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Introduction Bristol Royal Infirmary sleep unit is a busy tertiary service reviewing patients with Obstructive Sleep Apnoea. As part of a larger service and pathway evaluation project, we looked at streamlining the oximetry issue pathway, in particular patient and staff time.Method We completed a 4N chart (Dodds, 2018) with clinical and administrative staff, reviewing themes which included the limitations of paper records. A process map was completed to identify inefficiencies in the pathway. An Action Effect Diagram was used to summarise requirements to change the process. Using the Model for Improvement (Langley et al., 2009), Plan-Do-Study-Study-Act (PDSA) cycles were used to monitor progress and refine the pathway change. Ideas and planning to implement the change were developed using Six Sigma thinking (Fillingham, 2007).Results PDSA1: An electronic database was designed to replace the paper folder used to record oximetry issues. To improve data quality, the database included: mandatory boxes, pre-populated drop-down boxes to minimise typing errors, oximetry serial numbers issued to individual patients that could be scanned with an optional free text box for additional comments.PDSA2: To ensure oximetry devices could be scanned onto the database, Quick Reference (QR) codes linking the serial number to the oximetry device were generated. The QR code was attached to the oximetry device and box.PDSA3: Patients previously attended a 10-minute group masterclass. Written, audio and visual instructions were developed. Written instructions included a QR code and website link to access the patient video (figure 1).PDSA4: The final cycle was stopping the group masterclass. Staff had training on the database, QR codes and the new process. A Standard Operating Procedure was written for the new oximetry issuing pathway. Oximetry devices were prepared by the physiology team and oximeter number allocated to the patient’s name. The patient list, oximetry allocation and prepared equipment was given to reception to issue to equipment.Abstract P60 Figure 1QR code for oximetry patient instructionsConclusion Using established quality improvement models, the project was successful in streamlining the oximetry issuing pathway. This improved record keeping, patient and staff experience. Following this project, patient CPAP videos have been recorded and a centralised electronic database platform was developed.