SANE programs have been implemented throughout the United States for the purposes of improving care to sexual assault victims and criminal justice outcomes for their cases. In a SANE program, specially trained nurses provide comprehensive psychological, medical, and forensic services to victims of sexual assault. A SANE also works with various members of the criminal justice system to improve the response to victimization and increase the prosecution of sexual assault cases. The practice philosophy and implementation of SANE programs vary widely, and few have been rigorously evaluated by either practitioners or researchers. An earlier NIJ-funded project crated the SANE Practitioner-Oriented Toolkit (Toolkit) to enable SANE programs to perform self-evaluations. The Toolkit guides practitioners through the evaluation process in seven steps. It begins with evaluation questions and concludes with steps that assist practitioners in sharing their evaluation findings with other stakeholders and create action plans for improving SANE services. The study summarized in the current report evaluated the implementation and outcomes of the use of the Toolkit in six SANE programs. Researchers first examined the substantive findings from the six evaluations. One major finding was that the majority of reported sexual assaults did not result in arrests and prosecutions. Researchers also examined the use of the Toolkit itself. Researchers found the use of the Toolkit resulted in many positive outcomes for the SANE programs. Recognition of the importance of evaluation increased among stakeholders; and programs applied their findings in making changes designed to improve criminal justice outcomes for sexual assault cases.