Aims Timely initiation of postoperative radiotherapy (PORT) is critical in head and neck cancer, with delays exceeding 42 days associated with inferior oncological outcomes. Despite this, delays remain common, particularly in regional settings where coordination and geographic factors may impact service delivery. This study aimed to evaluate the effect of targeted quality improvement (QI) interventions on PORT timeliness in a regional Australian tertiary hospital. Methodology A single-centre QI study was conducted at Townsville University Hospital. Five interventions targeting referrals, multidisciplinary coordination and radiotherapy workflow were implemented. Serial audits were performed six-monthly for three cycles and compared with pre-intervention. The primary outcome was time from surgery to PORT and proportion of patients exceeding 42 days. Secondary outcomes included key interval analyses across the treatment pathway. Results A total of 78 patients were included. Median time to PORT decreased from 50 days pre-intervention to 42 days in the final audit cycle, with the proportion exceeding 42 days reduced from 79% to 43%. Improvements were primarily driven by reductions in early pathway delays, with surgery to radiation oncology (RO) consult decreasing from 27 to 20.5 days and fewer patients exceeding 21 days for this interval. Timeliness of RO referrals for externally operated patients also improved (31 to 10 days), Following RO referral, patients were reviewed within 2 days, compared to 7 days pre-intervention. However, the interval from RO consult to PORT did not improve and remained largely unchanged. Conclusion This QI project meaningfully improved early pathway efficiency and reduced extreme delays in PORT. However, the persisting interval between RO consult and PORT likely reflects underlying radiotherapy delivery capacity constraints. Future work should focus on scheduling, resource allocation and workforce capacity to further improve timeliness to PORT.