The Teen Advisory Committee (TAC), Boston Children's Hospital (BCH), began in 2002 and has been meeting monthly since that time. The top lessons learned by adolescents, committee facilitators, and hospital staff incorporate principles of adolescent development, joint decision-making, and a respect and commitment to patient and family-centered care. The program addresses the unique needs of teens with chronic illness from their perspective through special projects that have led to the development of hospital policies, procedures, and quality improvement initiatives. The discussion of the framework of the TAC and lessons learned are intended to support youth-driven initiatives and models for improvement at children's hospitals nationally.