Policy questions associated with the conduct of outcomes studies are addressed and outcomes management and outcomes research are differentiated. Multiple outcomes initiatives are being undertaken in the United States, from the institutional to national and international levels. Nurses have had limited involvement, thus far-although the array of outcomes being examined is considerable. Members of an American Academy of Nursing expert panel on quality health care discuss the environmental context and multiple focuses of outcomes analysis. They provide an overview of current activities, present the challenges confronting nursing in its pursuit of a quality assessment agenda, and make recommendations for increasing nurses' participation in quality initiatives.