This session will review information from the HCAHPS and Press Ganey Surveys to understand how reliably patient expectations related to room cleanliness are being met.   These data will be examined to identify the types of hospitals and patients that are most at risk for poor cleanliness reports.    We also will examine ways in which these perceptions are related to other organizational outcomes, including “positive word of mouth” and hospital acquired infection scores.   The session will end with a review of design considerations to facilitate room cleaning and improving patient perceptions of cleanliness.