Planning psychosocial care for cancer patients: if at first you don't succeed, shift your paradigm

Concerned with our capacity to bridge the gap between patients' and families' psychosocial needs and the services provided, we developed a psychosocial intake and referral service. This paper will describe the lessons learned in trying to introduce an innovation whose time had not yet come and, after analyzing the outcome, to present a new approach to planning. The service was not approved and, on reflection, eight factors were identified as contributing to the failure of the service to reach fruition. In light of what we learned, we developed a new planning model that reflects planning as a circular, iterative process rather than as a linear process.