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Worldwide journey in pediatric anesthesia quality and safety

The journey to achieve the highest quality anesthesia service possible for children is common to pediatric anesthesiologists around the world, regardless of geographic location and year of practice. As quality of care for children is important to Pediatric Anesthesia, the journal devotes a section to quality and safety, publishes many articles on pediatric quality and safety, and periodically offers a themed issue on the topic. It has been 9 years since this journal devoted a special issue to quality and safety.1 At that time, the sciences of quality improvement (QI) and safety analytics were emerging in healthcare and being implemented at a few children's hospitals under the guidance of the Institute for Healthcare Improvement.2 That themed issue described the initial application of these sciences to improving the quality of pediatric anesthesia care. As evident in the current issue, these sciences have been adopted widely by departments in Europe, Asia, and North America with evidence of improved quality.3– 13 Also evident is the variability in pediatric anesthesia quality across the world, noted by the lack of basic infrastructure and clinicians to deliver optimal care in lowand middleincome countries, and persistent healthcare inequities in minority populations in highincome countries.7,11,12 It is instructive to review the definitions and the key steps in the journey to improving quality and safety. Quality is broadly defined in industries through metrics of the productor serviceoriented to the customer into three domains.14