The tenets of patient-centered care call for ensuring that clinical decisions are guided by a true partnership with patients. Patient safety is no different, and The Joint Commission called for hospitals to engage patients in safety efforts as a 2009 National Patient Safety Goal. This systematic review critically evaluates the published literature on patients' attitudes toward involvement in safety efforts and the effectiveness of such efforts. Overall, patients have a positive attitude toward engaging in safety programs, but some studies have found reluctance to engage in behavior that may seem confrontational toward providers. Although patient engagement in safety efforts should be encouraged and continues to increase, the authors note a lack of rigorous studies evaluating the effect of such efforts on safety outcomes.