The raison d'etre for new journals has evolved.  Successful journals have filled existing voids, but the nature of that void has become increasingly specific. * The New England Journal of Medicine* began in 1812 with no introductory statement.  Its first issue was broad in scope, containing articles covering internal medicine, pediatrics, and surgery.  Seventy-one years later, the *Journal of the American Medical Association* was initiated to document the organization's proceedings. 

The *American Journal of Diseases of Children* was the first pediatric journal, launched in 1911, citing inordinate publication delays for pediatric material in the *Journal of the American Medical Association*. * The Journal of Pediatrics* and *Pediatrics* subsequently appeared in response to increasing volume of scientific articles related to pediatric diseases.  Pediatric subspecialty periodicals originated, with the *Journal of Pediatric Surgery* in 1966 and many others followed, each citing their respective disciplines' coming of age, differentiating themselves from their adult counterparts and declaring the need for an outlet.  Many noted an advantage to having one journal in which to concentrate relevant information and debate current issues. 

Although most peer-reviewed journals in clinical medicine focus on disease, another viewpoint exists---a focus on the care delivery system itself.  Quality improvement (QI) science has gained considerable attention, accelerating in the past decade.  QI journals, *Quality Management in Health Care* and *American Journal of Medical Quality*, first appeared in 1992, and several more are currently publishing. 

As QI science has matured, it is apparent that the pediatric QI perspective is unique and distinct from that observed in adult care.  Measures and metrics whereby we measure progress and improvement are often uniquely pediatric and provide special challenges compared with adult outcomes.  So, it is the right time for a quality and safety journal that focuses on pediatrics. * Pediatric Quality and Safety* is birthed in response to the discipline's maturity, a rising literary output, and the need to debate and discuss relevant pediatric issues.  We welcome articles across a broad array of topics related to QI, including but not limited to QI methodologies and QI tool schools, QI- related Morbidity and Mortality, collaborative and network QI research, value and payment reform, population health, human factors helping to improve performance, guidelines and pathways, QI organizational structure, and QI education for staff and trainees (see Journal author instructions).  Our diverse, multidisciplinary, international, and very experienced editorial board (see Journal information---editorial board) will work with authors worldwide to meticulously review submitted articles with the intent of publishing first-rate scholarly work that will contribute to improving the systems that care for our most precious resource: our infants and children.  We are excited to begin this QI journey with you and look forward to receiving your best scientific and improvement work.  We realize that the challenges ahead are many, but with your support and feedback, we believe that this an important step forward for pediatric-specific improvement science.  With great humility, we present the first issue of *Pediatric Quality and Safety*. 

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The authors have no financial interest to declare in relation to the content of this article.