Efforts to improve safety culture within an institution may be limited by the fact that hospital units may vary widely in their perception of safety. The comprehensive unit-based safety program (CUSP) focuses on improving important determinants of safety culture—teamwork, management involvement, and reporting and learning from errors—by engaging staff at all levels in a continuous quality improvement process. The specific CUSP interventions in this study, conducted in a surgical inpatient unit at an academic hospital, included implementation of a daily goals sheet, geographic localization of patients, and integration of nurses into physicians' daily rounds. The CUSP resulted in a significant and sustained improvement in 6 of 7 safety culture domains. The study's senior author, Dr. Pronovost, recently published a book on his trailblazing patient safety career.