Patients with advanced cancers prefer shared decision making that includes conversations about their prognosis, values, preferences, and goals for life and care. Patients who are engaged in these goals of care (GOC) discussions by their oncology providers have better outcomes, less healthcare utilization, and lower costs of care. Unfortunately, only a small percentage of advanced cancer patients are engaged in GOC conversations.This mixed-methods evaluation studied the implementation experience of a collaborative intervention to enhance GOC discussions across 10 large, academic cancer hospitals. This research combined analysis of process measures with survey responses from implementation leaders, to describe the organizational and implementation factors that contributed to operational integration and improvement. The results and recommendations should assist other cancer providers in adopting GOC programs and thus improve care for patients with advanced cancer.