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number DDG 334/19-06-2019). Subcutaneous immunotherapy (SCIT) is an effective treatment for allergic rhinoconjunctivitis. However, adverse events, including life-threatening systemic reactions, may occur. The purpose of this project is to identify risk factors for systemic reactions to SCIT and to provide practice-based solutions using a quality improvement (QI) framework. A QI initiative was performed in a hospital-based, Canadian Allergy clinic administering SCIT in a 12-month period. A total of 4242 injections of SCIT were performed o