The United Kingdom's Safer Patients Initiative (SPI) is a large-scale effort to improve patient safety, with past studies demonstrating positive perceptions of the program among participants. In this phase one study, the SPI focused efforts in 4 hospitals, where a $1.2 million investment was made in each to secure improvements across a wide range of aims, including a 50% reduction in adverse events. The multifaceted interventions targeted organizational factors, such as safety culture and specific clinical issues (e.g., medication errors and communication), through continuous quality improvement methods. The robust program, including this independently requested evaluation, demonstrated a few improvements associated with introduction of SPI, but no additional benefit on many other targeted issues. An accompanying editorial [see link below] discusses the study findings, and emphasizes the continued need to run toward science rather than away from it in evaluating quality improvement efforts.