Objective. To examine the benefits of a high-performance work environment (HPWE) for employees, patients, and hospitals. Study Setting. Forty-five adult, medical-surgical units in nine hospitals in upstate New York. Study Design. Cross-sectional study. Data Collection. Surveys were collected from 1,527 unit-based hospital providers (68.5 percent response rate). Hospitals provided unit turnover and patient data (16,459 discharge records and 2,920 patient surveys). Principal Findings. HPWE, as perceived by multiple occupational groups on a unit, is significantly associated with desirable work processes, retention indicators, and care quality. Conclusion. Our findings underscore the potential benefits for providers, patients, and health care organizations of designing work environments that value and support a broad range of employees as having essential contributions to make to the care process and their organizations. Key Words. Acute inpatient care, quality of care/patient safety (measurement), patient assessment/satisfaction, health care organizations and systems, work environment, high performance work systems, management practices, organizational behavior Work environment, sometimes also called "work climate" or "culture," has become an important factor in health services research, shown in numerous studies to be associated with positive outcomes for workers, patients, and organizations. However, what do we mean when we say an organization has a good work environment or culture or climate? Does an organization have multiple cultures or work environments, for example, on different units or among different professions? If so, whose work environment matters for understanding what an organization does or how it performs? These [Correction statement added after first online publication 20 June 2012: The columns for Table 2 (page 9) were published in incorrect order. The table has been altered and is now correct.]