Aim: To establish a system for measuring resident satisfaction in multi-purpose services, benchmarking and performance improvement. Setting: Six multi-purpose services in rural New South Wales were involved in the project. Design: Residents were surveyed and the results benchmarked. Benchmarking included a comparison of results along with an exploration of work processes across participating sites. This preceded quality improvement activities conducted by individual multi-purpose services. Resident surveys were repeated and staff and managers interviewed. Outcomes: Benchmarking was a useful method for identifying performance leaders and enabling the dissemination of better practice. The majority of staff members were comfortable with the PDSA (Plan, Do, Study, Act) quality improvement cycle to guide their improvement efforts. The ability of staff to complete quality improvement cycles was related to the management styles of their supervisors. Resident satisfaction was related to the understanding and confidence of staff. Conclusion: A resident satisfaction survey can provide the direction for effective quality improvement activities. Benchmarking results with other sites not only empowers staff members at those sites recognised as leaders, but can also stimulate dissemination of leading practice. Management styles which empower staff enhance their ability to implement quality improvement projects.