The need to improve the safety and quality of radiotherapy treatments is broadly recognized. Significant efforts are underway by a variety of groups to provide guidelines, tools and techniques that can be employed in the clinic to improve safety and quality. This symposium will review recent work in this area including: 1) The use of incident reporting systems in radiation therapy, 2) Database elements and design underlying such systems, 3) Education and training of medical physicists in error management. The initiatives of AAPM, ASTRO and other affiliate groups will be described. Learning objectives of this symposium are to understand current developments in patient safety improvement and to gain familiarity with safety improvement tools available to the clinical medical physicist.