The Institute of Medicine's seminal report on patient safety, To Err Is Human: Building a Safer Health System, was published 17 years ago, triggering what we now refer to as the patient safety movement. This Views from the Top session examines the state of the movement – where we’ve been, what we’ve accomplished, and how we can accelerate safety improvements. There are clear signs of positive change but we all know that many challenges remain. Leadership, culture and systems-thinking play a huge rule. Health IT stays an important part of the solution. No matter what stage of your safety journey, it is critical for IT leaders to foster trust and accountability and sharpen patient safety skills.