The Society for Pediatric Anesthesia, the largest professional group for pediatric anesthesiologists in the United States, sponsors Wake Up Safe, which has been certified by the Agency for Healthcare Research and Quality (AHRQ) as a Patient Safety Organization. Wake up Safe contains a registry of serious adverse events reported on a voluntary basis by participating institutions. Names of patients, individuals involved in the event, and institutions will not be identified and are confidential. Each institution reports the event and a structured analysis of why the event occurred. From a review of the reports, we hope to find ways to improve care of children in the perioperative environment through quality improvement initiatives. We are also developing a program of peer visitation where anesthesiologists visit other institutions and critique their processes of care, looking for areas for improvement and trying to find best practices.