Where you stand depends on where you sit: Alignment of quality measures to strategic intentions.

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265 Background: Identifying quality measurements for discovering and delivering effective cancer care are dependent on the strategic vision of the cancer center and its respective units yet, each unit encompasses a distinctive set of competencies. We propose a framework for evaluating and structuring the alignment of quality and unit strategy measures within the overall vision of a cancer center. Methods: Prospective analysis was conducted with structured interviews across leadership and key opinion leaders (1) at the executive level, (2) within cancer center units (including basic science, cores, clinical research, and oncology service lines) and (3) across key hospital and research integration points. Quality and strategic areas reviewed were success measures, strategic focus, competitive dimensions, key strategies, and significant barriers. Risk of bias was accounted for through interrater reliability across the consensus of three independent reviewers. Measures of consistency were quantitatively assessed through triangulation of multiple perspectives based on roles and responsibilities. Results: 61 individuals were interviewed, generating 875 responses across the five areas. Responses were grouped into 303 categories, and then into 32 specific perspectives. These perspectives were linked with each of the five quality and strategic categories. Assessment and prioritization of quality and strategic measures were calculated based on tabulation of responses. Conclusions: While overarching strategy is well understood throughout the cancer center, quality, and strategic measures must be developed to integrate activities of each functional units across the cancer center to support overall goals. The framework for aligning quality measures to strategy facilitates the ability for centers to develop, align, and prioritize quality measures across the institution. [Table: see text]