Leaders representing healthcare quality, purchasing, and certifying sectors convened at a national leadership meeting to address the issue of Healthcare-Associated Infections (HAIs). A session entitled "The Quality Choir: A Call to Action For Hospital Executives" featured harmonization partner organizations for the National Quality Forum Safe Practices (SPs) for Better Healthcare-2009 Update. (NQF SPs) The objective of the meeting was to determine if zero HAIs should be the improvement target for hospitals and what a Chasing Zero Department (CZD) should be like. Discussion and consensus building among these experts determined what a CZD would look like and what it would take to implement it. Given that zero HAIs must be the goal, Hospital Infection Control Departments need to be restructured. Key design issues to the CZD addresses leadership, resources, and systems. Leadership: CEOs and boards must communicate to the organization that the typical Infection Control Group might be restructured into a CZD. The leader must provide "will, ideas and execution," recognize the power of collaboration, provide funding, and establish a roadmap through use of NQF SPs. Funding for these efforts must be provided. Chief Financial Officers (CFOs) need to understand that zero HAIs will preserve revenue. Systems: Change can be made through leaders' championship, use of SPs, performing improvement, information flow and Automated Infection Identification and Mitigation System (AIIMS). These are the key to systems change toward zero HAIs.