The patient's role in quality and safety improvement efforts has focused on tips recommended to keep patients safe and mechanisms to engage them with patient-centered strategies. Although past research suggests that patient complaints relate more to service quality rather than quality of care, debate about this relationship persists. This study advances our understanding by examining patient perceptions of care, measured through a validated survey tool, and technical measures of quality and safety, measured through Hospital Quality Alliance data and the AHRQ Patient Safety Indicators (PSIs). Patients' overall rating and "likelihood to recommend" a hospital had strong associations with technical performance measures in more than 900 hospitals. The authors highlight the limitations in their detailed analysis and advocate for further research to better understand these relationships. However, their findings do add to the argument for greater patient-driven measures in assessing the quality of care provided.