University Physicians, Inc., has been impacted by the rising cost of professional liability insurance in recent years. Our internal risk management program needed to be enhanced to heighten provider sensitivity to the challenges certain practice processes (e.g., paper medical records) posed, and to tie this information to new patient and risk management strategies. The Institute of Medicine’s 2003 report Priority Areas for National Action: Transforming Health Care Quality and the Agency for Healthcare Research and Quality’s 2004 report Closing the Quality Gap: A Critical Analysis of Quality Improvement Strategies were used to establish priorities and develop indicators for measurement.