Outcomes research took hold in the late 1980s. Because of the rising costs of health care, policymakers demanded an objective analysis of treatments and interventions as demonstrated by cost-effective patient outcomes. More recently, outcomes management programs have surfaced. In contrast to outcomes research, which is concerned with effectiveness, outcomes management is concerned with efficiency. Therefore, this one concept, outcomes, has moved in two related but different directions. Understanding outcomes from both the research and management perspectives is a challenge facing the nursing profession.