Abstract
This article describes how an acute care organization in Texas, a peer review mandated state, created a nonpunitive peer feedback structure and process for nursing staff. Strategies were targeted to improve patient outcomes. A peer feedback committee designed, implemented, and evaluated the feedback model to coexist with the state-required formal peer review committee structure. Peer feedback provided opportunities to advance skill development, enhance quality improvement, improve patient outcomes, and support a culture of safety within the healthcare environment.