The purpose of this study was to determine the effect of participating in a safety management system, the OSHA Voluntary Protection Program (VPP) and its impact on safety culture at the Illesheim Army Health Clinic. This study is critical and timely for the Department of the Army and the U.S. Army Medical Command (MEDCOM), as both organizations begin the process of implementing a safety management system throughout their area of responsibility. The Army and MEDCOM want to implement safety management systems to achieve lower accident rates and workers compensation costs, reduced absenteeism, higher morale, and enhanced public recognition. The case study was conducted at an Army Health Clinic located in Illesheim, Germany which had a strong safety program before the implementation of the OSHA VPP. The clinic piloted VPP for the MEDCOM and achieved certification in June 2012 after seventeen months of implementation. The OSHA VPP was not well known or understood at military treatment facilities and Army health clinics in MEDCOM. Medical units have complied with the Army Safety Program and the Joint Commission standards. Many Army leaders questioned the value and return on investment of implementing another safety compliance program. The case study found the implementation of VPP not only maintained a high standard of safety, but achieved an active, visible level of management and leadership commitment, employee involvement, and a positive morale and respect for all levels of staff work and effort. Finally, there was a unique and special deep feeling of pride, communication, concern for patient and employee safety, safety awareness, and patient satisfaction within the clinic after the implementation of the VPP.