The combination of a top-down and bottom-up strategy ensured participation from all involved departments, a strong foundation and a shared vision on patient centered care. The FTC facilitates sharing information between different medical specialists through both proximity and a shared electronic patient record. The implementation of the FTC comprises a change in organization, but not a change in structure.

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Background This descriptive study was conducted in order to determine the self-respect and school success of the healthy siblings of the trainable mentally disabled children. Methods The data of the study was collected by informative data form and Coopersmith Self-Esteem Scale between. The school grades of the healthy siblings at the end of the year were obtained from e-school system. The healthy siblings of 91 mentally disabled children who are getting private training and who have siblings were icluded in the study. Results The healthy siblings of the mentally disabled children icluded in the study, 42.8% were between the ages of 12-14 and 57.1% were female, 42.8% were attending second-level primary school classes. The self-respect point average of the healthy siblings of the mentally disabled children was 59.2 ± 14.9; and 69.2% of them had medium level, 27.5% of them high level of self-respect. The self-respect of the healthy siblings was affected by the gender of the mentally disabled sibling and the employment status of the father. The school success level of 60.4% of the healthy siblings at the end of the year was found to be 'good'. Conclusion Supporting the self-respect and school success of the healthy siblings of the mentally disabled children in a way that they would not be affected by their siblings' disability, the families' sparing enough time for the daily needs of the healthy children and their performences at school, improving the cooperation between parents. Background and aims Continuous quality improvement (QI) in healthcare is necessary. However many publications prove that often the implementation of innovations fails in daily hospital practice. We found a lack of knowledge and skills within the executing staff of our children's clinic in this field. The aim was to develop and realise an efficient and effective training to empower the responsible staff nurses in order to improve the success rate of QI implementation projects on the wards. PO-0891Methods After a critical analysis we developed basic principles for this training:· 'learning on the job'; students are using their own project during the course · focus on key elements of implementation and necessary competencies · immediately applicable in daily practice · the use of already in-hospital available knowledge · thorough quantitative and qualitative evaluations (oral and written). Results In 2013 we developed, realised and evaluated this implementation training; · developed by 6 professionals from 4 different fields · training in 4 daily periods (afternoons) in a 3-4 weeks interval · based on 4 implementation key-topics and 7 implementation competencies · 14 students; simultaneously invested in their own QI projects · student-scores (scale: 1-5) mean total training: 3.5 · high scores: applicability (4.4), personal learning efficiency (3.6), trainers (3.9). Discussion/conclusion We successfully designed and realised a training to improve the implementation knowledge and skills of the nursing staff. At present we are improving the train...

102 Background: The incidence of gastrointestinal (GI) tract tumours in the Netherlands is rising. However, GI oncological medical care is still delayed and fragmented. There is a need for better and faster diagnostic work-up, faster start of treatment, but also for expert multidisciplinary deliberation. Therefore, the GIOCA, Gastro Intestinal Oncological Centre Amsterdam, started in 2009 as a one day fast track multidisciplinary outpatient clinic for patients with GI malignancies. The goal was an admission time (AT, time from referral to consultation) of < 1 week and a run through time (RTT, time from multidisciplinary meeting to start of treatment) of < 3 weeks. The aim of this study was first to evaluate the AT and RTT at GIOCA and secondly to evaluate the subjective impact of this novel strategy on patients burden and satisfaction. Methods: Patients were seen at GIOCA in the morning on a colorectal (CRC ), an oesophago/gastric (OES) or a hepatopancreaticobiliary (HPB) day. That same morning (additional) diagnostics were performed. At the multidisciplinary meeting afterwards, a final diagnosis and treatment plan was made, which was later communicated to the patient. The patient then met all involved specialists. AT and RTT were prospectively recorded for all GIOCA patients. For HPB malignancies, AT and RTT could be compared to historical controls from the preceding year. Patient impact and satisfaction was evaluated using a before/after cohort study design, with a written questionnaire prospectively administered to all GIOCA patients and compared to data obtained 3 months prior to GIOCA start. Results: Analyses of 2009 and 2010 showed the following results: The average AT for CRC, OES and HPB was 7.6, 9.5 and 9 days respectively. The average RTT for CRC, OES and HPB was 20.8, 24 and 25 days respectively. For HPB malignancies, this was 10.4 days (AT) and 59.8 days (RTT) in the year preceding GIOCA. Higher levels of patient satisfaction were obtained in GIOCA patients compared to controls. More than 90% of the patients interviewed would advice the GIOCA outpatient approach to other patients. Conclusions: Progress has been made in the AT and RTT in GI malignancies in GIOCA, but the goals were still not all reached. Patients were very satisfied with this novel approach.