title: Providing supportive care to cancer patients: a study on inter-organizational relationships.
abstract: BACKGROUND
  Supportive cancer care (SCC) has historically been provided by organizations that work independently and possess limited inter-organizational coordination. Despite the recognition that SCC services must be better coordinated, little research has been done to examine inter-organizational relationships that would enable this goal.
  
  
  OBJECTIVE
  The purpose of this study was to describe relationships among programs that support those affected by cancer. Through this description the study objective was to identify the optimal approach to coordinating SCC in the community.
  
  
  METHODS
  Senior administrators in programs that provided care to persons and their families living with or affected by cancer participated in a personal interview.
  
  
  METHODS
  South-central Ontario, Canada.
  
  
  METHODS
  administrators from 43 (97%) eligible programs consented to participate in the study.
  
  
  RESULTS
  Network analysis revealed a diffuse system where centralization was greater in operational than administrative activities. A greater number of provider cliques were present at the operational level than the administrative level. Respondents identified several priorities to improve the coordination of cancer care in the community including: improving standards of care; establishing a regional coordinating body; increasing resources; and improving communication between programs.
  
  
  CONCLUSIONS
  Our results point to the importance of developing a better understanding on the types of relationships that exist among service programs if effective integrated models of care are to be developed.
authors.affiliation: St. Joseph's Health System Research Network, Supportive Care Research Unit, Juravinski Cancer Centre, Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Brazil
authors.forename: Daryl
authors.initials: D
authors.lastname: Bainbridge
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sussman
authors.forename: Tim
authors.initials: T
authors.lastname: Whelan
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: O'Brien
authors.forename: Nancy
authors.initials: N
authors.lastname: Pyette