Shifting to a nonpunitive approach to adverse events can improve error reporting and the overall safety culture. This article describes findings from focus groups with nurses at Children’s Hospital of Philadelphia (CHOP) regarding the perceived punitive nature of the hospital’s incident reporting system and outlines how those findings informed changes to the error review process. Lessons learned highlight the importance of who performs error follow-up, skills for navigating difficult conversations, transparency, and executive-level support. Five years after these program changes were implemented, 96% of nurses surveyed felt that the new process was nonpunitive.