Improving outcomes for patients and their families in inpatient and residential settings requires an organized approach to improving the system processes that influence care delivery. Child and adolescent psychiatrists can become effective leaders of clinical programs by enhancing their understanding of systems and adopting quality improvement principles. Participants learn the potential risk of patient and staff injury on inpatient and residential psychiatric units and understand how the care system contributes to the severity of injury risk; methods to develop, lead, and sustain quality improvement programs that improve patient and staff safety; and leadership skills that promote positive organizational change to improve clinical processes and patient outcomes.