e19223 Background: While multidisciplinary teams (MDTs) are well-established in many healthcare institutions, both how they function and their role in decision making vary widely. This study assessed the effectiveness of a multipronged approach to strengthening multidisciplinary team performance for a cancer service over three years. Methods: The study comprised the introduction of a structured quality improvement program, the Tumour Program Strengthening Initiative (TPSI), to improve MDT performance, and an annual survey to evaluate MDT members’ perceptions of their teams’ performance. Three iterations of the survey have been completed. Results: 12 teams participated in TPSI with 129, 118, and 146 members completing the MDT member survey in 2017, 2018, and 2019 respectively. Of the 18 questions that were asked throughout the study, nine showed significant improvement, and of these, seven were highly significant. Questions related to patient wellbeing and to audits and quality improvement showed no significant change. Conclusions: The Tumour Program Strengthening Initiative resulted in sustained and significant improvement in MDT performance over three years. The MDT survey proved to be useful not only for cancer care teams to identify their strengths and weaknesses and monitoring performance but also for management to flag priority areas for improvement and further support. The significance of this initiative is that overall program improvement reflects the strengthening of the weakest teams as well as further improvement in highly performing MDTs. [Table: see text]