Quality improvement is an integral component of cancer care. In 1999, the Institute of Medicine (IOM) published “Ensuring Quality Cancer Care,” a seminal report on the state of cancer care in the United States. The IOM found that patients with cancer do not always receive effective care, and there has been little study of the reasons for this variation. The IOM reiterated these concerns in a 2013 report entitled “Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis.” The IOM highlighted that cancer care in the United States is in a state of crisis; treatment decisions are often not based on scientific evidence, and symptoms and adverse effects are sometimes overlooked. The findings of the IOM highlight that it is imperative for cancer specialists (ie, medical, radiation, and surgical oncologists) to improve delivery of cancer care. Ideally, this work should have an academic focus to ensure that projects are rigorously designed and the results are relevant to a wider audience. There is limited evidence, however, that cancer specialists are pursuing academic quality-improvement work. A systematic review by Coory et al found that between 1990 and 2012, there were only 12 published studies of quality-improvement interventions targeted at cancer specialists. These authors concluded that although there has been much work to describe quality problems in cancer care, more research is needed on the impact of qualityimprovement interventions. Since the review by Coory et al, there have been several more reports of quality-improvement work in the cancer literature. For example, Newcomer et al conducted a 3-year study of five medical oncology groups and found that a program which rewarded quality care reduced medical costs by 34%. ASCO’s Quality Oncology Practice Initiative has also had a positive effect on participating practices, and ASCO’s Quality Training Program holds similar promise. Yet, despite these favorable trends, there continues to be a relative dearth of publications on quality-improvement efforts in oncology. Such publications may not only identify best practices in delivering cancer care, but also improve adoption of evidence-based care by cancer specialists. Although cancer specialists are well poised to engage in academic qualityimprovement work, they require guidance in making this transition. Table 1 outlines a framework for understanding the key barriers to pursuing academic qualityimprovement work. The framework is on the basis of this author’s experience in leading quality-improvement efforts, as well as themes from the literature.