We develop a conceptual model of customer‐focused voice and test it in a hospital setting. Drawing from theory and research on voice, we find that customer orientation and job autonomy are positively associated with customer‐focused voice. In addition, consistent with social information processing theory, these relationships are moderated by service climate, such that a high service climate compensates for the less desirable aspects of employees or their jobs. Finally, we provide evidence for a critical but untested assumption of the voice literature by linking hospital‐level customer‐focused voice to hospital‐level service performance. Results based on data from four unique data sources, provided at varying points in time, and at different levels of analysis demonstrate support for our conceptual model.