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Background Great Ormond Street Hospital for Children (GOSH) is undertaking a Trust-wide Quality Improvement (QI) programme to enhance outcomes for acutely deteriorating patients. Multidisciplinary collaboration is essential to improve care processes, but sustaining engagement in long-term projects is challenging. 1 This paper evaluates the use of local multidisciplinary improvement groups as a mechanism for gathering feedback and shaping a patient pathway that supports patients and families throughout their care journey.Methods To support local improvement efforts, weekly reviews of patient stories were introduced across six specialties to explore the complexities and human factors surrounding deterioration. Multi-level, multidisciplinary staff attendance ( table 1) ensured breadth of perspective. Key themes were prioritised using a Pareto tool and shared with the Trust-wide steering group. QI specialists and ward educators co-designed educational materials tailored to local needs based on lessons learned.Results Since June 2024, 48 individual patient stories have been discussed at 79 meetings. Stronger collaboration between nursing and medical teams has been a key outcome. Shared perspective has led to more effective communication and timely escalation, demonstrating how structured multidisciplinary engagement helps overcome longstanding barriers. Local ownership has grown, with speciality teams increasingly driving improvements themselves. Learning has informed process changes at both local (e.g. increased involvement of Clinical Site Practitioners in patient deterioration on specific wards) and Trust-wide levels (e.g. inclusion of ‘lethargy’ as an early identifier of deterioration). Challenges included workload pressures and aligning schedules, but adapting flexibly to team needs has maintained engagement.Conclusion Structured, multidisciplinary feedback has proven effective in refining a pathway that places patients and families at the centre of personalised care. The locally powered, Trust-wide model has enabled staff to develop confidence, adapt processes to their specialty, and embed learning in daily practice. Next steps include establishing outcome measures to track impact across the whole patient journey.Reference Elizalde J, Lumibao J, Lizarondo L. Barriers and facilitators to health professionals’ engagement in quality improvement initiatives: a mixed-methods systematic review. International Journal for Quality in Health Care 2024 Apr;36(2):mzae056. doi: 10.1093/intqhc/mzae056.Abstract 132 Table 1Structure of the multidisciplinary learning group: roles and responsibilities