The oncology pharmacy team at University of Cincinnati Medical Center undertook several initiatives to improve safety, quality, and efficiency of cancer care. They centralized hazardous drug preparation, designed an integrated electronic medical record, standardized treatment plans, implemented barcode medication administration, redesigned chemotherapy processes, and generated quality metrics dashboards. As a result, the cancer center achieved 100% consent documentation rates, exceeded barcode medication administration goals, improved standards of safety by 45%, and decreased chemotherapy ordering errors by over 90%. The expanded oncology pharmacy team has allowed for increased services and support of quality improvement initiatives.