Highly specialized healthcare professionals organize comprehensive cancer management around team-based care at the Toronto Sunnybrook Regional Cancer Centre (TSRCC) and Sunnybrook & Women's College Health Sciences Centre (S&WCHSC), Toronto, Canada. In 1999, the Division of Orthopaedics at S&WCHSC and the RRRP initiated the Bone Metastases Clinic (BMC) to provide a systematic approach to the care of cancer patients with bone metastases. Complementary management approaches are required to provide patients with effective symptom and pain control and quality of life. Multidisciplinary evaluation of patients with metastatic disease to the bone allows comprehensive management of associated symptoms, determines the risk for pathologic fracture, and helps coordinate administration of available antineoplastic therapies. The challenge is in achieving an accessible, sustainable treatment management system for this patient population. This research, undertaken in 2002, was designed to systematically identify and evaluate organizational and functional strategies that influence the BMC team's progression along the healthcare continuum to guide the future development, enhancement and refinement of the current program.