The role of academic health centers in addressing social responsibility.

Despite the many successes achieved by academic health centers and the significant attention paid to the importance of the impact of social determinants on health, a broader movement of the academic health center community to share best practices and standardize these efforts across institutions and communities has not taken hold. The "guild mentality" of the health professions, the existing university/academic health center structure, regulation and accreditation, and misaligned incentives in the health care system all inhibit the development of this movement. In this article, we propose a new model for how the academic health center community might better address the social determinants of health.

Commentary: Compliance education and training: a need for new responses in clinical research.

Increasing regulatory mandates, heightened concerns about compliance, accountability, and liability, as well as a movement toward organizational integration are prompting assessment and transformation in education and training programs at academic health centers, particularly with regard to clinical research compliance. Whereas education and training have become a major link between all research and compliance functions, the infrastructure to support and sustain these activities has not been examined in any systematic, comprehensive fashion, leaving many critical interrelated issues unaddressed. Through a series of informal interviews in late 2008 with chief compliance officers and other senior leadership at 10 academic health centers, the authors studied the organization, management, and administration of clinical research compliance education and training programs. The interviews revealed that while clinical research compliance education and training are undergoing growth and expansion to accommodate a rapidly changing regulatory environment and research paradigm, there are no strategies or models for development. The decentralization of education and training is having serious consequences for leadership, resources, and effectiveness. The authors recommend that leaders of academic health centers conduct a comprehensive analysis of clinical research compliance education and training as clinical trials administration undergoes change, focusing on strategic planning, communication, collaboration across the institution, and program evaluation.