This article describes a pediatric primary care network's initiative to implement an office-based quality improvement (QI) program. First, network physicians determined their priorities for quality improvement. Then primary care practitioners on the Quality Committee (QC), representing each local group practice, were educated about a physician-led QI process. The four steps of this process are as follows: (1) Set quality aims, (2) determine measurements of improvements, (3) generate ideas for change, and (4) test changes. Next, the QC selected two initial projects--office preparedness for pediatric emergencies and asthma management--and corresponding subcommittees were formed. The pediatricians identified QI practice changes they believed could be implemented successfully to make a measurable difference in children's healthcare.