Transformation of patient safety through leadership and organizational alignment.

Purpose of review: Although tremendous progress has been made in patient safety in the past few decades, critical gaps still remain. This review will address how leadership and organizational alignment can help move patient safety forward.

Recent findings: Alternative leadership styles may have positive impacts on safety climate, psychological safety, and clinician burnout.

Summary: Patient safety in anesthesiology has made tremendous strides since the discovery of anesthesia, but progress over the past few decades has been less visible. Critical gaps and opportunities still remain; leadership and organizational alignment play a key role in making continued improvements in patient safety. Safety efforts may stall due to problems with incident reporting, lack of sufficient resources and training, and clinician burnout. Leadership approaches that focus on transparency, accountability, humility, vulnerability, and a nonpunitive response to error can help improve safety climate and encourage engagement in patient safety work. Leadership should dedicate time and resources to a Patient Safety Committee and a Patient Safety Officer. Finally, proactive leadership that fosters a positive culture of safety is essential to navigating new payment models and reporting structures.