Background: Per accepted guidelines, pGCSF is not recommended for pts receiving CT regimens with low risk ( < 10%) for FN. Factors contributing to inappropriate pGCSF use include lack of provider familiarity with national guidelines as well as the presence of standing pGCSF orders in EMR CT templates. Inappropriate use of pGCSF increases pt morbidity and healthcare costs. Methods: A multidisciplinary team performed a QI project through the ASCO Quality Training Program. All NSCLC pts at TCI who initiated a new CT regimen from April 2013 to October 2014 were reviewed. First-cycle pGCSF use was deemed appropriate if prescribed for CT associated with high risk of FN ( > 20%) or intermediate risk (10-20%) if other risk factors for FN were present. Use with low-risk CT was considered inappropriate. We implemented three QI strategies: education of NSCLC providers, development of TCI Consensus Guidelines for the use of pGCSF in NSCLC, and EMR modification: labeling of CT regimens by FN risk and removal of standing pGCSF orders from low-risk CT. Follow up data were collected from January to October 2014. FN rates before and after the QI interventions were documented. Results: 300 NSCLC pts received a new CT regimen during the specified time period. Prior to the interventions, 34/118 pts (29%) treated with low-risk CT received pGCSF (average 2.6 doses/pt). In all other instances pGCSF use was in accordance with guidelines. Following QI interventions, 8/126 (6%) treated with low-risk CT received pGCSF. No patient treated with low-risk CT required inpatient admission for FN during post-intervention follow up. Cost analyses indicate a potential reduction of $1.9 million in charges over 1 year with guideline-based pGCSF usage with low-risk CT. Conclusions: Excessive pGCSF use can be improved with focused provider education and EMR modification. The lack of FN admissions in the post-intervention period validates current guidelines. Appropriate pGCSF administration in NSCLC leads to significant cost savings without increasing neutropenic complications.