Patients can play a crucial role in identifying safety events. Prior studies have shown that patient surveys can identify errors and adverse events that were not detected through other safety surveillance mechanisms. In this study, investigators conducted interviews with patients after hospitalizations at two urban tertiary care hospitals, specifically querying patients about perceived breakdowns in their care. Nearly 40% of patients perceived at least one breakdown, most commonly relating to communication with clinicians or issues with medications. Younger and more highly educated patients, as well as those who had a caregiver participate in the interview, were more likely to report a breakdown in care. This study highlights the importance of directly asking patients about perceived safety concerns as part of patient safety surveillance. Approaches to engaging patients in patient safety are discussed in a Patient Safety Primer and PSNet perspective.