Gradually, evidence is accumulating that links work environments to behavior, attitudes, and motivations among clinicians. These behaviors and orientations can, in turn, affect quality processes and outcomes. A growing number of studies in health care show that members of organizations are more satisfied when they work in climates that have more supportive and empowering leadership and organizational arrangements, along with more positive group environments (often reflecting elements of group support and collaboration). Moreover, although the research base is not as strong, there is emerging evidence that these same organizational attributes impact employee turnover and, most important, patient safety. Improving the organizational climate is likely to improve patient safety and decrease overall health care costs. However, future research studying specific interventions and their cost effectiveness is needed.