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Contaminated blood cultures are a known cause of increased hospital cost, prolonged length of stay, and exposure to unnecessary antibiotics. In 2007, the Clinical and Laboratory Standards Institute adopted an acceptable benchmark of overall blood culture contamination rate of <3%.1 However, multiple research studies have revealed that rates vary between institutions and are frequently greater than this benchmark.2,3 In this issue of Hospital Pediatrics , Bram et al4 describe a multifaceted quality improvement (QI) initiative to reduce the percentage of contaminated blood cultures in a pediatric emergency department at a freestanding children’s hospital. The results were impressive. Rates of contaminated blood cultures decreased from 6.7% to 2.1% over a 16-month period. The authors also estimated significant cost savings due to the reduction of contaminated blood cultures and their sequelae. The tremendous reduction in contaminated blood cultures and the cost savings are compelling. The improvers are to be commended for performing a true patient-centered QI initiative, avoiding unnecessary venipunctures, antibiotics, emergency department visits, hospital admissions and prolonged length of stay, work-life disruption, and concern over a potentially severe infection in a child. Although recognition of this accomplishment is appropriate, the point of publishing QI reports is to describe the context and interventions with enough specificity to replicate successful projects (with adaptations in new contexts) or to avoid ineffective interventions on the basis of the learnings of previous improvers. This report provides several replicable strategies but also raises interesting questions about …