identified that additional physician resources are needed to deal with false positive results. doi:10.1016/j.clinbiochem.2014.07.025 Unsatisfactory dried blood spot sample rates: Does audit and feedback drive quality improvement? Shelley Dougan a , Christine McRoberts b , Sandra Dunn a , Jennifer Milburn b , Ann Sprague a , Pranesh Chakraborty b a Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, Canada b Newborn Screening Ontario, Ottawa, Ontario, Canada The Better Outcomes Registry and Network (BORN Ontario) is the authoritative source for maternal and child information in the province of Ontario. With over 100 birthing hospitals, over 80 midwifery practices and about 140,000 babies born in Ontario each year, there is measurable variation in practice and patient outcomes across the province. BORN's Maternal Newborn Dashboard (MND) is a data feedback mechanism with the goal to “promote change, decrease practice variation and encourage best practices”(1) by alerting users to their organizations' performance status across a set of key performance indicators (KPI). Newborn Screening Ontario (NSO) has screened over 1 million infants since its founding in 2006, and has uploaded over 300,000 newborn screening records since BORN go-live in January 2012. These records include those samples that are unable to be tested for a variety of sampling errors. There are inherent risks when an infant's sample is deemed unsatisfactory for testing, including the possibility of delayed diagnosis. For this reason, and that sampling practice is amenable to improvement, the “unsatisfactory sample rate” has been included as one KPI in the BORN MND, which became available to hospitals in November 2012. The overall unsatisfactory sample rate at that time was 2.6%. One year later, the provincial unsatisfactory rate is 1.5%. This dramatic improvement in sampling may be due to hospitals' awareness of the KPI coupled with NSO's education initiatives and support of change at the submitter level. Case examples will be presented. (1) JOGC 2013;35(1):29–38. doi:10.1016/j.clinbiochem.2014.07.026 Implementing newborn screening policy through a province wide communication campaign Teresa L. Earl, Courtney K. Felker, Manu Chaturvedi Alberta Health Services, Alberta, Canada Objectives: Alberta Health Services (AHS) was directed by the provincial Ministry of Health to implement new provincial newborn screening policy standards to reach the target of screening 100% of infants born in Alberta. An innovative approach was required to implement the policy standards within an organization of 104,000 employees and diverse geographical challenges. Methods: Over 100 stakeholders were consulted across Alberta to implement a province wide policy within AHS for Alberta's Newborn Metabolic Screening (NMS) Program. Over a four month period in 2013–2014 a communication campaign was used to im- plement the policy and supporting documents. The purpose of the communication campaign was to integrate, organize and man- age provincial policy implementation with the goal of sustaining changes in practice. This was achieved through three multiface- ted communication engagement phases, each introducing infor- mation and support, including e-learning, to clinical areas across Alberta. Results: The evaluation findings of the policy implementation indicate the communication campaign was successful. The three engagement phases each created health care provider awareness, satisfaction and commitment to newborn screening. By focusing on the capacity building through facilitation and the availability of resources, health care providers are taking ownership of newborn screening services in their clinical areas and increasing the quality of the NMS Program. Conclusions: Applying a communication campaign approach to implementing province wide policy appears to be a successful way to support newborn screening program quality. However, sustaining quality newborn screening practices will depend on continued quality management through dedicated provincial coordination. doi:10.1016/j.clinbiochem.2014.07.027 Parent attitudes to newborn screening consent practices Stuart G. Nicholls a , Brenda J. Wilson a , Jamie C. Brehaut a, b , Holly Etchegary c , Beth K. Potter a , Robin Z. Hayeems d , Daryl Pullman e , Jennifer Milburn f , Pranesh Chakraborty g , Monica Hernandez g , Janet Marcadier g , Laure Tessier a , Charlene Simmonds h , Lesley Turner h, i a Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada b Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Ontario, Canada c Clinical Epidemiology, Memorial University, St. John's, Newfoundland & Labrador, Canada d Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada e Division of Community Health and Humanities, Faculty of Medicine, Memorial University, St. John's, Newfoundland & Labrador, Canada f BORN Ontario, Centre for Practice-Changing Research (CPCR), Ottawa, Ontario, Canada g Newborn Screening Ontario, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada h Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland & Labrador, Canada i Janeway Children's Health Centre, Canada Introduction: Newborn bloodspot screening is routinely offered to all newborn babies in Canada. As with many procedures for children, this requires proxy decision-making on the part of the parents. In addition, technical advances have led to a situation where the information generated by screening can exceed providers' capacity to intervene therapeutically. Studies have indicated support for mandated screening in the case of treatable conditions, and a need for consent for those that are not treatable. However, these studies assume that parents have a shared understanding of not only the terms such as informed or implied consent, but also the requirements that the different approaches create. To date, there has been little exploration of the perceived benefits or drawbacks from alternative consent approaches. Objective: To explore the attitudes of parents towards different consent approaches for newborn bloodspot screening. Methods: Qualitative interviews with parents in Ontario and Newfoundland & Labrador, Canada. Results & conclusion: We will present the results of semi-structured interviews with parents regarding consent practices for newborn Abstracts 133