STRATEGIC ALLIANCES: CREATING LONG TERM SUCCESS

Given today's increasingly competitive environment, firms in every industry are searching for new ways to increase their competitive advantage. Many firms have realized that, due to a variety of different reasons (e.g., fast-paced technological advances), significant performance improvements cannot be achieved alone. As such, the traditional response of performance enhancement through acquisition is no longer the only option. Strategic alliances are a new alternative that enable partnering firms to combine their individual strengths while compensating for their internal resource scarcities without making the investment required for actual ownership. While interest in alliances is growing, firms are often unsure how to build and maintain successful alliances. This research examines alliances between manufacturers and their suppliers in the food and health/personal care industries to determine what factors lead to successful, long term alliances.Farm Management,

Evaluating Food Commodity Procurement Strategies

We use a case study approach to determine the primary factors affecting food manufacturers' commodity procurement decisions, as well as to examine the strategic nature of commodity procurement departments. The research fills a gap in both the commodity and procurement literature. A large literature exists on commodity marketing; however, very little exists on the topic of commodity procurement. Existing procurement literature tends to focus on non-commodity products rather than commodity products. The results suggest a model for the strategic role of commodity procurement departments within food manufacturers. The initial procurement strategy must be supply maintenance, which once accomplished, allows the commodity procurement department to progress to a profit-focused strategy, which is generally cost-based. Finally, the role of the commodity procurement department can expand by offering additional services to customers, such as designing promotional programs.Marketing,

SUPPLY CHAIN INTEGRATION IN THE FOOD AND CONSUMER GOODS INDUSTRIES

The interorganizational structures necessary to implement and achieve the logistical performance improvements identified in the Efficient Consumer Response (ECR) initiative and related supply chain management concepts are difficult to develop. Firms continue to struggle to implement integrated programs and techniques, particularly with respect to changing operating structures, relationships, and mindsets to facilitate true supply chain integration. This research explores the logistical strategies and structures used by selected food and consumer goods firms to integrate their supply chains. It illustrates effective integration strategies and identifies critical success factors and barriers to successful ECR implementation. A framework is used to guide managers in developing the competencies essential to integrating the supply chain and to establishing the relationships necessary to operate in an ECR environment. The framework, entitled Supply Chain 2000, depicts supply chain value creation as achieving synchronization and coordination across four critical supply chain flows: product/service; market accommodation; information; and cash.Industrial Organization,

Executive Summary:International Clinical Practice Guidelines for Pediatric Ventilator Liberation, A Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Document

Rationale: Pediatric-specific ventilator liberation guidelines are lacking despite the many studies exploring elements of extubation readiness testing. The lack of clinical practice guidelines has led to significant and unnecessary variation in methods used to assess pediatric patients’ readiness for extubation. Methods: Twenty-six international experts comprised a multiprofessional panel to establish pediatrics-specific ventilator liberation clinical practice guidelines, focusing on acutely hospitalized children receiving invasive mechanical ventilation for more than 24 hours. Eleven key questions were identified and first prioritized using the Modified Convergence of Opinion on Recommendations and Evidence. A systematic review was conducted for questions that did not meet an a priori threshold of &gt;80% agreement, with Grading of Recommendations, Assessment, Development, and Evaluation methodologies applied to develop the guidelines. The panel evaluated the evidence and drafted and voted on the recommendations. Measurements and Main Results: Three questions related to systematic screening using an extubation readiness testing bundle and a spontaneous breathing trial as part of the bundle met Modified Convergence of Opinion on Recommendations criteria of &gt;80% agreement. For the remaining eight questions, five systematic reviews yielded 12 recommendations related to the methods and duration of spontaneous breathing trials, measures of respiratory muscle strength, assessment of risk of postextubation upper airway obstruction and its prevention, use of postextubation noninvasive respiratory support, and sedation. Most recommendations were conditional and based on low to very low certainty of evidence. Conclusions: This clinical practice guideline provides a conceptual framework with evidence-based recommendations for best practices related to pediatric ventilator liberation.</p

Executive Summary: International Clinical Practice Guidelines for Pediatric Ventilator Liberation, A PALISI Network Document

RATIONALE: Pediatric specific ventilator liberation guidelines are lacking despite the many studies exploring elements of extubation readiness testing. The lack of clinical practice guidelines has led to significant and unnecessary variation in methods used to assess pediatric patients' readiness for extubation. METHODS: Twenty-six international experts comprised a multi-professional panel to establish pediatric specific ventilator liberation clinical practice guidelines, focusing on acutely hospitalized children receiving invasive mechanical ventilation for more than 24 hours. Eleven key questions were identified and first prioritized using the Modified Convergence of Opinion on Recommendations and Evidence. Systematic review was conducted for questions which did not meet an a-priori threshold of ≥80% agreement, with Grading of Recommendations, Assessment, Development, and Evaluation methodologies applied to develop the guidelines. The panel evaluated the evidence, drafted, and voted on the recommendations. MEASUREMENTS AND MAIN RESULTS: Three questions related to systematic screening, using an extubation readiness testing bundle and use of a spontaneous breathing trial as part of the bundle met Modified Convergence of Opinion on Recommendations criteria of ≥80% agreement. For the remaining 8 questions, 5 systematic reviews yielded 12 recommendations related to the methods and duration of spontaneous breathing trials; measures of respiratory muscle strength; assessment of risk of post-extubation upper airway obstruction and its prevention; use of post-extubation non-invasive respiratory support; and sedation. Most recommendations were conditional and based on low to very low certainty of evidence. CONCLUSION: This clinical practice guideline provides a conceptual framework with evidence-based recommendations for best practices related to pediatric ventilator liberation.The project was funded by Eunice Kennedy Shriver National Institute of Child Health (NICHD) and Human Development National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) (R13HD102137), in addition to funds from department of pediatrics at Indiana University School of Medicine, Indianapolis, Indiana

Operational Definitions related to Pediatric Ventilator Liberation

BACKGROUND: Common, operational definitions are crucial to assess interventions and outcomes related to pediatric mechanical ventilation. These definitions can reduce unnecessary variability amongst research and quality improvement efforts, to ensure findings are generalizable and can be pooled to establish best practices. RESEARCH QUESTION: Can we establish operational definitions for key elements related to pediatric ventilator liberation using a combination of detailed literature review and consensus-based approaches? STUDY DESIGN AND METHODS: A panel of 26 international experts in pediatric ventilator liberation, two methodologists and two librarians conducted systematic reviews on eight topic areas related to pediatric ventilator liberation. Through a series of virtual meetings, we established draft definitions which were voted upon using an anonymous web-based process. Definitions were revised by incorporating extracted data gathered during the systematic review and discussed in another consensus meeting. A second round of voting was conducted to confirm the final definitions. RESULTS: In eight topic areas identified by the experts, 16 preliminary definitions were established. Based on initial discussion and the first round of voting, modifications were suggested for 11 of the 16 definitions. There was significant variability in how these items were defined in the literature reviewed. The final round of voting achieved ≥80% agreement for all 16 definitions in the following areas: what constitutes respiratory support (invasive mechanical ventilation and non-invasive respiratory support), liberation and failed attempts to liberate from invasive mechanical ventilation, liberation from respiratory support, duration of non-invasive respiratory support, total duration of invasive mechanical ventilation, spontaneous breathing trials, extubation readiness testing, 28-ventilator free days, and planned vs rescue use of post-extubation non-invasive respiratory support. INTERPRETATION: We propose these consensus-based definitions for elements of pediatric ventilator liberation, informed by evidence, be used for future quality improvement initiatives and research studies to improve generalizability, and facilitate comparison.The project was funded by Eunice Kennedy Shriver National Institute of Child Health (NICHD) and Human Development National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) (R13HD102137), in addition to funds from the Department of Pediatrics at Indiana University School of Medicine, Indianapolis, Indiana

THE ALLIANCE FORMATION PROCESS

While interest in developing strategic alliances within the food system continues to increase, there remains considerable risk when firms adopt such a cooperative strategy. The risk is due in part to the lack of concrete guidelines that illustrate the steps or stages of alliance development and the important strategic and operational decisions required at each stage. The existence of such guidelines would facilitate alliance formation and enable managers and researchers to better understand alliance practice. This paper provides an alliance formation model that incorporates the process of alliance formation with the strategic and operational considerations required for long term success. The model can be used by managers and academicians to develop and understand alliances

STRATEGIC ALLIANCES: CREATING LONG TERM SUCCESS

Given today's increasingly competitive environment, firms in every industry are searching for new ways to increase their competitive advantage. Many firms have realized that, due to a variety of different reasons (e.g., fast-paced technological advances), significant performance improvements cannot be achieved alone. As such, the traditional response of performance enhancement through acquisition is no longer the only option. Strategic alliances are a new alternative that enable partnering firms to combine their individual strengths while compensating for their internal resource scarcities without making the investment required for actual ownership. While interest in alliances is growing, firms are often unsure how to build and maintain successful alliances. This research examines alliances between manufacturers and their suppliers in the food and health/personal care industries to determine what factors lead to successful, long term alliances