174 Background: Cancer Care Ontario (CCO) organizes and ensures quality cancer care for 16 million residents in Ontario. CCO's goal is to create a tool to enable reporting of the patient experience in real time. The study objective was to develop a validated real-time (close to or at point of care) patient reported experience measurement (PREM) tool to drive quality improvement, advance system planning and ensure cost effective resource allocation based on patients’ needs, wants and preferences in ambulatory oncology treatment phase. Methods: Consisting of 28 questions – 18 core questions; 2 open-ended responses; and 8 demographic questions the tool underwent cognitive testing with patient family advisors and was validated using a pilot at 6 cancer centres from April to August, 2015. It was administered using several delivery modes: tablets, patient portals, post cards and paper. The patient journey in visiting centres was conceptualized as containing the steps or domains of interest: arrival, appointment/consultation and overall experience. To validate the patient experience conceptual model, an exploratory factor analysis was performed and compared to CCO’s 8 domain patient experience model. Reliability and validity of the tool was tested using Cronbach’s alpha and multiple variable regression analysis in partnership with Ipsos Reid. Results: 557 responses (496 electronic and 61 paper) formed the basis of the analysis. The tool was shown to be both valid and reliable - an overall adjusted R2 value of 64% from multiple variable regression on overall patient experience; and an overall Cronbach alpha value of 0.83, respectively. Individual Cronbach alpha values ranged from: 0.69 for “appointment/consultation”, 0.55 for “overall experience” and 0.24 for patient “arrival.” Conclusions: Statistical analysis results were used to produce a final validated tool for deployment to systematically capture PREMs through an electronic system in Ontario, Canada in 2016.To our knowledge this is the first of its kind. Collection of real time PREMS will ensure local and system level planning and quality improvement in the cancer system are rooted in what matters most to patients and their families.

Background While community pharmacies have been successful in providing harm reduction support for illicit substance consumers, little research has explored their role in addressing the needs of anabolic-androgenic steroid (AAS) consumers. Objective This study aims to understand the attitudes and experiences of AAS users in relation to community pharmacies, with the goal of identifying opportunities for harm reduction interventions and creating safer-use environments. Methods Semi-structured interviews were conducted with eight AAS consumers living in Australia between December 2022 and April 2023. Interview data were analysed using reflexive thematic analysis. Results Participants discussed accessing AAS equipment and overcoming challenges, such as limited access in rural areas. They highlighted the disparity between the availability and accessibility of equipment from pharmacies and needle and syringe programs. Participants expressed a preference for community pharmacies, perceiving them as less confronting and a feasible avenue for accessing professional advice, highlighting the potential role of pharmacists in nurturing therapeutic alliances with users of AAS. Overall consumers supported the idea of AAS safe-injecting kits being available in pharmacies and they were receptive to pharmacies as potential sources of information and support. Conclusions The findings suggest that community pharmacies can further contribute to promoting safer AAS use and providing support for consumers. However, further research is needed to address knowledge gaps and training needs for pharmacy staff, with the aim of creating a safer environment for AAS consumers.

Chronic venous disease (CVD) occurs because of structural or functional disturbances to the venous system of the lower limbs. Signs and symptoms include leg pain, swelling, varicose veins, and skin changes, with venous ulceration ultimately occurring in severe disease. To assess the prevalence of CVD among health care workers, a scoping review of existing publications exploring the prevalence of CVD among health care workers was conducted in July 2022. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines were used. A total of 15 papers met the inclusion criteria and these formed the basis of the review. Among health care workers, the mean prevalence of CVD was 58.5% and the mean prevalence for varicose veins was 22.1%. There is an increased prevalence of CVD in health care workers when compared with the general population. Therefore, there is a need for early diagnosis and the use of preventative measures to protect health care workers from CVD and varicose vein development.

Patient-reported experience measures (PREMs) capture the patient’s view about his or her experience while receiving care across the continuum of care. Your Voice Matters (YVM), a real-time electronic PREM tool, was developed to measure the patient experience in the outpatient cancer setting and to drive quality improvements in the cancer system. This study describes the development and validation of YVM, a real-time electronic PREM tool in cancer services. Cognitive interviewing was conducted with patient and family advisors for both the French (n = 3) and English (n = 5) versions of the YVM tool. YVM was administered through five Regional Cancer Centers (RCCs) between April and August 2015. Shapley value regression used overall experience-dependent variables to determine core items and items eligible for removal from YVM. Exploratory factor analysis was used to determine the underlying factor structure.Internal consistency reliabilities were calculated using Cronbach’s alpha. A total of 557 YVM tools were completed by cancer patients in the treatment phase. Shapley value regression identified five lower scoring items for removal. Exploratory factor analysis showed that a 27-item, five-factor structure reflected the underlying patient experience dimensions in the cancer treatment visit. Cronbach’s alpha of 0.827 for all items suggested good internal consistency. YVM is a validated tool for measuring the experience of cancer patients during the treatment phase through the visit trajectory in real time. YVM will help drive improvements based on patients’ preferences and needs, and will provide robust patient experience data for cancer care delivery.

111 Background: Cancer Care Ontario organizes and ensures quality cancer care for 13.5 million residents in Ontario, Canada and is systematically deploying a web-based tool, called Electronic Patient Reported Experience Measures (ePREM), through a touch-screen platform previously deployed within Regional Cancer Centres (RCCs). ePREM has been used to disseminate the first patient reported experience measure (PREM), called Your Voice Matters (YVM). YVM will be collected on all patients in Ontario undergoing cancer treatment in real time, creating the largest known, linkable patient experience dataset. Methods: Implementation feasibility and readiness was assessed across all 14 Regional Cancer Programs through a provincial assessment which informed the phased implementation. Implementation was rooted in a change management framework: clinical and administrative champions, available resources, existing technical environment and competing program priorities. In March 2016 a four-wave implementation was initiated controlling for readiness and centre volumes, with a focus on extensive stakeholder engagement, tool training, launch and operational support. To date, ePREM is fully operational in 10 of 15 RCCs. Results: Provincial deployment was 66% complete in October 2016. By March 2017 full provincial implementation will be complete. Successful implementation has been directly linked to an adaptive design within the implementation and change management framework as a four-wave roll out. Key factors included: multi-faceted communications with centre leadership, and implementation teams. During this initial data stabilization phase, there were 9,266 completed surveys submitted and 10,932 partial survey responses submitted. Conclusions: PREMs are appropriate quality improvement indicators for cancer patients within the treatment phase. ePREMs enables systematic, linkable collection of real time PREMs to improve the patient experience in Ontario and contribute to the planning of new initiatives. Upon full provincial implementation ePREMs will allow for the largest known dataset of PREMs. Successful implementation has been directly linked to an adaptive, four-wave approach.