Workplace violence is one of the most complex and dangerous occupational hazards facing hospital healthcare workers today. The United States Occupational Safety and Health Administration recommends that all hospitals have a violence prevention program. The purpose of this article is to describe the development and implementation of a preparedness program to address violent situations in healthcare as an essential component of workplace safety. The foundational program elements are leadership involvement, policy development, organization assessment, response personnel deployment, education, data repository and culture shift. A triad leadership from patient safety, security and nursing led the program. Key implementation lessons involved coordination of change within and across multiple sites.