Objective To establish a nursing illness observation competence improvement team based on the Systems Engineering Initiative for Patient Safety (SEIPS) model, and to evaluate its operational effectiveness. Methods A nursing illness observation competence improvement team was established, and a nursing illness observation competence improvement program was designed based on the SEIPS model, which was used in 162 nurses from the surgical division for one year by optimizing five elements of the nursing work system:people, tasks, tools, organization, and environment.The nurses′ illness observation competence, effective complaint rate of nursing quality problems and patient satisfaction were assessed and compared before and after the intervention. Results After the intervention, nurses′ illness observation competence and patient satisfaction were significantly higher than those before the intervention, while the effective complaint rate of nursing quality problems was significantly lower （all P＜0.05）. Conclusion The construction and practice of a nursing illness observation competence improvement team based on the SEIPS model is conducive to improving nurses′ illness observation competence and nursing quality, and providing a reference for establishing a patient-centered nursing safety model.