Background. Sexual harassment is endemic in medicine, negatively impacting victims and bystanders. Experiencing sexual harassment is associated with poor physician well-being and attrition from the physician workforce, resulting in suboptimal patient care. However, there is limited understanding of how institutions can effectively prevent and mitigate sexual harassment to improve physician well-being. Significance. ARISING directly aligns with the Quintuple Aim and the National Action Plan to Advance Patient Safety by improving physician well-being through addressing sexual harassment. Institutions urgently need strategies to prevent and mitigate the impact of sexual harassment on physicians. This study will leverage institutional variation in sexual harassment rates, which offers opportunities to identify innovative and beneficial systematic practices and policies that address sexual harassment and improve physician well-being. Innovation and Impact. ARISING is innovative by systematically studying sexual harassment to improve physician well-being using an explanatory sequential mixed-methods approach. First, we will identify 4 high-, average-, and low- performing institutions for sexual harassment and well-being (N=12). Second, we will conduct semi-structured interviews of physicians and other key stakeholders. These will allow us to study the implementation of sexual harassment and wellness policies through a Safety-II lens and understand how these policies differ across institutions. The mixed methods analysis will inform a modified RAND/Delphi panel to develop a graded best practices framework. Specific Aims. (A1) Identify top- and bottom-performing institutions for sexual harassment and physician well-being. (A2) Understand physicians’ sexual harassment experiences and identify systematic policies that support well-being and psychological safety. (A3) Identify and create a graded best practices framework rated on validity, impact, and feasibility which can be utilized to prevent and mitigate the impact of sexual harassment, thereby improving physician well-being. Methodology. Using Intern Health Survey data from 2022-2024, we will calculate sexual harassment rates across institutions. We will empanel 4 high–, 4 average–, and 4 low–performing institutions (N=12) and prospectively survey 3,600 physicians on burnout and psychological safety. A nested cohort of semi-structured interviews with physicians will be conducted to explain in more detail what institutional programs and policies worked towards mitigating sexual harassment and improving physician well-being. We will also conduct interviews with key stakeholders, including administrators and other staff, at the empaneled institutions, detailing the efforts and innovations across units and departments. Using a modified RAND/Delphi panel, we will assess the validity, impact, and feasibility of these best practices, and in doing so will create a graded best-practice framework to reduce sexua...