Fairview Health System implemented a systemwide harm metric to align quality goals across nine acute care hospitals. While establishing targets is essential, translating those goals to frontline units is often where improvement efforts break down. This project developed a standardized, data-driven method to cascade system, hospital and unit targets — ensuring each team understood its contribution to harm reduction. Using Vizient safety domain metrics, peer benchmarks and event-based unit goals, leaders created a transparent structure to track, communicate and act on performance. This approach led to significant reductions in harm, demonstrating the power of clear communication and aligned targets.