Background The standardization of quality measures has been key in advancing the aims of the National Quality Forum established to improve health outcomes. Methods The National Cancer Database was used to identify eligible patients. Two quality metrics were evaluated including time to treatment initiation (TTI) and chemotherapy in locoregionally head and neck squamous cell carcinoma (HNSCC). Results TTI was significantly associated with mortality reflected by a hazard ratio (HR) of 1.13 for 60–90 days of TTI (95% CI 1.08–1.17), 1.19 for >90 days of TTI (95% CI 1.13–1.26). Patients with locoregionally advanced HNSCC had an 87% adherence to chemotherapy, which correlated with reduced mortality (HR 0.57; 95% CI 0.55–0.59). Patients treated at high quality centers had a 9% increase in survival (HR 0.91; 95% CI 0.88–0.93). Conclusion We identified that both TTI and chemotherapy for locoregionally advanced HNSCC meet criteria for valid quality metrics potentially suitable for national adoption.