Over the last several months, I have been thinking about how we can deliver consistent, high-quality surgical care to your patients. In 2001, the Institute of Medicine produced a report titled, Crossing the Quality Chasm. In this report, they state: “The current care systems cannot do the job. Trying harder will not work. Changing systems of care will.” Now, 15 years later, this still holds true. We have witnessed fundamental change in our health care system with Obamacare. We have also witnessed a groundswell of change in quality improvement initiatives at the hospital, regional, state, and national levels. I have seen a culture of safety permeate through our hospital. I am proud of this culture shift but we have a long way to go. In the next decade, team-based approaches are required for success and will lead to meaningful long-lasting improvements in health care quality and outcomes.