In preparation for a cross-campus move to a newly built tower, the women and infants department at a large academic medical center identified the need for a women and infants communication center (CC) to coordinate patient, staff, and physician communication. The development of the CC was a demonstration of nursing autonomy applied during a major organizational change. Beginning with newly hired staff in the CC, the nursing staff and leadership developed the initial after-hours phone triage program and collaborated with patient experience leadership to develop scripting for preprocedure calls and patient follow-up calls as well as methods for appropriate data collection. New positions were approved by the organization to implement the CC, with coverage of one nurse 24 hours/day, 7 days/week. The first priority of the CC was to transition after-hours patient phone triage from the resident physicians to the CC nurses. After shadowing other after-hours programs, staff nurses created standard work, orientation checklists, tip sheets, reference materials, and the tools necessary for implementation. Nursing leadership and staff collaborated with physician leadership to approve standard obstetric phone triage protocols. Additional planning included development of policies and procedures, set up of equipment and call recording, creation of a call auditing process, and revision of published marketing materials. After successful implementation of the after-hours phone triage program, additional roles added to the CC included preprocedure calls, procedure scheduling, patient experience follow-up calls, patient placement, and patient charge auditing. Qualitative data from resident physicians showed that they had increased time to focus on patient care. The CC team experienced an increase in call volume of 17.39% the first 3 months postimplementation and an increase in call length of 39.07%, which shows that nurses provided thorough, protocol-guided advice and support to pregnant women. Continued increases in call volume and length of communication are expected. As a result of their heavy involvement in planning and development of the CC, the nurses working in the CC continue to lead CC operations. The CC has improved communication between units and with patients, outpatient offices, physicians, and nursing staff.