In 2009, we launched National Initiative II and expanded participation to 35 AIAMC-member teaching hospitals from Seattle to Maine. Each participating hospital developed a quality improvement team led by a resident or faculty member. These teams met on-site four times and participated in monthly conference calls over an 18-month period. Quality improvement projects focused upon one of the following areas: Communication, Hand Offs, Infection Control, Re-admissions and Transitions of Care. The objectives of this second phase were as follows: 1) to align/integrate academic programs with quality initiatives to accelerate the efforts of quality and patient safety; 2) assist residency program directors and house staff in the teaching, learning and assessment of the core competencies focused on Practice-Based Learning and Systems Based Practice; 3) inform hospital and policy leaders about the contributions that can be made by faculty and house staff in expediting patient safety; and 4) integrate house staff into multidisciplinary team-based safety initiatives as a national priority.