Cancer remains Australia’s leading cause of disease burden. Evidence suggests that supportive care approaches are valuable in improving cancer experiences and outcomes. It is important to screen for supportive care needs so that patients and their families can be referred to, and receive appropriate care. In 2010, the Southern Melbourne Integrated Cancer Service, in partnership with Southern Health, Peninsula Health, and Alfred Health conducted a pilot study introducing supportive care in the Chemotherapy Day Units. Pilot results indicated that difficulties were encountered in implementation. This qualitative multi-site study drew on a quality improvement approach to identify the barriers and enablers to implementing supportive care and screening into clinical practice. Three focus groups were conducted with registered nurses (n=21) and allied health staff (n=3) using semi-structured questions. Focus groups took an hour, audio-recorded, transcribed verbatim and content analysed. Results indicated that barriers included: staff uncertainty about the purpose of the tool, when to screen and re-screen; high workloads with competing priorities in delivering symptom management, chemotherapy and supportive care screening; screening without providing the service to meet identified needs; under-resourcing of allied health staff; patient anxiety at time of screening; patients refusing referrals; staff resistance thinking they already identify supportive care needs. Enablers included: engaging staff in design and implementation; allocating a specific time and person to complete the screening; developing a resource folder; triggers, such as having the tools visually accessible when patients present; and staff support. Benefits reported included: a holistic tool that increased awareness of supportive care needs; useful for monitoring change; and normalisation of the stress response to cancer diagnosis. Participants recommended more education of staff and patients; refinement of the tool; and review of the distress score cut-off point. These findings can be used to inform future activities to improve supportive care in practice.