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Operationalising perioperative safety: learning to walk the talk. Perioperative care represents a high-burden area for preventable harm, attributable to both clinical complexity and systemic barriers, wherein evidence-based safety guidelines are often inadequately implemented. We highlight the need to bridge the gaps between proven interventions and implementation-ready strategies using systems-based, culture, and context-sensitive approaches. Engaging frontline teams and aligning proposed solutions with real-world clinical workflows are essential to achieving patient safety. To advance perioperative safety, we must bridge the gaps between recommendations and practice by implementing actionable, scalable strategies rooted in implementation science and responsive to the real world challenges of clinical work and the hazards that lead to harm.