Continuous quality improvement (CQI) is increasingly being adopted by health care, including child and youth mental health services. As part of the commitment to ongoing quality improvement, child and youth mental health teams in the Fraser region in British Columbia undertook CQI projects over a one year period (2007-2008). The projects covered a range of domains and service features and staff gained experience in developing projects. Patience, management support and ongoing dialogue were key elements in the implementation of CQI. Three projects are highlighted to illustrate how teams developed their own unique projects and the outcomes. (Contains 1 table.)