Great job Dr. Spenard et al! I really appreciate your use of figures and tables to summarize this initiative and the outcomes. I notice a huge increase in the treatment rate for anemia screening after the third and fourth intervention that were introduced simultaneously, can you share any insight regarding whether or not you have a sense of what was most impactful at that time when treatment rates started to decline - educating providers and patients or creating a process that is triggered for patients who meet the criteria? I know education and training staff about a new intervention can be very helpful to increase uptake in the short-term but can be tricky in sustaining individual behaviour changes in the long term without having an intervention that targets the system. Again, well done!

Great work in an important area! A few comments/questions: 1. 'readiness' is not defined making it unclear how it enables improved outcomes 2. more description of the intervention would help others decide if feasible in their settings 3. it would be helpful to display outcomes data as SPC or run charts. It is not clear from the bar graphs whether the differences observed is statistically significant 4. what were the balancing/process measures and their results?

Congratulations Dr. Spenard et al. for the OPRA study! Your data is well presented and within a few months, you have already improved rate of preoperative anemia treatment and reduced perioperative transfusion. It would be interesting to know what % of preoperative anemia you are hoping to reach with your interventions. Also, I would like to know the impact of your interventions on postoperative complications such as VTE, SSI, length of stay. Good work!

Your poster very nicely presents the range of factors that participants identified as likely to influence the success of the PPH bundle implementation as well as the system-level factors contributing to management delay. I'm wondering if you identified any patterns of perceived facilitators or barriers by professional group in your results? If yes, are there implications for the intervention strategy?