- •Employee willingness to speak up about errors and opportunities for improvement is a hallmark of a health care safety culture and factor contributing to successful central line–associated bloodstream infection prevention efforts.
- •Interviews with 158 key informants at 6 hospitals across the United States found that organizational quality improvement and interdisciplinary care processes, along with leader behavior, employee training, and robust reporting systems, facilitated improvement-oriented speaking up related to central line–associated bloodstream infection prevention.
- •Although initiative-specific efforts are important to central line–associated bloodstream infection prevention, efforts to facilitate speaking up may be best implemented at the broader organizational level.
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Funding/Support: Supported by a contract awarded to the Health Research and Educational Trust by the Agency for Healthcare Research on Quality (contract no. HHSA290200600022, task order 5), on which The Ohio State University was a subcontractor.
Conflicts of Interest: None to report.
Disclaimer: The views expressed in this article are solely those of the authors and do not represent any U.S. government agency or any institutions with which the authors are affiliated.