Maintenance of uniform quality of service is a problem confronting administrators in multiple-hospital systems. Establishment of a monitoring system necessary for such maintenance requires reliable measures and acceptance of the measures by staff in all hospitals. One eight-hospital group, part of an HMO, successfully inaugurated such a program by actively involving hospital staffs in questionnaire modification, survey feedback, and action planning based on survey results. The "Patient Perception of Care" questionnaire was used as the core instrument. Reliabilities of scales containing ratings of service and attitudes of major staff groups were moderate to high, allowing cross-hospital comparisons. Administrators found results useful in problem diagnosis and management decisions.