Bernardo Ramirez

Contract research organizations: an industry analysis

Purpose – The aging of the population, high prevalence of chronic diseases, and increased need for evidence‐based practice are factors that have boosted a high demand for clinical trials in the United States. In recent years, an increasing number of clinical trials have shifted from academic medical centers, to community‐based practices, to global sites in different countries. Contract research organizations (CROs) are service organizations that provide research and support services to pharmaceutical, biotechnological, and health companies. This paper aims to explore the evolution of the CRO industry in the United States and worldwide, and to discuss the benefits and pitfalls of the globalization of CROs.Design/methodology/approach – The organizational ecology framework is used to analyze the lifecycle of CROs in response to their environment including their emergence, growth, and evolution to date.Findings – The authors discuss the drug development process, the role of CROs and outsourcing in clinical re...

Not-for-profit versus for-profit health care providers--Part II: Comparing and contrasting their records.

The debate over which health care providers are most capably meeting their responsibilities in serving the publics interest continues unabated, and the comparisons of not-for-profit (NFP) versus for-profit (FP) hospitals remain at the epicenter of the discussion. From the perspective of available factual information, which of the two sides to this debate is correct? This article is part II of a 2-part series on comparing and contrasting the performance records of NFP health care providers with their FP counterparts. Although it is demonstrated that both NFP and FP providers perform virtuous and selfless feats on behalf of Americas public, it is also shown that both camps have been accused of being involved in potentially willful clinical and administrative missteps. Part I provided the background information (eg, legal differences, perspectives on social responsibility, and types of questionable and fraudulent behavior) required to adequately understand the scope of the comparison issue. Part II offers actual comparisons of the 2 organizational structures using several disparate factors such as specific organizational behaviors, approach to the health care priorities of cost and quality, and business-focused goals of profits, efficiency, and community benefit.

The laboratory workforce shortage: a managerial perspective.

Most clinical laboratories in the nation report severe difficulties in recruitment and retention of most types of personnel. Other important factors impacting this problem include work complexities, increased automation, and a graying workforce. As a further challenge, institutional needs for clinical laboratory personnel are expected to grow significantly in the next decade. This article examines the current situation of the clinical laboratory workforce. It analyzes the different types of personnel; the managerial, supervision, and line positions that are key for different types of laboratories; the job outlook and recent projections for different types of staff; and the current issues, trends, and challenges of the laboratory workforce. Laboratory managers need to take action with strategies suggested for overcoming these challenges. Most importantly, they need to become transformational leaders by developing effective staffing models, fostering healthy and productive work environments, and creating value with a strategic management culture and implementation of knowledge management.

Recommendations for the design of an integrated informatics policy in Costa Rica

This article presents ideas for the development of a health information system in Costa Rica. These series of political guidelines were developed as part of a workshop, held in Costa Rica in the beginning of 2011, in which officials from the Ministry of Health and the Costa Rican Social Security Institute participated. From the perspective of the participants, it is possible to consolidate a health information system in Costa Rica that articulates the efforts of the health sector institutions in order to offer the population high quality medical care. The Ministry of Health and the Costa Rican Social Security Institute are the main actors in enforcing this policy.

Hospitals for Sale

Abstract The pace of hospital merger and acquisition activity reflects the economic theory of supply and demand: Publicly traded hospital companies, private equity funds, and large nonprofit hospital systems are investing capital to purchase and operate freestanding community hospitals at a time when many of those hospitals find themselves short of capital reserves and certain forms of management expertise. But the sale of those community hospitals also raises questions about the impact of absentee ownership on the communities which those hospitals serve.