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Emergency departments across the nation are faced with ever-increasing high volumes, overcrowding, and patient acuity. Along with these growing trends, the Joint Commission on the Accreditation of Healthcare Organizations is instituting new patient safety initiatives to reduce patient medical errors in the hospital setting. The emergency department is one area under great scrutiny with patient identification as primary concern. This article discusses a case study involving patient misidentification in the pediatric emergency department and reviews the legal and safety programs implemented at a children's hospital to improve patient safety outcomes.