Background: Cancer Care Ontario is the government agency responsible for improving cancer services across Ontario’s 14 regions. To promote advances in best practices related to systemic treatment, Cancer Care Ontario hosts annual Systemic Treatment Safety Symposia, which serve as a platform to discuss quality and safety issues and results of quality improvement (QI) initiatives in alignment with the Systemic Treatment Provincial Plan. For the first time, the 2015 Symposium brought together patients and providers to discuss gaps and opportunities for improvement in relation to toxicity management (TM) during chemotherapy. The main goal of the event was to define improvement priorities. Methods: The Symposium presents a valuable engagement opportunity with regional stakeholders including medical oncologists, nurses, pharmacists, administrators and patient and family advisors. An interactive agenda was designed to elicit direction from these stakeholders. At the event attendees identified and prioritized improvement opportunities using a simulated investment scenario, where marked bills were given to participants to finance the solutions they felt would best address the challenges posed by current TM. The mock money was counted and analyzed based on the role of the ‘investors’ and the prioritized theme. Results: The Symposium had 92 attendees including 17 patients and caregivers. Themes that emerged are presented in the Table below. Endorsement varied depending on stakeholder group. For example, Access was the top improvement priority for patients, whereas Communication was highest for providers. Conclusions: A one day engagement event that brings together patients and providers can be successful in identifying priority areas for quality improvement. Based on the outcomes of the prioritization exercise, improving access to oncology providers for TM 24/7 was identified as a focus area for provincial and regional QI initiatives.