title: Evaluating program integration and the rise in collaboration: case study of a palliative care network.
abstract: BACKGROUND
  There is increasing global interest in using regional palliative care networks (PCNs) to integrate care and create systems that are more cost-effective and responsive. We examined a PCN that used a community development approach to build capacity for palliative care in each distinct community in a region of southern Ontario, Canada, with the goal of achieving a competent integrated system.
  
  
  METHODS
  Using a case study methodology, we examined a PCN at the structural level through a document review, a survey of 20 organizational administrators, and an interview with the network director.
  
  
  RESULTS
  The PCN identified 14 distinct communities at different stages of development within the region. Despite the lack of some key features that would facilitate efficient palliative care delivery across these communities, administrators largely viewed the network partnership as beneficial and collaborative.
  
  
  CONCLUSIONS
  The PCN has attempted to recognize specific needs in each local area. Change is gradual but participatory. There remain structural issues that may negatively affect the functioning of the PCN.
authors.affiliation: Department of Clinical Epidemiology and Biostatistics, McMaster University, Juravinski Cancer Centre, 699 Concession Street, Room 4-203, Hamilton, Ontario, Canada L8V 5C2. daryl.bainbridge@jcc.hhsc.ca
authors.forename: Daryl
authors.initials: D
authors.lastname: Bainbridge
authors.forename: Kevin
authors.initials: K
authors.lastname: Brazil
authors.forename: Paul
authors.initials: P
authors.lastname: Krueger
authors.forename: Jenny
authors.initials: J
authors.lastname: Ploeg
authors.forename: Alan
authors.initials: A
authors.lastname: Taniguchi
authors.forename: Julie
authors.initials: J
authors.lastname: Darnay
mesh_terms: D026683:Advisory Committees; D019058:Community Networks / Q000458:organization & administration*; D019538:Health Care Surveys; D006801:Humans; D007373:Interinstitutional Relations; D009864:Ontario; D019982:Organizational Case Studies; D010043:Outcome and Process Assessment, Health Care; D010166:Palliative Care / Q000458:organization & administration*; D016730:Program Development; D012922:Social Change