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This paper aims to examine the concept of sustainability in health care organizations and the key managerial competencies and change management strategies needed to implant a culture of sustainability. Competencies and management development strategies needed to engrain this corporate culture of sustainability are analyzed in this document.

This paper draws on the experience of the authors as health care executives and educators developing managerial competencies with interdisciplinary and international groups of executives in the last 25 years, using direct observation, interviews, discussions and bibliographic evidence.

With a holistic framework for sustainability, health care managers can implement strategies for multidisciplinary teams to respond to the constant change, fine-tune operations and successfully manage quality of care. Managers can mentor students and provide in-service learning experiences that integrate knowledge, skills, and abilities.

Further empirical research needs to be conducted on these interrelated innovative topics.

Health care organizations around the world are under stakeholders' pressure to provide high quality, cost-effective, accessible and sustainable services. Professional organizations and health care providers can collaborate with university graduate health management education programs to prepare competent managers in all the dimensions of sustainability.

The newly designated accountable care organizations represent an opportunity for managers to address the need for sustainability.

Sustainability of health care organizations with the holistic approach discussed in this paper is an innovative and practical approach to quality improvement that merits further development.

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.

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.

The authors discuss the drug development process, the role of CROs and outsourcing in clinical research. Pharmaceutical companies began outsourcing research activities to increase their profit margins and better position themselves in the rapidly‐changing healthcare environment. The paper analyzes the evolution of the CROs over time and the factor that affected it, including the current globalization stage with special emphasis in India, China and Central and Eastern Europe. Consequences of globalization include the stimulation of research collaboration, policy and issues related to quality.

The evolution of CROs over time points to transformation/evolution of these organizations, with challenges as they become an integral part of the drug development process in the USA and other countries.

Although researchers have highlighted the importance of relational and family factors for the sustainability of a family firm, there is not much empirical research exploring how emotions and the management of emotions play a role in the interpersonal dynamics of family business owners. The purpose of this paper is to explore how the way family members manage their emotions affects the interpersonal dynamics in the family, business, and ownership subsystems of a family firm.

The paper presents an in-depth case study from a family firm in Colombia-South America.

The results indicate that the capability that family members have to manage their emotions influences the interpersonal dynamics that take place in the family firm at the individual and group level. In this case, the paper found that although emotional intelligence (EI) affected interpersonal relationships in a firm, this effect was based on the individual's willingness to use their EI capabilities, previous history between people, and the goals individuals have within each subsystem in a family firm. The paper also found that interpersonal dynamics, in turn, influence how family members work together.

Because this study uses an in-depth case study, the intention of the paper is to provide an initial picture of how EI can play a role in the interpersonal interactions between family business owners. The authors hope that this study can be used as a building block to enhance the understanding of the role of EI in family firms.

EI represents an individual's capability to perceive, understand, manage, and regulate self and other's emotions. For family firms, this means that family business owners can use this capability to determine how to enact their roles in the family firm and how to interact with other to ensure harmony in their relationships.

This paper builds on previous work on emotions in family firms to explore the role of EI in family firms, and provides an empirical exploration of the role of management of emotions in family firms.

The purpose of this paper is to focus on the family protocol as a governance policy tool that can help ameliorate intra-family conflict and enhance the probabilities of survivability of the family business.

Using equity theory and organizational justice as theoretical frameworks, the authors explain how and why the development of a protocol can help the family firm and their survivability. The authors combine academic and practitioner knowledge to present a process model for creating family protocols.

Based on four important considerations (i.e. process view, deep knowledge about the family business, dynamic environment, and the need for change and adaptation) the authors develop a process model for the development of family tailored protocols.

This paper integrates the work of practitioners and academics to help understand what is a family protocol, why and how the protocol affects the family and business relationships and presents a procedural model for the development of a family protocol that can help govern the relationship between the family and the business.

This study aims to explore how emotional intelligence (EI) in members of family businesses can enhance the relationships with the stakeholders and whether adopting a relationship marketing approach could extend a family businesses' longevity, the businesses' success through generations.

A mixed-method approach was adopted, and two studies (quantitative followed by qualitative) were conducted in Mexico on small to medium-sized enterprises. This study considers the perspective of owners and employers of family businesses.

The study provides important insights into the relationship between EI and relationship marketing. Enhancing EI in family members whilst conducting a relationship marketing approach, both internal and external, will result in better performance. Family businesses can alleviate conflicts inherent to family emotions whilst building and maintaining strong relationships with customers and suppliers that can secure the long-term success of the organisation by enhancing EI.

Considering the majority of the literature is focussed on highly developed economies such as the USA, the UK and major developing economies such as China and India, this mixed-method study offers Mexico as a novel setting that has become an important procurement hub in light of the recent global developments and international relationship policies.

This paper attempts to fill the gap that exists in research regarding 20th-century heritage and its social appreciation. The purpose of this paper is to explore different ways of evaluating the heritage value and tourism potential and to propose an innovative model validated in the Zarzuela Hippodrome as an example of cultural asset from 20th century with important economic, social, cultural, aesthetic and architectural aspects.

This study opted for an interpretation of heritage from an ecosystem, integrating and global paradigm, understanding the asset as a set of resources that interact with each other, generating a common and enriched tourist experience among all the elements that make it up. From this perspective, it is conceived that by modifying one of the elements, the whole (tourist) ecosystem will be equally influenced. On the other side, it was incorporated non-parametric techniques based on the implementation of surveys for the validation of the tool to the case study of the Zarzuela hippodrome.

The results suggest that the hippodrome's internal values have been evaluated very positively, while its external values are low. Through this study, the paper has identified several weaknesses that impede its functioning as a viable “tourist product.” The distance from the city center, the lack of available information and the scarce diffusion and tourism promotion are its main weaknesses. The proposed analysis tool reveals the importance of the active participation of visitors to evaluate cultural assets through the combination of aspects related to the conservation of cultural assets and, in turn, elements that encourage their commodification as tourist products, break down barriers between these two disciplines.

The management tool proposed in this study can be used to underpin the creation of tourism experiences in cultural or heritage assets by diagnosing the current state of its tourist potential, quantifying its value in relation to the visitors’ perception and making visible those problematic aspects to develop actions to solve them. Although the present study is support for future research, as well as for improving the marketing of heritage in tourist settings, an in-depth analysis of the technical elements of heritage, as well as of its intervention (if applicable), will be necessary for the managers who want to use the tool.

One of the most differentiating characteristics between the construction typology of 20th-century historical buildings is perhaps the scarcity of decorative ornamentation, with exposed concrete being the main surface coating. Many of these constructions have an important cultural and historical relevance, however, the social perception, as regards its consideration as architectural and artistic heritage seems to reflect discordant aspects. This study provides support as a decision-making tool to determine the existing valuation of a building and how to enhance it.

This study takes steps toward the creation of a model that supports decision-makers and owners of cultural assets through a measurement system that makes it possible to quantify and determine the current state of tourism use through the social evaluation of heritage criteria. It defines which are the elements that favor the resilience of the property or, on the contrary, which are those that undermine its enhancement.

The purpose of this paper is to address the use of sludge from water treatment plant (WTP sludge), in its natural form (wet), in the construction industry, especially in the production of concrete, evaluating the effects of replacing natural sand with different WTP sludge levels in the concrete properties.

The dosage study evaluated mixtures with replacement levels of 0, 5, 7 and 10 percent of wet sludge in relation to the mass of natural sand, analyzing their effects on mechanical properties and water absorption in concrete with water/cement (w/c) ratios of 0.45, 0.55 and 0.65.

From the results obtained, it is possible to note that the addition of WTP sludge in its natural form (wet) reduces the strength of concrete. However, from a technical point of view, a level of replacement of up to 5 percent for applications in concrete is suitable, provided that it is not structural concrete.

Further studies should be conducted to verify the influence of the replacement of sand for heat-treated sludge in concrete properties, also analyzing the environmental viability linked to the calcination process.

Few studies are conclusive in relation to the use of WTP sludge in concrete production. This study shows statistically the negative effect of the addition of wet sludge in the mechanical properties and in the water absorption of concretes from different w/c ratios.

This empirical study aims to identify the essential strategic leadership and management factors underlying sustainability in healthcare. It also examines which factors drive sustainability performance outcomes (SPO) in health-care organizations, an analysis lacking to date. It provides a strategic leadership and management perspective toward sustainable healthcare, responding to the United Nations Sustainable Development Goals.

The investigation adopted Sustainable Leadership as its research framework. Using a cross-sectional survey, 543 employees working in health-care and pharmaceutical companies in Thailand voluntarily provided responses. Factor analyses and structural equation modeling were employed.

The results revealed an emergent research model and identified 20 unidimensional strategic leadership and management factors toward sustainability in healthcare. The findings indicate significant positive effects on SPO in health-care organizations. Significant factors include human resource management/development, ethics, quality, environment and social responsibility, and stakeholder considerations.

The study was conducted in one country. Future studies should examine these relationships in diverse contexts. In practice, health-care firms should foster significant strategic leadership and management practices to improve performance outcomes for sustainability in healthcare.

This paper is the first empirical, multidisciplinary study with a focus on strategic leadership, health-care management and organizational sustainability. It identifies a proxy for measuring the effects of essential strategic leadership and managerial factors for sustainability in pharmaceutical health-care companies. It advances our currently limited knowledge and provides managerial implications for improving performance outcomes toward sustainable healthcare.

The purpose of this paper is to examine how service companies can create value by developing cooperative relationships between different network actors, with particular focus on the role of the customer.

The actual analysis is preceded by a review of the principal articles on service management, with particular reference to the move from Fordist to neo‐industrial logic as well as the role of customer participation in value creation, highlighting how the role of the customer in service production has changed and how the customer can participate in creating value in a network perspective.

Effectively developing cooperative relationships in a network is linked to the key role played by the strategic centre firm. This paper highlights the role of the strategic centre firm in organizing relationships by coordinating all the actors involved.

This paper shows how each actor in the network makes an important contribution to value creation by actively participating in multiple cooperative arrangements coordinated by the strategic centre firm.