Preterm birth (PTB) is one of the most acute problems in obstetrics today. It is recommended that quality measures related to the prevention and management of PTB be identified and implemented for systems of clinical care. With its professional commitment to women and families, nursing is positioned to play an important role in this professional issue of quality improvement. A nursing team joined forces with a managed care organization to develop and implement a quality program to improve perinatal outcomes for pregnant women enrolled in the managed care organization. The team integrated a holistic framework, the best evidence, their clinical expertise, and the pregnant member's values and concerns. Using a pre/postprogram implementation design, perinatal outcomes in terms of neonatal intensive care length of stay were improved, with resultant cost savings. The improvement of these proxy measures for the health of the infant is an initial step in the reduction of PTB.