BACKGROUND: Although the benefits of early palliative care have been established in advanced cancers, there remains a lack of access to and poor uptake of these services. Barriers include healthcare provider attitudes, lack of standardized referral approach, misaligned policy limited resources, and lack of palliative care expertise. PURPOSE: In consideration of these barriers, a description of the development and implementation of an early palliative care initiative at CancerCare Manitoba in Canada is presented. Explanations of innovative planning, processes, teams, and interventions are offered to facilitate insight for those intending to offer early palliative care. DISCUSSION: Barriers and facilitators to integrating a nurse-led early palliative care initiative are discussed. Considerations to mitigate common barriers encountered and leveraging existing resources are offered. CONCLUSIONS: This information may be beneficial to those working to facilitate access to palliative care in oncology for patients with advanced cancers. This model has been successful at our institution with pre and post implementation data presented in an upcoming publication.