simplest one.

Her focus is building systems that work on the busiest days, so the safe option is also the easiest. This is a philosophy she is now applying as a Chief Pharmacy Information Officer (CPIO) helping to deliver Nova, a UK first-of-type unified electronic patient record across Essex, and as an elected member of the national Digital Health Networks CCIO Advisory Panel.

Learning in the middle of delivery

Yvette supported the Broadmoor Hospital go-live as Senior ePMA Pharmacist at West London NHS Trust. Implementing digital prescribing in a high-secure hospital, one of only four in the UK, left no margin for ambiguity. As the work scaled beyond Broadmoor and she stepped into the Lead ePMA Pharmacist role, DHLP became the lever that made scale possible: tightening governance, clarifying decision rights, and making benefits measurable.

"I was learning about process mapping at the same time as we were rebuilding real prescribing processes," she says. "It meant I wasn’t learning for some point in the future; I was applying the structure the very next morning."

The scaffolding: Design for reality

The core lesson she took was to design for work as it is, not as it should be.

Too often, systems are built around a "perfect world" workflow. DHLP gave Yvette an operating model to challenge that assumption and align the build to clinical risk management standards (DCB0129/0160). In practice, it meant explicit decision rights, a single risk/hazard log with agreed "stop" criteria, and resolving issues once at source before they became recurring local workarounds.

By testing the build against real ward pressures such as staffing constraints, interruptions and, locum access, she ensured the safety case reflected real risk, not idealised workflows. This helped prevent ‘local fixes’ becoming system failures and strengthened the programme’s assurance evidence.

The proof: Data quality at source

Standardising the pathway didn't just save time; it improved data quality at source.

• 170 hours released in 12 weeks through digital signatures
• 1,001 prescriber hours saved through better workflows
• 582 paper drug charts removed, reducing clinical risk
• Same-day discharge enabled across three boroughs
• 2.2 million administrations supported safely across 35 wards

"It isn't just about implementing a system," Yvette notes. "It is about a clinician saying, 'I’m not chasing signatures today', and 'discharge is actually possible' and that only happens when ward teams, pharmacy, digital and operational colleagues shape the workflow until the standard fits real practice."

Scaling up: Enterprise leadership

Yvette is now applying these principles as a cross-Trust CPIO across Mid and South Essex NHS Foundation Trust and Essex Partnership University NHS Foundation Trust.

She is embedded in the delivery of Nova, a UK first-of-type Unified Electronic Patient Record spanning acute, mental health, and community services. The programme requires bridging the operational gaps between distinct care settings to transform care delivery across all clinical environments. It also requires clear information flows and controls around access, interoperability and data protection to ensure care remains safe across settings.

Her remit spans strategic clinical informatics, system safety, and data integrity, translating frontline issues into system standards.

"At this scale, the focus shifts to operational control," she notes. "It is about benefits realisation and rigorous integration that prevents local workarounds from becoming enterprise risk. In practice, that means being clear on what will be standardised, what will be stopped, and how progress and risk will be reported to ensure variation doesn’t creep back in."

It is here that the DHLP’s focus on strategic governance is most vital, providing the framework to support a programme of ambitious scale and complexity.

National influence: AI safety

The programme also provided a route into the wider digital health community. Following a recommendation from the course, Yvette applied for the Digital Health Networks mentorship scheme, connecting with senior leaders outside her immediate Trust.

This experience supported her subsequent nomination to the CCIO Advisory Panel, where she now serves as an elected member for the 2025–2027 term. In this role, she engages with national leaders to support digital health policy and standards.

She applies this governance lens to emerging challenges such as AI safety and algorithmic security. She argues that adopting these tools requires a shift from static testing to continuous assurance.

"Closing the AI safety gap is the key to unlocking its potential," she argues. "When we treat safety as a continuous process of active monitoring, we build the trust required to scale. Good governance turns experimental technology into reliable clinical tools, giving us the confidence to innovate safely."

The reflection: Advice to the next cohort

Yvette describes the programme as a "transformative opportunity", largely because of how practical it is. She often found the coursework landed exactly when she needed it in her day job, whether that was drafting a ‘plan on a page’ for a real project or mapping a complex process.

"It stops being 'homework' and starts being a toolkit," she says. "You aren't learning for later; you are getting the structure to handle the decisions you are facing right now."

Her advice is not to wait for a 'quiet time' to apply, because in the NHS, that time rarely comes. Instead, she suggests using the programme to support the work you are already doing, turning daily pressures into material for your learning.