Caloundra Private is a 64 bed acute medical/surgical hospital. Assessment and early intervention for clients who require emergency care is currently carried out by the Registered Nurses and Enrolled Nurses working in the medical and surgical units. Previously staff at Caloundra expressed concern they were not sufficiently skilled to provide the expected higher level of care during critical incidents. Following an adverse event relevant systems and processes were reviewed at an organisational level and key issues requiring strategic direction were identified. To address these issues a Certificate in Advanced Nursing Practice was developed in partnership between Ramsay Health and CQUniversity. This twelve week program was designed to address the identified issues. Sixteen staff ranging in ages and experience completed the program. Positive outcomes from the program included increased clinician confidence and competence and improvements in organisational processes and engendered a culture of learning within the organisation. This innovative program demonstrates that partnerships between a university and health care provider can effect real change at a clinical level.