Primary outcome: Formal Interactions (FI), defined as formal exchanges through scheduled activities that can promote the transfer of knowledge (details see outcomes section). Previous research in TREC (2007-2012) clearly suggested that some context areas on the ACT have the potential to exert greater impact on quality of care and implementation of change. Of these, FI has the greatest single impact. At the microsystem level no unit scored above 1.9 (max. possible score is 4) and the mean was 1.3, leaving substantial room for improvement. The correlation of FI with the overall ACT context score is .5, and combinations of FI plus three additional ACT concepts (Evaluation, Social Capital, Slack Time) increased the correlation to .8. Field surveys suggested that care managers are interested in FI as an actionable concept of facility context and consider it a prime accessible target for action and change. FI constitutes the most actionable, cost-effective, and easy-to-improve context for enhancing quality, since the mechanisms for improvement are readily available. FI makes use of existing resources and requires little investment beyond organizational adaptations (scheduling training or meeting sessions, developing educational materials to disseminate research findings, etc.). Finally and importantly, FI is also a proximal goal. The organizational behavior literature is clear that the goal set cannot be too distal.