In a large academic pediatric medical center the formation of specialty care teams in the pediatric critical care setting led to the improvement in quality delivered to patients who had tracheostomies. Through frontline staff participation and interdisciplinary leadership – the team developed and strengthened processes that led to implementation of improvement strategies aimed at reducing hospital acquired pressure injury and decannulations. During this two-year time 150 nursing surveys and comprehensive literature reviews were completed to identify best practices and essential learning needs of the staff. The outcomes of these reviews helped to create improvement strategies which included developing educational initiatives focused on to support specific pathophysiologic issues impacting morbidity of patients leading to the quality metric goals. Upon completion of the educational and training initiatives led by the specialty care team, the incidence in tracheostomy decannulations and pressure injuries reduced significantly. Conclusions from this work highlight the importance of frontline staff as pivotal leaders in process change management and quality improvement changes. The teamwork among the interdisciplinary members allowed for enhanced collaboration in improving patient care outcomes and remains an active forum for evaluation of improvement in patient care. The efforts of the specialty care team provided sufficient data to support the implementation of specialty care teams that align efforts with that of organizational goals and aimed at reducing patient harm.