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Even though safety culture in health care has been on the agenda for more than a decade, the implementations have been difficult. The aim of this study was to out of the sensemaking perspective, examine the process behind implementing safety culture. The present study tested a hypothetical model where open communication, clear information and leader safety attitude predict reporting incidents (part of safety culture) which in turn mediate to safety performance. Survey data was obtained from 104 employees at a Swedish hospital which has tried to implement safety culture recently. To test the model, structural equation modeling was used. Results showed a strong model fit and all factors predicted reporting incidents. Reporting incidents predicted safety performance and mediated between the predictors and safety performance. Thus, in line with theoretical background all three predictors seem to be important in the implementation process of safety culture.