Providing practitioners with locally developed, consensus-driven, evidence-based clinical pathways can improve the quality of care by (1) incorporating national guidelines and recommendations into routine care practices, increasing the use of validated practice; 2) reducing unnecessary variation in care by a single physician or group of physicians, improving efficiency and timeliness and reducing disparities; and (3) standardizing care processes, improving safety. Pathways make it easier to identify opportunities for future improvements in care processes while simultaneously making those improvements easier to enact. Pediatric hospitalists have a vital role in creating, implementing, evaluating, and improving clinical pathways. Involving house staff enriches the scholarly components of pathway development while actively engaging them in the science and practice of quality improvement.