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Examines how Dartmouth-Hitchcock Medical Center (DHMC) in Lebanon, New Hampshire and Saratoga Hospital in Saratoga Springs, New York had achieved the Magnet accreditation which recognizes achievements of nurses. Quality of the academic medical center of DHMC; Activities of DHMC which promote community involvement; Quality of leadership at Saratoga Hospital.

Answers several questions involving the use of the continuous periodic performance review process in assessing job performance of nurses in the U.S. Difference of the 2005 version of the Periodic Performance Tool released by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) from the previous years; Reason JCAHO decided to change the process; Availability and access of healthcare organizations to the tool.