The role of organizational leadership in ensuring patient safety has been recognized by accrediting organizations such as The Joint Commission, who issued a sentinel event alert calling attention to the issue and have also developed leadership standards. This Canadian study sought to quantify the relationship between leadership and organizational learning from safety events, and found that hospitals with stronger safety leadership structures demonstrated a greater capacity to learn from errors and near misses. This relationship was particularly true for smaller hospitals. An AHRQ WebM&M perspective discusses how one hospital responded to a never event.