The Veterans Health Administration (VHA) has been a leader in the patient safety movement for more than two decades. VHA is committed to continuing to build these significant strides in improving safety and quality of care. In February 2019, VHA launched an enterprise-wide High Reliability Organization (HRO) transformation initiative and made a long-term strategic commitment to pursuing a Zero Harm. As Veterans Integrated Service Networks (VISNs) and VA Medical Centers (VAMCs) advance in HRO maturity, leaders are actualizing this organization-wide commitment to Zero Harm by strengthening organizational safety cultures, featuring empowered, collaborative frontline teams. These teams are also supported by engaged leadership within a Just Culture embodying a climate of trust and continuous improvement. After a review of Military Health System (MHS) performance in 2014, each Military Medical Department and the Defense Health Agency (DHA) took specific action to improve health care access, quality, safety, transparency, and patient engagement. Now the DHA is working to standardize and spread these efforts, in a coordinated path to high reliability for the entire MHS under the Ready Reliable Care (RRC) brand. Ready Reliable Care spans clinical and non-clinical settings to drive better outcomes for patients, staff, and the enterprise. High reliability supports increased standardization to deliver consistent high-quality care from one facility to the next, one patient to the next. This approach is not another project to work on in addition to competing operational priorities. It is a foundation of how to get everything else right. As the landscape of Military Health evolves, RRC serves as a crucial pillar to MHS success and its goal towards zero harm. To support both Service Members and Veterans in receiving the highest quality healthcare, the DHA and the VHA each embarked on their respective, yet complementary, journeys to become HROs. Both agencies deployed common strategies to accelerate adoption of, and sustain, HRO behaviors and practices. The aim of this HRO-focused poster is to share aligned strategic initiatives and infrastructure supporting each system on its Journey to High Reliability, and nuances within each agency’s approach based on differences in organizational culture, complexities of care delivery and patient populations. Attendees will have the opportunity to review specific frameworks, tools and lessons learned from early implementation and adoption of HRO principles and practices for application to their own work.