84 Background: The Woodlands RCC opened the Ambulatory Treatment Center in September 2010. The center houses 14 infusion units. Within 1 year, the demand for its infusion therapy services had more than doubled with continued rapid growth expected. The perception was that more patients could not be accommodated without additional space and staff. Therefore, a performance improvement team was formed in August 2011 with the goal to increase operational efficiency to satisfy patient demand, while maintaining the highest level of quality care. The increased access for patients allows for treatment to start sooner. Methods: The six sigma Define-Measure-Analyze-Improve-Control methodology was used to manage the project, and several lean and six sigma tools were utilized. The project commenced with a project charter with a measureable AIM statement to increase infusion volumes from 1.7 to 2.4 patients/unit per 9 hour day. Historical data was extracted, and all patients’ movements were timed for 3 weeks. Benchmarking, observations, and process mapping were also performed. Baseline performance was measured using SPC charts. Sources of variation were uncovered using statistical quality tools, brainstorming techniques, and cause/effect analysis. Key interventions consisted of standardized scheduling practices, development of a scheduling template, creation of a fast track room, new processes for overbooks and preschedules, and work balancing of nursing staff using an acuity rating system. In addition, staff workload was redistributed, and the lab was reorganized. Results: Within 3 months, the center met targeted capacity and provided regional care access to 41% more patients without additional staff, space, or working hours. By March 2012, the center accommodated 67% more patients (2.9/unit or 40/day) without adversely affecting patient wait time. Infusion room utilization increased by 15%. Conclusions: Although space constrained, The Woodlands RCC was presented with the challenge to provide patients’ open access to infusion therapy services. The team successfully applied lean and six sigma principles to evaluate the current state, perform a gap analysis, and deploy interventions to support quality and operate more efficiently.