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Communication and Resolution Programs (CRP) are becoming more commonplace in the United States. ChristianaCare adopted this approach after participating in a demonstration project through the US Agency for Healthcare Research and Quality in 2014-5. This paper documents our successful implementation of our CRP and the first five years of our results. Our organization saw increased reporting of medical events, improved patient safety, mitigation of medico-legal risks and improved patient and caregiver experience. The path to implementation is challenging and represents a major shift in how organizations deal with unexpected medical outcomes. The process is complex involving individuals from patient relations, risk management and patient safety. But the benefits are satisfying. Keys to success include strong leadership support and engagement of a multidisciplinary team.