Almost a decade-and-a-half after the landmark Institute of Medicine report, many have found progress in patient safety to be slow and frustrating. This commentary, by patient safety expert Dr. Mark Chassin, recommends that health care shift its focus from preventable complications to safety culture to ensure sustainable improvements. The commentary also calls for a dedicated focus on eliminating overuse, which is an area that has largely been ignored thus far by the patient safety movement. A prior AHRQ WebM&M interview with Dr. Chassin discussed the role of the Joint Commission in advancing patient safety.