Organisational learning as it relates to the development of a peer review system within a clinical area of nursing practice is the focus of this study. Sixteen Public Health Nurses, with the manager of their service, and three key managers from the employing Crown Health Enterprise in provincial New Zealand, took part with the researcher in this praxis-oriented participatory action research process. A framework of the learning organisation was created to direct the research inquiry and evaluate data in relation to the developing peer review system. Through the use of critically reflexive discussions in an ongoing spiral of planning, implementing, observing, and assessing, this study illuminates the growth of the learning organisation and the building of a peer review system. within a cost-conscious healthcare service delivery environment. The account of the research process includes factors facilitative of, and critical to, the learning organisation. Use of many direct quotes from participants creates a context against which to visualise problems and constraints faced by the research group, and offers the reader a decision trail with which to resolve issues of credibility. Use of the peer process, it is suggested, will generate vital information about organisational performance, which will enable nurses to assume legitimate control of clinical nursing workplaces. Conclusions derived from this study suggest that peer review and the learning organisation are important tools for both assuring the quality of clinical nursing performance and securing organisational goals.