Healthcare is a complex, high-risk industry as evidenced by frequent accounts of unintended patient and staff harm as well as other disruptions leading to financial, reputational and facility losses. Canadian healthcare organizations have struggled to adopt effective organization-wide risk management programs to reduce the likelihood and impact of these losses. This paper outlines an evidence-based initiative to spread, at scale, an effective and efficient program for integrated risk management. National results and benchmarks from the first three years of implementation are provided.