The Institute of Medicine's report Crossing the Quality Chasm recommends "six aims for improvement." The aims are safety, effectiveness, equity, timeliness, patient-centeredness, and efficiency. This review focuses on the quality of care information relevant to the Institute of Medicine's six aims to assess their relevance, potential impact, and affect on pediatric critical care practice. It is concluded that if the care for pediatric intensive care patients is to be fundamentally improved, an understanding of the current care environment, the existing evidence base, the opportunities for improvement, and the documentation of the improvements needs to be realized. The Institute of Medicine's six aims provide a useful framework to advance the quality of care in this pediatric subspecialty and perhaps others.