The need for the application of research-based data to diversified healthcare systems has led to more attempts by nurse researchers to investigate phenomena across clinical sites. Nurse executives increasingly are asked to justify resource allocation among organizations, and must compare patient-care practices within complex systems that are often geographically distant. This article describes the pitfalls encountered and the progress made by researchers during a 4-year multisite, multimethod clinical investigation collecting clinical outcome and organizational context data from seven hospitals.