title: Measuring Integration of Cancer Services to Support Performance Improvement: The CSI Survey.
abstract: OBJECTIVE
  To develop a measure of cancer services integration (CSI) that can inform clinical and administrative decision-makers in their efforts to monitor and improve cancer system performance.
  
  
  METHODS
  We employed a systematic approach to measurement development, including review of existing cancer/health services integration measures, key-informant interviews and focus groups with cancer system leaders. The research team constructed a Web-based survey that was field- and pilot-tested, refined and then formally conducted on a sample of cancer care providers and administrators in Ontario, Canada. We then conducted exploratory factor analysis to identify key dimensions of CSI.
  
  
  RESULTS
  A total of 1,769 physicians, other clinicians and administrators participated in the survey, responding to a 67-item questionnaire. The exploratory factor analysis identified 12 factors that were linked to three broader dimensions: clinical, functional and vertical system integration.
  
  
  CONCLUSIONS
  The CSI Survey provides important insights on a range of typically unmeasured aspects of the coordination and integration of cancer services, representing a new tool to inform performance improvement efforts.
authors.affiliation: Scientist, Cancer Services and Policy Research Unit, Cancer Care Ontario.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Dobrow
authors.forename: Lawrence
authors.initials: L
authors.lastname: Paszat
authors.forename: Brian
authors.initials: B
authors.lastname: Golden
authors.forename: Adalsteinn D
authors.initials: AD
authors.lastname: Brown
authors.forename: Eric
authors.initials: E
authors.lastname: Holowaty
authors.forename: Margo C
authors.initials: MC
authors.lastname: Orchard
authors.forename: Neerav
authors.initials: N
authors.lastname: Monga
authors.forename: Terrence
authors.initials: T
authors.lastname: Sullivan