Background: Organizational change is challenging in a well-resourced large academic cancer center. Such challenges are greater in a resource-constrained safety net cancer center. This project sought to learn how the combination of ASCO QOPI data submission and the Quality Training Program (QTP) could assist JPS with implementing a quality improvement project. Methods: The results from QOPI data submissions for Fall 2016 and Spring 2017 indicated opportunity in the area of oral chemotherapy education. This was prioritized due to increasing use of oral chemotherapy and relatively poor adherence data nationally ^1,2. The team recognized the relatively low sample size in the QOPI results and supplemented the data with additional abstraction to validate the original hypothesis. Following the structure provided by the QTP enabled JPS to focus its limited resources on understanding the existing process and formally interrogating it to determine the key causes of the problem. Additional information was obtained from the provider team via the use of an online survey. The team found that no single intervention would achieve the goals of improving the metric to above the QOPI mean they implemented small changes over time. These included reducing variation in ordering processes by defaulting to an electronic method; adding the Via oral chemotherapy protocols to the EMR; and developing and deploying a pre-chemotherapy checklist. The team learned that continual reinforcement and inquiry was necessary to ensure the effectiveness of some interventions. Results: Post-implementation results revealed improvements beyond the targeted measure. Approaching the problem systematically and methodically deploying solutions, the team observed improvements in multiple related oral chemotherapy QOPI measures. Conclusions: Meaningful change can result from the ASCO QOPI data and QTP combination in a safety net cancer center. Projects need to start small and remain focused. Challenges to implementing QI in a resource limited environment remain; however, these can be addressed with a methodical approach and strong support from leadership.