Background: In 2013 ASCO and ONS published guidelines to promote safe practices for oral chemotherapy use. These agents can have significant toxicities and pose safety risks without proper adherence. Guided by the ASCO/ONS recommendations, Dana-Farber Cancer Institute (DFCI) designed a program to provide comprehensive patient education and adherence monitoring. Methods: To address patient safety risks associated with oral chemotherapy use, a multidisciplinary team assembled to design a process for timely and appropriate patient education and adherence monitoring. Physicians, Nurse Practitioners or Physician Assistants initiate education by reviewing the dosing schedule, side effects and providing a standard education sheet. Within 24 hours, a pharmacist contacts the patient and completes a teaching session utilizing a template based upon the MOATT Tool, a teaching tool developed by the Multinational Association of Supportive Care in Cancer. The MOATT Tool includes a review of the dosing schedule, side effects and management, drug handling, drug/food interactions and practice contact information for questions. Lastly, within five days of therapy initiation, a nurse calls the patient to reinforce education and to assess toxicity and adherence. To evaluate the effectiveness of the program, chart audits and patient satisfaction surveys were conducted. Results: To date 78% of patients started on oral chemotherapy have received a teaching session and 73% have received a follow up adherence call. Patient satisfaction surveys conducted demonstrate that 100% (N=12) of patients strongly agreed with the following statement; “following my counseling session with the Dana-Farber pharmacist, I understood how and when to take my oral chemotherapy medication(s)” and 94% agreed with the statement; “overall I feel that the oncology nurse phone session provided me with useful information.” Conclusions: Implementing a standard patient education and adherence monitoring program for patients initiating oral chemotherapy is essential to guarantee safe patient care. Compliance monitoring at the disease and provider level is necessary to ensure continual quality improvement.