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The design of the SAFE or SORRY? study: a cluster randomised trial on the development and testing of an evidence based inpatient safety program for the prevention of adverse events.
van Gaal BG, Schoonhoven L, Hulscher ME, et al. BMC Health Serv Res. 2009;9:58. 

This study describes the implementation of a patient safety program focused on evidence-based guidelines to reduce the incidence of pressure ulcers, falls, and urinary tract infections. The authors discuss the challenges of their program development and implementation, including the need for reliable feedback systems on performance.
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