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• Patient engagement identified environmental cleaning as a priority for HAI prevention. • Patient's perceived that cleaning while occupying the room is a potential barrier to cleaning. • Patient input during environmental cleaning can provide opportunities for patient-centered care. • VA facilities with Veteran patients and staff can facilitate supportive and therapeutic patient interactions. Environmental cleaning and disinfection are important for preventing healthcare-associated infections (HAIs) via contaminated surfaces. Hospital cleanliness plays a large role in patient perception and satisfaction regarding their healthcare. However, patient perceptions of environmental cleaning procedures remain unclear. The objective of the study was to engage patients in achieving patient-centered care and examine patient perspectives on environmental cleaning work systems in healthcare. A qualitative descriptive study was conducted using semi-structured interviews with hospitalized patients at a Midwestern Veterans Administration Hospital. Interviews were audio recorded, transcribed, then coded to identify recurring themes. Fifteen patient interview were conducted. Patients reported expecting a clean hospital room. Some patients expressed feeling "in the way" during cleaning, possibly rushing cleaning procedures. Patients expressed confidence in Environmental Management Service (EMS) staff's skilled work and noted "soft skills" as desirable attributes, including camaraderie which can develop between Veteran patients and Veteran staff during room cleaning. Patients identified environmental cleaning as a priority for HAI patient-centered infection prevention practices. Cleaning occupied rooms may be an important entry point for intervention to address actual or perceived disruption to patients or build upon Veteran peer relationships. Cleaning procedures may become more patient-centric if cleaning procedures were explained and based on patient preferences. [ABSTRACT FROM AUTHOR]