This study was exploratory in nature, utilizing a phenomenological collective case study approach. The phenomenon under study was the lived experiences of individuals surrounding employee voice and upward communication. The purpose was to understand CEO behaviors and actions that promote employee voice and upward communication in performance excellence award-winning healthcare organizations. The results suggested the award-winning CEOs facilitated employee voice and upward communication by being approachable, largely achieved through their regular presence throughout their organization. By being consistently visible and available to employees, these CEOs fostered relationships, built trust, and promoted open, upward communication. Leaders in the current case studies created a cultural focus on continuous improvement largely built around transparency of information, and particularly looking for the bad news from their employees. Voice invitation and positive voice response from leaders’ reinforced critical upward feedback as not only welcome, but expected. Findings from the study provided insight into leadership behaviors promoting employee voice and upward communication, which may be valuable to both scholars and practitioners. In-depth descriptions of CEO actions and behaviors address a gap in the current literature and add to the understanding of the phenomenon of employee voice and critical upward feedback.