Background: ASCO guidelines recommend that newly diagnosed patients with advanced cancer should consult with Palliative Care (PC) within 8 weeks of diagnosis. Across Minnesota Oncology’s 11 clinic sites, the average of Stage IV cancer patients seen by a palliative care provider within 8 weeks of diagnosis was 21% in 2022. Aim: To increase early integration of PC service in the care of newly diagnosed stage IV cancer patients seen in two MNO sites (A&B) identified as having the lowest average rate of 15% at the start of the project. Methods: The Institute for Healthcare Improvement Model of Improvement was used as our quality improvement (QI)framework. A Pareto chart showed the top barriers to improvement were: 1- providers not discussing PC with patients, 2- Problems with order entry and completion, 3- Patient cancellation or no show for their scheduled PC consult. The following interventions were implemented: staff and provider education, highlighting eligible patients through bi-weekly PC list, and PC nurse calls prior to patient visit to educate and address any potential barriers to PC visit completion. Results: Interventions were associated with an increase of new Stage IV cancer patients seeing a PC provider within 8 weeks of diagnosis from 15% to 36%. Rate of referral to PC improved from 30% to 62%, the no show/cancel rate dropped from 48% to 35%, and the time for new patient consult to PC visit dropped from 50 days to 13 days. Nurses time spent in pre-PC visit calls to patients averaged 7 min per patient. Conclusions: A multi-faceted QI initiative was successful in increasing the percentage of early integration of palliative care service in stage IV cancer patients. To help sustainability of the project we plan to create a “Palliative Care Dashboard”, establish PC education as part of onboarding for new clinicians and staff, and start implementing the intervention across the rest of Minnesota Oncology’s 11 clinic locations.