Health care quality and safety are becoming more transparent, and consumers will increasingly value safety and quality rating in choosing where they go for surgery. Perioperative services are major drivers to a hospital’s safety rating. Surgical services are often the most, or one of the most, profitable services, and loss of referrals and poor media reports will directly reduce margins. This article aims to guide leaders and perioperative staff in how to start improving perioperative quality and safety in health care and surgical services.