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PURPOSE: Cancer clinical trials offices (CTOs) support the investigation of cancer prevention, early detection, and treatment at cancer centers across North America. CTOs are a centralized resource for clinical trial conduct and typically use research staff with expertise in four functional areas of clinical research: finance, regulatory, clinical, and data operations. To our knowledge, there are no publicly available benchmark data sets that characterize the size, cost, volume, and efficiency of these offices, nor whether the metrics differ by National Cancer Institute (NCI) designation. The Association of American Cancer Institutes (AACI) Clinical Research Innovation (CRI) steering committee developed a survey to address this knowledge gap. METHODS: An 11-question survey that addressed CTO budget, accrual and trial volume, full-time equivalents (FTEs), staff turnover, and activation timelines was developed by the AACI CRI steering committee and sent to 92 academic cancer research centers in North America (n = 90 in the United States; n = 2 in Canada), with 79 respondents completing the survey (86% completion rate). RESULTS: The number of FTE employees working in the CTOs ranged from 4.5 to 811 (median, 104). The median number of analytic cases (ie, newly diagnosed or received first course of treatment) reported by the main center was 3,856. Annual CTO budgets ranged from $250,000 to $23,900,000 (median, $8.2 million). The median trial activation time, based on 61 centers, was 167 days. The median number of accruals per center was 480 (range, 5-6,271) and median number of trials per center was 282 (range, 31-1,833). Budget and FTE ranges varied by NCI designation. CONCLUSION: The response rate to the survey was high. These data will allow cancer centers to evaluate their CTO infrastructure, funding, portfolio, and/or accrual goals as compared with peers. A wide range in each of the outcomes was noted, in keeping with the wide variation in size and scope of cancer center CTOs across the United States and Canada. These variations may warrant additional investigation.

Purpose: This study’s purpose was to optimize the efficiency of and to design a scalable research scheduling team to meet the growing demands of an academic cancer center with increasing clinical trial accruals. Methods: The Plan, Do, Study, Act improvement methodology was deployed to increase the efficiency of research scheduling, to reduce non–value-added (NVA) activities, and to reduce cycle time to meet takt time. In the Plan phase, voice-of-the-customer interviews were conducted. In the Do phase, the baseline workflow was mapped and billing data were analyzed. In the Study phase, cycle time, takt time, and capacity analysis metrics were calculated at baseline. In the Act phase, interventions were implemented to increase efficiency by reducing NVA activities and increasing value-added activities, and metrics were reassessed after intervention. Results: An 8% increase in appointment requests was noted from baseline to after intervention, and the cycle time for appointment scheduling decreased by 11%, demonstrating increased efficiency. Process steps decreased from 15 to 10, eliminating NVA activities and rework and waiting, two types of waste. Conclusion: Although efficiency increased, the number of total appointments scheduled weekly increased by 4%, resulting in a reduced takt time, or a shorter time to schedule each appointment to meet demand. A capacity analysis demonstrated that even after interventions, an additional 0.5 full-time employee is required to reduce cycle time to equal takt time. Capacity analysis creates a scalable framework for the scheduling team and facilitates movement from reactive to proactive staffing, which can be applied throughout the research enterprise.

This paper reports on the findings of an investigation into supply chain process variability in the UK defence supply chain. The study's objectives were twofold: (1) to investigate the nature and causes of variability in the defence supply chain; and (2) to ascertain whether a six sigma methodology could be applied usefully in this context. Herein it is described how, by following the DMAIC (define, measure, analyse, improve and control) framework and employing a mixture of quantitative and qualitative tools, a number of specific problems and their root causes were identified. An action plan for improvement is put forward based on the findings of the study. The research concluded that six sigma has applicability in the defence supply chain. However, it was also concluded that it is unlikely to be implemented throughout the supply chain under present circumstances, due to current stock holding policies and low levels of activity in certain demand categories. Statistical process control methods were neverth...

Supply chain vulnerability has become a fashionable area of management research. The purpose of this paper is to provide a critique of the extant canon and to review of the positioning of research in the field, together with literature drawn from several relevant and overlapping fields of research and practice. The aim is to foster a more explicit understanding of the relationships between supply chain vulnerability, risk and supply chain management, and in turn their relevance to related fields such as corporate governance, business continuity management, security and emergency planning. The ultimate objective is to clarify the agenda for further research. The paper begins with an examination of the concept of a “supply chain” and the scope and nature of supply chain management (SCM), then the fusion of SCM with the many and varied interpretations of “risk” and its faltering relationship to risk management. It is argued that attitudes to risk and approaches to risk management vary greatly within SCM and ...

PurposeThe purpose of this paper is to address the increasingly important question of supply chain design for global operations. With the rise of off‐shore sourcing and the simultaneous need for improved responsiveness to customer demand, the choice of supply chain strategy is critical.Design/methodology/approachThe paper draws its conclusions from case‐based research supported by survey data.FindingsThe paper provides evidence that the choice of supply chain strategy should be based upon a careful analysis of the demand/supply characteristics of the various product/markets served by a company. It presents the basis for a taxonomy of appropriate supply chain strategies.Research limitations/implicationsThe case studies and empirical research reported in this paper are specific to the clothing manufacturing and fashion industries and there would be benefit in extending the research into other sectors.Practical implicationsGiven the increasing trend to out‐sourcing and off‐shore sourcing, the choice of supply chain strategy is of some significance and clearly impacts competitive performance.Originality/valueWhilst there is a growing recognition of the need to match the supply chain to the market, there is still limited research into what criteria should be utilised to aid the choice of supply chain strategy. This paper attempts to extend our understanding of the issues.

PurposeThis paper aims to report on findings of a cross‐sector empirical study of the sources and drivers of supply chain vulnerability.Design/methodology/approachThe research was undertaken in accordance with the realist tradition. It begins with a descriptive exploratory stage involving an in‐depth exploratory case study of aerospace industry supply chains, validated through in‐depth interviews with managers representing other “critical sectors” of the UK economy. This is followed by an explanatory theoretical stage. The work is supported throughout with reference to relevant literature sources.FindingsThe findings highlight the absence of any widespread understanding of the scope of and dynamic nature of the problem, which should be considered from multiple perspectives and at four levels of analysis: value stream/product or process; asset and infrastructure dependencies; organisations and inter‐organisational networks; and social and natural environment.Research limitations/implicationsThe paper is normative rather than positive, so focuses on understanding why supply chains are vulnerable to disruption, rather than presenting itself as a prescription for management. The paper does not investigate academic definitions or existing taxonomies of risk.Practical implicationsThe work provides some useful insights for practising managers and policy makers.Originality/valueThe paper reports on empirical research, then draws as appropriate on network theory and complex systems perspectives to produce a conceptual model of a supply chain as in interactive adaptive system.

Fashion markets are synonymous with rapid change and, as a result, commercial success or failure is largely determined by the organisation's flexibility and responsiveness. Responsiveness is characterised by short time‐to‐market, the ability to scale up (or down) quickly and the rapid incorporation of consumer preferences into the design process. In this paper it is argued that conventional organisational structures and forecast‐driven supply chains are not adequate to meet the challenges of volatile and turbulent demand which typify fashion markets. Instead, the requirement is for the creation of an agile organisation embedded within an agile supply chain.

In today's uncertain and turbulent markets, supply chain vulnerability has become an issue of significance for many companies. As supply chains become more complex as a result of global sourcing and the continued trend to “leaning‐down”, supply chain risk increases. The challenge to business today is to manage and mitigate that risk through creating more resilient supply chains.

In recent years the issue of supply chain risk has been pushed to the fore, initially by fears related to possible disruptions from the much publicised “millennium bug”. Y2K passed seemingly without incident, though the widespread disruptions caused by fuel protests and then Foot and Mouth Disease in the UK, and by terrorist attacks on the USA have underlined the vulnerability of modern supply chains. Despite increasing awareness among practitioners, the concepts of supply chain vulnerability and its managerial counterpart supply chain risk management are still in their infancy. This paper seeks to identify an agenda for future research and to that end the authors go on to clarify the concept of supply chain risk management and to provide a working definition. The existing literature on supply chain vulnerability and risk management is reviewed and compared with findings from exploratory interviews undertaken to discover practitioners' perceptions of supply chain risk and current supply chain risk managem...

This paper reviews some of the existing literature on the subject of Co-Managed Inventory (CMI) and its antecedents, placing CMI within the wider lexicon of Efficient Consumer Response (ECR). It then moves on to consider the background and circumstances of the adoption of CMI by a number of leading players in the UK brewing industry, before presenting an empirical study of two of the programmes underway. Drawing on the experiences of these early adopters as they pass through the initial stages of implementation, it identifies some of the wider business implications ensuing from the introduction of these cooperative inventory management agreements.

Though a process perspective has been adopted in the emerging conceptualization of strategic marketing, little attention has been given to the development of relational exchanges from a strategy process perspective. In this paper we propose a framework for the investigation of corporate strategies for the management of suppliers in retailing companies. It focuses on retailer initiatives to transform arm's length relationships with suppliers into closer relational exchanges. By considering the interorganizational relationships at a subunit basis, it also integrates the role of relationships into the process. Using a case research approach, the authors derive research propositions for further investigation within the framework proposed.

The fashion industry has been beset by the problems of volatile and difficult to predict demand. Many companies involved in manufacturing and retailing in fashion markets have seen the profitability severely affected by their inability to match supply with demand. Traditionally, it was assumed that the problem lay with inaccurate forecasts and that if only those forecasts could be improved then everything would be fine. In fact, experience seems to suggest that even though forecasting techniques and methodology have continued to develop in their sophistication, they can never deliver the accuracy required for managing logistics in fast moving markets. The answer, we would suggest, lies not in better forecasts but in reducing the dependency on the forecast. The way to bringing this about, it can be argued, is through lead‐time management.

In this chapter we examine the customer market domain as the central market within the Six Markets model described in Chapter 1. The customer market domain addresses three broad groups: direct buyers, intermediaries and final consumers.

‘These are turbulent times in the world of organizations’, observed Miles and Snow 1 more than a decade ago, and there is every indication that the bumpy ride will continue beyond the turn of the century and into the new millennium. Behind the turbulence lies a series of frequently cited environmental factors: technological advances and the deregulation of markets, creating intensified global competition. These forces have changed and continue to change the dynamics of the marketplace, raising the profile of time-based competition and causing shifts in channel power. The world is becoming a buyers' market, where increasingly discerning customers are freer than ever to select from their global marketplace - something that many corporations in the Western world were woefully slow to grasp.

Strategy is the art of creating value. It provides the intellectual frame-works, conceptual models and governing ideas that allow a company's managers to identify opportunities for bringing value to customers and for delivering that value at a profit. In this respect, strategy is the way a company defines its business and links together the only two resources that really matter in today's economy: knowledge and relationships or an organization's competencies and customers.

This chapter addresses two key market domains within the six markets framework - the recruitment market and the internal market. It is appropriate to consider these two markets together, as it is the extent to which companies can successfully recruit, develop and train the right calibre of people for their organizations that will determine their future success in the internal market and ultimately with the customer market.

This chapter addresses two key market domains within the Six Markets model - referral markets and influence markets. In Chapter 1 of the book, the roles of referral markets and influence markets within the six markets framework were introduced. These two market domains can be described as follows.

The ‘Supplier’ and ‘Alliance’ markets or market domains are the focal point of this chapter. Whilst it may sometimes seem semantic to treat them separately - in the relationship marketing model they both need to be viewed as partnerships - there is a subtle distinction between the contributions they can make to the establishment of a successful relationship marketing strategy. Here we define them as follows

Under the leadership of Gorbachev and his instigation of the concepts of perestroika and glasnost, the USSR has had to admit to its economic problems and difficulties which are reflected in the extremely poor standard of living of the majority of its people. The problems have been exacerbated in the past by rigid ideology and theory which ignored the reality and led to the development of a vigorous illegal market. However, since the “revolutions” of 1989 many political changes have occurred, which in turn have precipitated greater communication between the states of Eastern Europe and those of the West. Some specific areas where there have been moves towards co‐operation between East and West are highlighted and examples given of organisations, which are achieving varying measures of success in expanding trade into Eastern Europe. The future prospects are analysed, particularly with reference to the debt problem, but overall the prevalent view is one of optimism and shared opportunities.