Line Staff Research Articles

Assessing the Effectiveness of a Non-Punitive Fall Prevention Program.

Our single-center, quality improvement project evaluated the impact of a fall reduction plan while using a Just Culture Algorithm that included weekly fall reviews involving front line staff using a non-punitive structure. The project has shown successful results. Prior to starting the program, data at this institution indicated falls were higher than the national fall rate of 3-5 per 1000 patient days. To achieve the goal of reducing the fall rate to below 3.1, an interdisciplinary fall committee was formed, consisting of nurses, nursing leaders, patient care technicians, pharmacists, and physical therapists. The committee operated in a non-punitive format and included all staff members directly involved in fall-related incidents. Protocols for implementing an evidence-based prevention program were developed to (1) address environmental concerns, (2) educate clinical workers and patients' families, (3) enforce interventions, (4) conduct weekly non-punitive, round table discussions, and (5) provide leadership support. Measures were implemented to proactively prevent falls. Data was collected and reported to all departments monthly. Following implementation of the program, results showed a statistically significant decrease in average fall rates per 1000 patient days from pre-intervention (4.05) to post-intervention (2.54) (P = .0001). Results showed improvement below the national average (3-5 falls per 1000 patient days), resulting in cost savings for the institution due to fewer falls. Inpatient medical-surgical and progressive care units had a noteworthy decline in the total number of falls, with notable estimated cost savings. Preventative interventions have shown effective results with compassionate, non-punitive leadership, an interdisciplinary team, and continuous follow-up education. Heeding to the Just Culture Algorithm as the foundation of weekly reviews, staff were empowered to engage in fall reduction strategies. A comprehensive weekly fall review program with ongoing staff education and transparent data reporting yielded a significant, sustained reduction in patient falls, with a substantial cost savings in excess of $1.6 million dollars over the life of the program.

A community-based ambulance model: lessons for emergency medical services and everyday health systems resilience from South Africa.

The role of the emergency medical service (EMS) is changing globally as ambulance crews respond to a shifting burden of disease, as well as societal stressors such as violence and inequality. New ways of thinking about how to provide emergency care are required to shift EMS from a role primarily focused on clinical care and transporting patients to hospital. In this paper, we present the experience of the Philippi Project (PP), an innovative community-based model of care developed by front line ambulance crews in a low-income neighbourhood in Cape Town, South Africa. Our insights were developed through observational, interview and document review work, within an overall embedded research approach. Our analysis draws on the everyday health systems resilience (EHSR) framework, which sees resilience as an emergent process that may be stimulated through response to stress and shock. Responses take the form of absorptive, adaptive or transformative strategies and are underpinned by system capacities (cognitive, behavioural and contextual). We consider the PP as a potentially transformative resilience strategy, defined as a new way of working that offered the promise of long-term health system gains. We found that the PP's initial development was supported by a range of system capacity attributes (such as the intentional development of relationships, a sense of collective purpose and creating spaces for constructive sense-making). However, the PP was hard to sustain over time because emergent ways of working were undermined both by other capacity attributes rooted in pre-existing organizational routines and two contextual shocks (Coronavirus and a violent incident). The paper adds a new empirical contribution to the still-small EHSR literature. In addition, the PP experience offers globally relevant lessons for developing community-based models of EMS care. It demonstrates that front line staff can develop creative solutions to their stressful daily realities, but only if space is created and protected.

Utilizing Technology to Fill the Ambulatory Care Communicable Disease Practice Gap

Background: Infection Prevention (IP) practices in ambulatory care are often reactive and many communicable diseases in the community often do not fall onto IP’s radar until the patient becomes ill enough to seek inpatient services. The gap between ambulatory and inpatient care can lead to increased transmission and illness severity. Early identification has substantial impacts on timely implementation of IP mitigation strategies, appropriate handoff upon entry into other care settings, and timely reporting to public health organizations. Current IP processes underutilize electronic health record (EHR) capabilities by relying upon lab driven notifications. This project sought to redesign the IP’s workflows, advancing the health system beyond the acute care setting and into the ambulatory care setting by adding the power of diagnosis codes to close a practice gap. Method: Infection Prevention and Information Technology collaborated to build silent best practice advisories (BPAs) in the EHR that utilized diagnosis codes related to Varicella zoster (VZV) infection charted by ambulatory care providers. These BPAs function by triggering infection statuses that populate the patient chart and include instructions to front line staff on personal protective equipment (PPE) requirements. These BPAs also trigger real-time notifications to the IP team to determine the validity of the infection status and exposure work-up necessity. Chart reviews of diagnosis codes utilized in pre and post intervention timeframes were completed to understand the impact of the silent BPAs. Percentages of patients captured, and Healthcare Worker (HCW) exposure reviews reported were evaluated to demonstrate effectiveness. Plan, Do, Study, Act (PDSA) was utilized to respond to gaps, increase efficiency, and limit erroneous infection statuses. Result: The one-year pre-intervention period revealed 36 total diagnosis codes used for Varicella zoster (VZV) infection; 3% of these infection cases were captured and 4% of eligible cases were reported for HCW exposure review. The one-year post intervention period revealed 40 total diagnosis codes used for VZV infection; 80% of these infection cases were captured and 70% of eligible cases were reported for HCW exposure review. PDSA quality improvement cycles allowed for refinement of the BPA logic that further increased infection cases captured to 100% with 100% of eligible cases reported for HCW exposure review. Conclusion: Utilizing the EHR, the organization appreciated enhanced identification of patients in real-time with VZV infection that allowed for appropriate mitigation strategies to be implemented. This proactive workflow design helps minimize the risk of transmission between ambulatory and acute settings and facilitated HCW exposure reviews.

A benchmark dataset with Knowledge Graph generation for Industry 4.0 production lines

Industry 4.0 (I4.0) is a new era in the industrial revolution that emphasizes machine connectivity, automation, and data analytics. The I4.0 pillars such as autonomous robots, cloud computing, horizontal and vertical system integration, and the industrial internet of things have increased the performance and efficiency of production lines in the manufacturing industry. Over the past years, efforts have been made to propose semantic models to represent the manufacturing domain knowledge, one such model is Reference Generalized Ontological Model (RGOM).11 https://w3id.org/rgom However, its adaptability like other models is not ensured due to the lack of manufacturing data. In this paper, we aim to develop a benchmark dataset for knowledge graph generation in Industry 4.0 production lines and to show the benefits of using ontologies and semantic annotations of data to showcase how the I4.0 industry can benefit from KGs and semantic datasets. This work is the result of collaboration with the production line managers, supervisors, and engineers in the football industry to acquire realistic production line data22 https://github.com/MuhammadYahta/ManufacturingProductionLineDataSetGeneration-Football,.33 https://zenodo.org/record/7779522 Knowledge Graphs (KGs) or Knowledge Graph (KG) have emerged as a significant technology to store the semantics of the domain entities. KGs have been used in a variety of industries, including banking, the automobile industry, oil and gas, pharmaceutical and health care, publishing, media, etc. The data is mapped and populated to the RGOM classes and relationships using an automated solution based on JenaAPI, producing an I4.0 KG. It contains more than 2.5 million axioms and about 1 million instances. This KG enables us to demonstrate the adaptability and usefulness of the RGOM. Our research helps the production line staff to take timely decisions by exploiting the information embedded in the KG. In relation to this, the RGOM adaptability is demonstrated with the help of a use case scenario to discover required information such as current temperature at a particular time, the status of the motor, tools deployed on the machine, etc.

Perceptions of organizational justice and life satisfaction among Nigerian prison staff

ABSTRACT Employee perceptions of fairness are a critical component of organizational justice, and empirical studies have shown that both distributive and procedural justice, the major dimensions of organizational justice, play a role in work performance and life satisfaction. In this study, we surveyed perceptions of organizational justice from 120 Nigerian prison staff and examined how it impacted their life satisfaction. The findings indicated both procedural and distributive justice were associated with higher levels of life satisfaction. Line staff had lower life satisfaction, but it was the only demographic variable to have a significant effect. As the costs of acting in a procedurally fair manner are minimal, interventions that increase perceptions of procedural justice are likely to improve staff’s life satisfaction, a result that has clearly positive consequences for both employers and employees. Improving distributive outcomes, such as pay and benefits, are costlier but should also result in improved life satisfaction.

Experiences, Benefits, and Challenges of Virtual Teamwork for Public Libraries in the US Midwest during the COVID-19 Pandemic

Experiences, Benefits, and Challenges of Virtual Teamwork for Public Libraries in the US Midwest during the COVID-19 Pandemic

The learning early childhood education and care institution as an inclusion arena

ABSTRACT Early childhood education and care in Norway have a broad mission and are, among other things, mandated through legislation and frameworks to remedy social injustice and emphasise inclusion. Nevertheless, research illustrates that symbolic power tends to be present in early childhood education and care institutions. In this conceptual paper, it is discussed how the local line leadership and staff in early childhood education and care institutions can analyse and challenge their work with inclusion when partaking in multicultural professional development. A model is presented to function as a tool to help the line leadership and staff in this process. It is argued that to function as learning inclusion arenas, it is necessary that the local line leadership and the staff critically explore how the institution function for all actors and that they visualise and challenge potential symbolic power in the institution.

Covid-19 Control Measures by some community Pharmacies in Sulaimani City/Iraq

Background: Coronavirus pandemic (COVID-19) has enormously affected various healthcare services including the one of community pharmacy. The ramifications of these effects on Iraqi community pharmacies and the measures they have taken to tackle the spread of COVID-19 is yet to be explored. In this cross sectional survey, infection control measures by community pharmacies in Sulaimani city/Iraq has been investigated. Methods: Community pharmacists were randomly allocated to participate in a cross-sectional survey via visiting their pharmacies and filling up the questionnaire form. Results and discussion: A total of 50 pharmacies responded to the survey. Results showed that large numbers of community pharmacies (50%) have started to implement infection control measures during May 2020, three months after reporting the first COVID-29 cases in Iraq. The data shows that wearing face masks and washing hands frequently were among the most common personal measures to curb the spread of the virus with 33% each. Results reveal that 70% of the pharmacies sanitized customer’s space on a daily base and more than half of the participants install 1 meter distance measures between the customers. Meanwhile, almost half of the community pharmacies reduced the number of front line staff into one, minimising the risk of contact with infectious customers. Upon having a staff member testing positive, testing or self-isolation on all other staff members were imposed by the participants. Conclusion: Community pharmacists in Iraq were facing unprecedented challenge when coronavirus hit the country. Taking control measures by community pharmacies were of paramount significance to curb the spread of the virus in their working place and the community as well all these need a sophisticated plan in the future.

Sexual and Reproductive Health Education for Youth with Intellectual Disabilities: a Mixed Methods Study of Professionals' Practices and Needs.

We conducted formative research to inform the creation of innovative new tools and strategies to engage professionals in communicating with youth with intellectual disabilities about sexual health. The research was guided by a multidisciplinary network of experts and an advisory board of self-advocates with intellectual disabilities and caregivers that make up Project SHINE: the Sexual Health Innovation Network for Equitable Education. A cross-sectional mixed-methods study utilized survey data from 632 disability support professionals who provide services to youth ages 16-24 with intellectual disabilities(ID). We then conducted focus groups with 36 professionals to obtain more in-depth information related to organizational support needs and suitable contexts, methods, and tools for sexuality education. Participants included licensed/credentialed direct service professionals (social workers, nurses, teachers), non-licensed direct service providers (case managers, supportive care specialists, residential care line staff), and program administrators. Quantitative and qualitative data analyses triangulated the findings across four content areas: attitudes about providing sexual health information to youth with ID, preparedness to communicate about sexuality, current communication practices, and professional needs in the field for new teaching tools and methods. We discuss how findings can be used to guide the creation and successful implementation of innovative new sexual health learning tools for youth with intellectual disabilities.

Practitioner perspectives on the challenges of implementing ‘alternative’ early childhood education (ECE) provision for nomadic children in Mongolia

Investment in early childhood education (ECE) is seen as key to improving life chances for children from economically disadvantaged backgrounds. Children from nomadic backgrounds often face difficulties in accessing ECE services because of geography, lack of services and the mobility of families. However, the provision of these services is seen as important in reducing educational inequalities between nomadic and non-nomadic children as well as in improving school readiness. Mongolia’s alternative provision policy for nomadic children is often presented as a case study of how ECE services can be provided for nomadic peoples. However, there is little to no literature on how this alternative provision policy is experienced on the ground by practitioners and the subsequent impact on front line staff and children. This research explored the perspectives of ECE practitioners in Mongolia, who are engaged in providing services to nomadic children, to understand their views on how the policy on alternative provision was experienced. Semi-structured interviews with 24 key informants were undertaken in 4 areas of Mongolia over the period 2019–2020. Practitioners highlighted issues around the funding of ECE alternative provision which impacted not only on sustainability of the programs but also impacted on access to programs, the resources available, the duration of programs and the quality of programs. Moreover, factors such as the qualifications of staff and a lack of teachers were highlighted. We conclude that appropriate funding is key in ensuring effective implementation of provision and identify areas of need in relation to ECE practitioner training as well as factors related to practitioner terms and conditions that require attention. Furthermore, some rethinking of the policy of ‘one child one type of provision’ needs to be undertaken as it leads to a lack of equity in relation to access and quality of provision between nomadic and non-nomadic children.

Immersive Technologies in Adult Learning as an Innovative Marketing Tool in the Educational Market

The article reviews the economic organization and effectiveness of adult education using virtual reality technologies. The main driver of the development of the immersive learning market is the demand from corporations. It is still expensive for most schools and universities, but companies, on the contrary, see it as a way to reduce costs. Immersive learning is a method that uses an artificial or simulated environment that allows students to become fully immersed in the learning process. In addition to creating a distraction-free environment, it can break the monotony of learning and development through stimulating visuals. Immersive learning can make learning more productive and valuable by increasing student engagement. The article also considers the factors that make immersive technologies an innovative tool for use in the marketing strategies of educational institutions and for the promotion of educational content. Immersive learning is a dynamic strategy that can improve e-learning and revolutionize the world of education. This method has great potential to lead the future of learning and help achieve its important goals. VR training is especially in demand in industries with a high line staff turnover: it reduces the cost of continuous training of new employees. Their business applications are almost limitless, from order picking and surgical operations to digital twins to modelling and tracking manufacturing plants, supply chains and other complex systems. AR and VR significantly increase the value and convenience that these opportunities create. These technologies improve how users visualize and access all new monitoring data, how they receive and follow instructions and product manuals, and how they interact. It was concluded that with immersive technologies in educational marketing, the educational market would develop, increase and change under the influence of innovations. It is also believed that the money spent on such technologies is not considered an expense but an investment in the development of the company and the person.

What drug to buy? generic brand substitution in base of the pyramid markets: Evidence from Ghana

Prescription brand substitution also known as generic substitution (GS)is a worldwide phenomenon. In the pharmaceutical industry, growth of the generic drug market implies growth in the number and types of substitutes for ethical (innovator) pharmaceutical products. This threat is relevant mainly due to the comparatively lower prices of these substitutes. Ultimately, prescription brand substitution renders the various marketing efforts and investments of the affected pharmaceutical companies fruitless. The efforts in the literature have focused more on cost as the reason but there seems to be more reasons than cost in developing countries like Ghana. The study examined the marketing-related impacts of prescription brand substitution at community pharmacies in Ghana. Utilizing the ideas of Porter’s five competitive forces model, specifically the threat of substitute products and services, the study which is cross-sectional, deductive and descriptive survey in nature, used a mix of cluster sampling and purposive sampling to arrive at a final sample size of 50 pharmacies and 9 pharmaceutical companies,. Data collected were analysed using simple linear regression and descriptive statistics. Weak but statistically significant relationship between frequency of pharmacy calls and nature of drug substitution was observed. Also, prescription brand substitution is prevalent at community pharmacies in Ghana, and that ethical companies are the most affected. Pharmacy front line staff and patients played contributory roles in this phenomenon. It is recommended that Ethical pharmaceutical companies should acknowledge, plan and act in order to minimize the competitive effects of prescription brand substitution

An unheard voice: infection prevention professionals reflect on their experiences during the covid-19 pandemic

The COVID-19 pandemic required a shift away from the evidence-based practices known to infection prevention professionals' (IPP). Relaying these guidelines to beleaguered front line staff contributed to the experience of moral distress and burnout among IPPs. A mixed methods design was used to explore the experiences of IPPs during the COVID-19 pandemic. An electronic survey was sent to a convenience sample from the Wisconsin APIC membership. A subset of this sample completed additional semi-structured interviews. A total of 61 IPPs responded to the survey, 18 agreed to interviews with 11 completions. Most respondents identified as female (n=58, 95.0%) and White (n=55, 90.1%). More than half of the respondents (n=39, 63.9 %) reported they experienced moral distress (MD). Themes from one-on-one interviews included: Feeling depleted, challenges to IPP role, validation of IPP expertise, value of peer support. We found that IPPs endured significant distress and exhaustion during the COVID-19 pandemic regardless of their practice setting. The long-term effects on the IPP profession must be examined. IPPs are susceptible to high levels of stress and anxiety similar to other frontline healthcare workers. IPPs deserve recognition for their service during the pandemic and should have access to resources that can support their well-being.

Factors Influencing the Choice of Geriatric Nursing as an Area of Specialization among Nursing Students in Ekiti, Nigeria

The ageing global population has necessitated adequate preparation for the healthcare needs of older adults. Nurses are front line staff in the health sector and are expected to a play major role in the care of the older adults. The study was descriptive and cross-sectional. Questionnaire was administered to 84 respondents who were final year students in two schools of nursing in Ekiti State, Nigeria. The study shows that 69.0% of the students perceived their experience while caring for older adults as interesting and this significantly influenced the decision of 31.0% of them who were willing to take up career in geriatric nursing. Adequate training and care facilities should be provided to give student nurses’ interesting experience during training in order to make geriatric nursing a more preferred area of specialization.

Integrasi Model Kesuksesan Adopsi E-Commerce Berbasis Technological Frames of References (TFR) – Knowledge Management (KM)

This study aims to examine several variables supporting the implementation of e-Commerce websites as digital platforms in supporting the business activities of SMEs. Several previous studies have found several variables/factors that support the implementation of e-Commerce with each perspective raised, so that in this study the variables/factors raised are the extraction of all factors from various perspectives and are expected to accommodate different points of view and previous research. Factor extraction is carried out using the Principal Component Analysis (PCA) method using the SPSS 22 Version tool to identify variables/factors from various and various needs, several factors that have components will be extracted and viewed in one category so as to minimize ambiguity factors as e-Commerce Enablers. In this study, data were collected through interviews and online dissemination to Clothing Line Business Actors and staff using digital platform users as many as 75 respondents and obtained some supporting data related to the use of digital platforms in the application of e-Commerce in daily business. Based on the extraction results obtained 5 main drivers that become e-Commerce Enabler based on several models of e-Commerce implementation based on Technological Frames of References (TFR) and Knowledge Management, namely: Organizational Trigger (OT), Environmental Trigger (ET), Individual Intention (II) , Knowledge Aspect and Capability (KAC), and Technology Infrastructure (IT) with each factor with components extracted so as to minimize ambiguity and still accommodate various needs and perspectives.Keywords : Specification Design, Information System, Integrated Document, Rational Unified Process, MASS Cargo

Strengthening Characteristics of Organizational Structures as An Effort To Improve Madrasah Employee Performance

This paper aims to analyze the characteristics of the organizational structure and the efforts of the head of the madrasa to improve employee performance at the Amanatul Ummah Pacet International Standard Madrasah. This type of research has used descriptive qualitative. For data collection techniques, researchers used observation, interviews, and documentation. The data analysis in this study begins before being in the field, analyzing data in the field, reducing data, presenting data, and drawing conclusions. The results showed that the characteristics of the organizational structure in the Amanatul Ummah Pacet International Standard Madrasah impacted employee performance. Characteristics of the organizational structure here using the line staff organizational structure are different from school institutions. The organizational structure at the Amanatul Ummah Pacet International Standard Madrasah impacts employee performance where the performance has a perfect communication pattern.

Intservqual Model di Stasiun Perpindahan Selama Masa Pandemik Covid-19

An interchange station or transfer station is a train station for more than one route that allows passengers to move from one route to another without leaving the station by paying a one-way fare. The purpose of this study was to determine the level of internal service capability in the organization in the field of internal customer service at the crossing station between front-line staff and support staff during the covid 19 pandemic. The research method used was a quantitative method with an analysis of internal quality measurements using the Intservqual model and measurements based on there is a gap between the service expected by internal customers (employees of other departments) and the service they actually receive. The sample used is accidental sampling of 105 support staff and 23 front line staff. The results of the study show that there is a gap that is still in a negative position, meaning that based on each dimension of the two gaps, it is still necessary to improve internal services between front-line staff and support staff.

COVID-19 crisis overshadowing the health workforces’ rights and resilience: a systematic review

Purpose In the time of the COVID-19 crisis, many physical, psychological and spiritual difficulties are imposed on the front line staff and overshadow their rights, resilience and retention. In addition, the loss of this important organizational resource imposes huge costs on the system. The purpose of this study is systemic review of the influential factors, policies and strategies applied to defend the rights of health-care staff and improve the resilience and retention of health system human resources in the COVID-19 crisis. Design/methodology/approach This systematic review was conducted in 2021. Data were collected by keyword search in Google Scholar, PubMed, Scopus, Web of Science, Science Direct, Magiran, SID and Irandoc databases until December 2021. In addition, the quality of the studies was evaluated by three experts using the Strobe checklist. The analysis used in this study to categorize the results was thematic analysis. Findings Factors that cause tension and injustice to employees and also strategies to overcome it and increase their resilience were classified into general categories according to their nature. Factors included factors related to safety, economic and financial, staff characteristics, crisis management characteristics, organizational climate and working conditions. Existing strategies also fall into four categories of physical, psychological and spiritual health promotion strategies; organizational climate and work environment; education and empowerment and economic and financial. Originality/value This study is a systematic review of the factors that affect the health workforce rights and resilience of health-care personnel during the COVID-19 crisis. On the other hand, the policies and strategies used in different countries to overcome the difficulties and increase the resilience and retention of health workers have been summarized and can be used in other crises.

Reduction of CAUTI Events in an ICU During the COVID-19 Pandemic Through Shared Governance and Using Process Improvement Strategies

BackgroundCatheter Associated Urinary Tract Infections (CAUTIs) are associated with an increase in mortality, morbidity, length of stay, and hospital costs. Intensive Care Units (ICUs) have higher rates of CAUTIs than other hospital units. During the Coronavirus (COVID-19) pandemic, Hospital Associated Infections (HAIs) have increased, including a 30% increase in CAUTI events within ICUs nationwide. The aim of this project was to engage the frontline staff in reducing CAUTI rates in the ICU.MethodsThis project occurred on a 40 bed Intensive Care Unit (ICU) in a 350+ bed community hospital. The patient population included patients positive for COVID-19. The Shared Leadership Council (SLC), which comprised of both unit leadership and frontline staff, utilized Plan-Do-Check-Act (PDCA) framework to reduce the incidence of CAUTIs on the unit. Peri-care and catheter care was identified as a gap in recent CAUTI events. The SLC developed a 4-pronged approach to include: hand hygiene cues, peri-care and catheter care training, CAUTI prevention bundle and external device review, and Patient Care Assistants (PtCA) to champion and standardize catheter and peri-care in daily unit workflow.ResultsThe result was a reduction in the number of CAUTI events in the ICU during 2021 from 3 in Quarter 1, to 2 in Quarter 2, to 0 in Quarter 3.ConclusionsThese results support success in engaging front line staff in Process Improvement Projects aimed at reducing HAIs. The SLC identified opportunities to close CAUTI prevention bundle element gaps, developed a set of interventions, and executed the interventions in the ICU.

Virtually, Anything is Possible: Implementation of an Electronic Patient Reported Outcome Platform Across A Multi-Center Radiation Oncology Department

Aim: To assess the implementation of an electronic patient reported outcomes (ePRO) application across a multi-center radiation oncology department. Process: Dalhousie University's Department of Radiation Oncology (DRO) is composed of four radiotherapy (RT) centres (Halifax, Sydney, Saint John, Charlottetown) across three provinces. The implementation of ePRO across our centres has been made possible by several key events: In 2009, a Canadian Partnership Against Cancer (CPAC) grant enabled 2 centres to begin paper-based distress screening using the Canadian Problem Checklist (CPC) and Edmonton Symptom Assessment System (ESASr). In 2015, a PRO retreat included representatives from all 4 centres to devise an action plan for ePRO implementation. In 2017, Accreditation Canada mandated routine evaluation of patient outcomes and in 2019, three DRO centres were awarded CPAC funding to launch ePROs. The fourth centre now hopes to use lessons learned in order to facilitate their ePRO implementation. Within the ePRO application (Noona) Canadian Partnership for Quality Radiotherapy (CPQR)-endorsed PRO tools are used to capture patient responses including CPC, ESASr, and the Brief Pain Inventory (BPI). Needs assessments were conducted in the areas of human resource (e.g. administrative support) as well as staff and patient education. Clinic workflows were revised to include an ePRO assessment at consultation, first and last RT review as well as follow-up in clinic or remotely. Official roll-out began in November 2021 with a phased approach across centres and tumors sites to allow for stakeholder and user feedback and to facilitate continued project planning. Benefits/Chellenges: Multi-centre and multi-disciplinary collaboration has been a major enabler of this project with significant potential to expand our Department's clinical and research programs. While the challenge of coordinating such a large-scale initiative was aggravated by constantly changing pandemic restrictions, project priority was escalated across the institutions with recognition of the electronic platform as a powerful tool to assess patient distress/symptoms remotely. While implementation of an ePRO program has been feasible, it has also been complex. Approvals from Privacy Impact Assessments to IT architectural reviews were required. An advisory board was formed to facilitate multi-stakeholder feedback including patient representatives, project managers, clinical clerks, nurses, radiation therapists, radiation oncologists, industry representatives, IT and legal. The project has been dependent on support from cancer program leadership to front line staff. Given that implementation of an ePRO application has introduced change in clinic workflow, change management strategies have been required to obtain buy-in for a system that aims to ultimately improve the quality and efficiency of patient care. Impact / Outcomes: PROs capture the patient perspective on physical, emotional and practical impacts of treatment, with the literature showing benefits to include improved patient-provider communication, patient quality of life and even survival. Future evaluation of the program will hopefully confirm that uptake and efficiency of PROs improves with use of the electronic versus paper system. More importantly, we await data collection and analysis to determine whether our multiple RT centres see improved patient outcomes through use of ePROs.