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Patient Safety State-of-the-Art in Health Care Management and Future Directions (Eric W. Ford & Grant T. Savage), Evidence-Based Medicine and Patient Safety: Limitations and Implications (Grant T. Savage & Eric S. Williams), The Anatomy and Physiology of Error in Adverse Healthcare Events (Patrick Palmieri, Patricia Delucia, Lori T. Peterson, Tammy E. Ott, & Alexia Green), Promoting Patient Safety by Monitoring Errors: A View from the Middle (Michal Tamuz, Cynthia Russell & Eric J. Thomas), Quality and Patient Safety from the Top: A Case Study of St. Francis Medical Center Governing Board's Call to Action (Louis Rubino & Marsha Chan), Trustee and Patient Safety: Redefining Boundaries (Richard A. Culbertson & Julia Hughes), Protecting the Patient: Collaborating to Achieve the Ideal Hospital Work Environment (Donde Batten, Gerald Goodman, & Susan M. Distefano), Privacy, Security and the National Health Information Network: A Mixed Methods Case Study of State Level Stakeholder Awareness (Kimberly A. Galt, Karen A. Paschal, Amy Abbott, Andjela Drincic, Mark V. Siracuse, James D. Bramble, & Ann Rule), Examining Barriers to Health Information Technology (HIT) Adoption (James D. Bramble, Mark V. Siracuse, Kimberly A. Galt, Ann M. Rule & Bartholomew E. Clark), Improving Patient Safety through Organizational Development: Considering the Opportunities (Ann Scheck McAlearney), S*T*A*R*T A Great Handoff: An Approach to Effective Medical Communication in a High-Risk Environment (Ellen S. Deutsch, Brian Binck, Gina Moore & Ben-Tzion Karsh), Changing a Pediatric Sub Acute Facility to Increase Safety and Reliability (Daved W. van Stralen, Racquel C. Calderon, Jeff F. Lewis, & Karlene H. Roberts)