Hospital-acquired conditions cause harm to patients and increase mortality. In addition to lowering the quality of patient care, hospital-acquired conditions also negatively affect financial performance, which makes them a business problem for hospital administrators. The purpose of this single case study, which was grounded in the theory of high reliability, was to explore strategies used to reduce the number of hospital-acquired conditions. The sample consisted of 13 senior leaders of a large academic medical center in the southeastern United States, who shared successful strategies used to reduce hospital-acquired conditions. Data collection took place through semistructured interviews and a review of plans and reports that showed rates of hospital-acquired conditions from 2014 to 2017. Data analysis involved using Yin's 5-step process as well as coding interview text and data from documents and then grouping related words to develop themes. Themes that emerged from this study included leadership style, communication practices, and trust. A key finding was the importance of positive and trusting leadership behaviors by senior leaders planning to reduce hospital-acquired conditions. Another key finding was the confirmation that hospital administrators can and should prioritize quality and financial improvement simultaneously. The implications of this study for positive social change include the potential to reduce health care costs and save patients' lives by reducing the number of hospital-acquired conditions.