PurposeThis article aims to describe the history of an annual regional conference devoted to patient safety, and presents highlights from its tenth annual event, held in May 2012.Design/methodology/approachThe paper presents a historical narrative description of major themes in the annual conferences, with more detailed description of major presentations in the 2012 conference.FindingsThe conference has provided topics and speakers to the community, reflecting changing national trends and priorities, and has helped develop an important resource, the Washington Patient Safety Coalition.Practical implicationsThe history reflects evolving North American concerns about quality of care and patient safety issues; the most recent presentations highlight recent achievements, current challenges, and provide insights from a broad range of settings.Originality/valueThis conference is the flagship activity of a state‐wide, voluntary coalition and provides an example of a major event bringing value to a diverse set of patient safety and quality improvement professionals.