Evaluating organizational design to assure technology transfer: the case of the Community Clinical Oncology Program

Current theories of organizational performance are used to guide researchers at the Health Services Research Center of the University of North Carolina at Chapel Hill and the University of Illinois Survey Research Laboratory in the evaluation of the National Cancer Institute's Community Clinical Oncology Program (CCOP) and to derive policy options to enhance program operations. CCOP represents an innovative mechanism designed to improve the accrual of patients to phase III clinical trials, involve community-based oncologists in clinical research, and potentially to disseminate new information on the state-of-the-art cancer treatment to areas distant from cancer centers and research-oriented medical centers. Examined in this evaluation of the second phase of the CCOP are the ability of the 52 currently funded CCOPs and 17 research bases to accrue patients to cancer treatment and cancer control research protocols, their influence on the patterns of practice for cancer treatment in CCOP communities, and their influence on cancer control awareness and activity among primary care physicians. The evaluation applies selected organizational perspectives to describe the intraorganizational and interorganizational characteristics of the CCOPs, research bases, and the Institute that may affect the performance of the CCOP. This organizational approach relates the accrual and influence of the CCOP to controllable aspects of the program's design and management strategies that can be changed through policies directed by the National Cancer Institute. These policies include the criteria used to select CCOPs, the role of research bases in the development and implementation of treatment and cancer control research protocols, and the use of accrual credits.