We propose to convene a 2.5-day conference titled, Assessing Organizational Features of Health Care Settings to Improve Quality of Care. This conference will be structured to advance our understanding and measurement of those organizational characteristics of health care settings that are amenable to improve the quality of care. Specific objectives of the proposed conference are to: 1. Review and refine a proposed conceptual framework that describes important organizational features of health care settings and their relationship to quality of care and patient outcomes. 2. Identify or foster development of a "tool box" of measures for assessing important organizational features of health care settings. 3. Review current applications of organizational assessment in ongoing or recently completed research, and their implications for understanding and designing more effective change processes to improve quality of care. 4. Using the conceptual framework and case examples, identify modifiable aspects of health care environments and appropriate processes and interventions to improve the quality of care. The conference planning committee has assembled an impressive group of national and local participants to serve as proposed speakers, discussants or conference participants. These people come from a variety of disciplines including family medicine, general internal medicine, organizational development, psychology, anthropology, nursing and public health. Conference participants will bring a wealth of knowledge and experience in the application of multidisciplinary approaches for understanding health care settings to improve quality. Both Conference Proceedings and a Monograph will be published to disseminate both the theory and methods that support this area of research.