Background: The American Society of Clinical Oncology and The Oncology Nursing Society’s guidelines recommend that consent be obtained and patient education provided prior to oral anticancer drug (OACD) initiation. The aim of this quality improvement project was to improve documentation rates of consent and education prior to OACD initiation in an outpatient breast oncology clinic. Methods: Plan-Do-Study-Act (PDSA) methodology was used to identify the root causes of inadequate OACD documentation; and to evaluate a standardized OACD workflow that included a multidisciplinary (physician, nurse practitioner [NP], and administrative staff) checklist on the disposition sheet and standardized patient education material, used in the Columbia University Irving Medical Center Breast Oncology Clinic. New OACD prescriptions were identified in the electronic health record (EHR) from 2/1/18-4/1/18 (pre-intervention) and 6/5/18-8/17/18 (post-intervention). Documentation of consent and education were evaluated by EHR review. Consent (yes/no) was determined by physician documentation in either the corresponding clinic note or scanned consent form, and education (yes/no) was determined by NP documentation in the education section of the clinic note. Documentation rates were compared pre- and post-intervention. Results: Pre-intervention, 19 patients received a new OACD, and 0 (0%) had documentation of consent or patient education. Root cause analysis revealed the driver of inadequate documentation was the inability to identify patients with a new OACD prescription at the time of their clinic visit. After implementation of the OACD workflow, 23 patients initiated a new OACD, 15 (65.0%) had documentation of consent and 7 (30.0%) had OACD education documented in the EHR. Conclusions: After the first PDSA cycle, documentation of consent and education improved from baseline. However, improvement in both metrics are still needed. Patient volume, staff changes, and the format of the OACD checklist may have limited the efficacy of this intervention. In the next PDSA cycle, the consent process will be linked to the required OACD pre-approval process to further increase OACD documentation.