This study summarizes the experience of four institutions in their design and implementation of Patient Safety Leadership WalkRounds^TM. The authors describe the basis for and importance of this activity by emphasizing the impact of bringing institutional leadership to the frontline staff. Basic concepts for WalkRounds are detailed, along with the demographics at each institution, descriptions of data collection methods, and graphic illustration of feedback mechanisms. Results encompass more than 230 one-hour sessions with categorization of nearly 1500 comments, with the largest proportion related to equipment and communications. Several tables also summarize the specific actions taken in various departments within hospitals. The authors conclude that the WalkRounds program serves an important role in fostering a culture of safety, particularly if combined with other organizational efforts. Their findings and guidelines for implementation provide the most comprehensive review to date.