The purpose of this K08 Mentored Clinical Scientist Award is to prepare Dr. Ann Kutney Lee for an independent health services research career, with a special focus on nursing outcomes research. The career development plan entails three approaches to achieve the immediate and long-term career goals of the candidate, including: 1) the completion of training dedicated to acquiring skills in advanced health services research methods and statistics, and gaining additional content knowledge in the area of chronic illness, 2) the enlistment of an expert mentorship team including Drs. Linda Aiken, PhD, FAAN, RN, Mary Naylor, PhD, FAAN, RN, and Jeffrey Silber, MD PhD, and 3) the conduct of a study to evaluate the longitudinal effects of changes in hospital care organization and patient characteristics (specifically chronic conditions), on patient and nurse outcomes, that will lead to future R-series grant applications. The research project will seek to understand how patient and nurse outcomes over time may be a function of both changes in hospital care organization, including nurse staffing and practice environments, and changes in the complexity of hospital patient populations.