The Pediatric Cardiac Critical Care Consortium (PC⁴) aims to improve the quality of care to patients with critical pediatric and congenital cardiovascular disease in North America and abroad. Formed in 2009 with National Institutes of Health funding, PC⁴ is a unique collaborative of leaders in pediatric cardiac critical care, cardiac surgery, and cardiology representing a diverse group of centers caring for these vulnerable patients. The core pillars of collaborative quality improvement serve as the foundation for PC⁴: purposeful collection of specific clinical data on outcomes and practice; timely performance feedback to clinicians, and continuous improvement based on empirical analysis and collaborative learning.