Patients appear in the patient safety agenda in three important places: first and foremost as the individual most likely to experience the positive benefits of good care or negative consequences of unsafe care; second, as surveyors of quality of care indicators; and finally, through their presence as patient representatives on institutional safety committees. However, patient safety programs largely address provider-interests, and many times overlook patient preferences and needs. Active engagement of the patient in all aspects of the patient safety agenda is necessary for its success. Patient safety, then, requires: a comprehensive agenda informed by patient preferences and experiences; an informed and motivated populace; mechanisms integrate safe practices and patient preferences, and investment in safety-enhancing devices and care strategies.