Patient safety is one of the greatest imperatives in healthcare today; however, there are many obstacles that must be overcome to make the healthcare system truly safe. This article describes one approach to successful implementation of a pediatric patient safety program. Specific strategies for operationalizing a safety program are provided. These strategies include the use of both unit-based and departmental level safety teams to proactively identify and address safety concerns; development of specific tools and resources that teams can use to support an environment of safety; and mechanisms to modify the program in response to patient and staff needs as well as changing priorities. Challenges associated with patient care complexities, the nuances of human behavior, as well as options for overcoming these challenges are discussed. Anecdotal outcomes data are provided and potential next steps for further program growth are outlined.