Virtual reality (VR) distraction during painful procedures has been established, yet lags in the integration of healthcare practices. A pilot, quality improvement project, guided by the Plan-Do-Study-Act model, is underway to implement VR at a paediatric orthopaedic hospital. A VR council, comprised of patients and clinicians, is overseeing implementation. Iterative PDSA cycles ensued, with seven healthcare professionals trained as VR champions, including five nurses, one child life specialist, and one social worker (n = 1), documented barriers and facilitators, and monitored safety with 53 patients aged 5-21 years old. VR headsets are available in the cast room (n =1), inpatient unit (n =1), and across clinics (n = 2) via child life and social work referrals. The VR council identified the following barriers: (1) technical problems with equipment; (2) incompatibility with supine position; (3) incompatibility with medical procedure. Solutions were co-developed to support implementation and ongoing training: (1) VR operation cheat-sheets; (2) alternative VR games; (3) training on non-pharmacological approaches to pain management; (4) VR education for patients and clinicians; (5) tracking use on electronic medical records; and (6) institutional policies and procedures. PDSA cycles are ongoing, and will continue until VR is safely implemented across the hospital.