Special article
The Pan American and Iberian Federation of Critical Medicine and Intensive Therapy develops its Strategic Plan
La Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva elabora su plan estratégico
N. Raimondia, A. Quintero Villarealb, A. Valdivia Nuñezc, M.C. Martín Delgadod,
, Participants in the Ad Hoc Task Force for the design of the FEPIMCTI Strategic Plan 1
Corresponding author
a División de Terapia intensiva, Hospital Juan A. Fernández, Buenos Aires, Argentina
b Servicio de Medicina Crítica, Imat Oncomédica, Montería, Colombia
c Consultor independiente en Gestión Estratégica y Administración, Estado de México, Mexico
d Servicio Medicina Intensiva, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain
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Fernández, Buenos Aires, Argentina" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Crítica, Imat Oncomédica, Montería, Colombia" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Consultor independiente en Gestión Estratégica y Administración, Estado de México, Mexico" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio Medicina Intensiva, Hospital Universitario de Torrejón, Torrejón de Ardoz, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "La Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva elabora su plan estratégico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1821 "Ancho" => 3167 "Tamanyo" => 551306 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">2017–2022 Strategic Summary from the Pan American and Iberian Federation of Critical Medicine and Intensive Therapy (FEPIMCTI).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The Pan American and Iberian Federation of Critical Medicine and Intensive Therapy (FEPIMCTI) is an organization comprising professional associations in Critical Medicine from different countries in the Americas and the Iberian Peninsula. The FEPIMCTI was founded in Mexico City back in September 12th, 1980 by doctors Alberto Villazón Sahagún, MD and Sergio Rangel Carrillo, MD in an attempt to broaden its horizons and consolidate the presence of Critical Care Medicine in its geographical scope of influence.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> To this day, it includes associations and societies from 17 different countries in the Americas, Spain, and Portugal with a wider scope of action and more significant international geographical setting.</p><p id="par0010" class="elsevierStylePara elsevierViewall">It is easy to understand what a tremendous challenge it is for this Federation<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">2,3</span></a> to bring together the efforts from different countries with such diverse levels of scientific, social, and economic development where different models of Intensive Medicine coexist with different organizational structures and, in some cases, limited resources including their own very respectable expectations and interests.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Scientific societies are created to promote, develop and share specialized knowledge which, in our case, is Critical Care or Intensive Medicine, to generate value for their associates and members in their corresponding professional settings.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Along its 38 years of existence, the Federation has accumulated multiple experiences and achievements. However, as it occurs with every evolving organization, there are important challenges ahead and opportunities for self-development.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Aware of this reality, the FEPIMCTI decided to come up with a long-term plan to define goals that would take into consideration the needs, interests, and aspirations of its member societies by giving value to their associates. This plan would become the meeting point for the collaborative efforts of these societies in an attempt to achieve their best academic and scientific level.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In the field of administrative sciences, there are different ways to design a strategic plan. The participatory methodology was the chosen one because of its proven effectiveness. The FEPIMCTI Board of Directors together with expert representatives from the different associations actively worked together in a 2-day workshop that was held in the City of Querétaro, México, from October 11th through October 12th, 2017 as part of the 44th Annual Congress organized by the Mexican College of Critical Care Medicine.</p><p id="par0035" class="elsevierStylePara elsevierViewall">At this event, there was a detailed analysis of all the internal and external factors that describe the actual and future situation of the Federation. As a matter of fact, through different group activities, the actual strengths and weaknesses of the organization were determined. The opportunities and threats the organization may face in the near future were also part of the discussion. Different factors from the economic, social and scientific backgrounds were also identified and then interconnected to build three different scenarios that may occur during the next five years.</p><p id="par0040" class="elsevierStylePara elsevierViewall">With the information generated and with the consensus of all participants, the mission, vision and principles, strategic goals, action programs, and performance indicators were defined together with the people who would be responsible for implementing the plan (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Among the strategic goals okayed in this plan, the consolidation of the legal, fiscal, and administrative structures of the Federation has been prioritized as an essential step before achieving the remaining goals.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The second strategic goal identified is to update the statutes that will stand as the appropriate legal framework within which the organization will take future steps.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Other strategic goals established are: the implementation of a process management system by defining and normalizing the Federation executive processes and proceedings within a culture of quality that will lay the foundation of homogeneous actions when facing different scenarios; another goal is the creation of expert committees in different areas of Intensive Medicine that, in a transversal participative approach, will promote knowledge as the cornerstone of our scientific society</p><p id="par0060" class="elsevierStylePara elsevierViewall">Another long-term goal is to achieve academic excellence through training and educational programs and courses that will consistently address different aspects on the management of the critically ill patient so they can be effective and efficiently replicated in different countries.</p><p id="par0065" class="elsevierStylePara elsevierViewall">The inclusion of new scientific societies or the creation of new societies in countries without and where the Federation can play a significant role was another goal of the strategic plan. This implies an intense and continuous effort to move ahead in the process of integrating the institutions responsible for Critical Care Medicine under the scope of action of the Federation.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Finally, to consolidate the presence, image and visibility of the Federation was considered a successful strategic boost and critical element. This means new ways of communication and participation to secure the positioning of FEPIMCTI as a reference scientific society in Critical Care Medicine.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Once the aforementioned goals and strategies have been defined, it is mandatory to implement the program worksheets and follow-up that will make the expected outcomes a reality.</p><p id="par0080" class="elsevierStylePara elsevierViewall">During the month of June of this year at the Congress of Critical Care Medicine held in Panamá, the first follow-up and assessment of the plan's progress was made. The results are promising and six months after the plan was designed, we can say that the programs envisioned have become a reality in due time.</p><p id="par0085" class="elsevierStylePara elsevierViewall">Achieving these goals thanks to the analysis, debate, and consensus of the CEOs and distinguished members of the Federation will bring us the image we wish to have in the future with a clear vision in mind as this statement shows:<span class="elsevierStyleDisplayedQuote" id="dsq0005"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">“The FEPIMCTI wishes to be recognized worldwide as a dynamic and inclusive organization that comprises the associations, colleges and societies in Critical Care Medicine in the Americas and the Iberian Peninsula. Our goal is to promote the development and spreading of knowledge and scientific research on Intensive Therapy by expert multidisciplinary teams under the ethical principles of humanism, scientific rigor, social solidarity and professionalism for the benefit of all critically ill patients, healthcare institutions, intensivists, and society in general”.</p></span></p><p id="par0090" class="elsevierStylePara elsevierViewall">Strategic planning is writing in a piece of paper, in a systematic and orderly manner, how an organization wishes to transcend itself from its actual situation to an ideal situation in the future.</p><p id="par0095" class="elsevierStylePara elsevierViewall">It is a set of decision-making criteria and resolutions—that an organization implements to guide its activities and configuration in a decisive and permanent way. The strategic plan is transformational in nature and looks after the competitive advantage of the organization.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">In sum, a strategic plan brings added value to an organization, it makes the board of directors think about the future, predisposes and prepares to face new changes, improves the coordination of activities, anticipates unexpected events by reducing possible conflicts, improves communication, and adjusts the resources available to the opportunities that may arise.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">In general, the medico-scientific societies led by their democratically elected-CEOs or Board of Directors make decisions based on their criteria and experiences without taking into consideration the framework of reference that a strategic plan provides, which ends up conditioning the future—at least in the short or mid-term—of these societies. Past experiences show how valuable strategies are for the directors of these associations since they make them feel responsible for the decisions made that affect the future of the society. Also, strategies encourage the society to be more participative—especially if all groups of interest are involved—and reduce the possibility of error in the decision-making process under the idea of strategy-based decisions.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">7</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">The main obstacles to a successful strategic plan are: the involvement of the wrong kind of people, leave out the most important aspects, not take into consideration the necessary resources to implement it, or exhaustion during the planning stage before it is ever implemented.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">FEPIMCTI's strategic plan should be capable of bringing a strategic position to this Federation to make its member national societies feel included, represented, willing and motivated to elevate the Intensive Medicine of all member countries to a level of excellence that will eventually result in better care for critically ill patients and their families. Scientific development and research should be the driving force to lead this change. Hence, the Federation needs to do whatever it takes to make this possible.</p><p id="par0120" class="elsevierStylePara elsevierViewall">From the Federation Board of Directors, we hope that this strategic plan will meet the goals for which it was intended. It requires the exposure and participation from all agents involved through a systematic, rational, and comprehensive process that will put our organization at the heart of much-needed, relevant, and lasting transformations in the future.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest whatsoever.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:7 [ 0 => array:3 [ "identificador" => "xres1172592" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1096783" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1172591" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1096782" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 5 => array:2 [ "identificador" => "xack400698" "titulo" => "Acknowledgments" ] 6 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-07-31" "fechaAceptado" => "2018-08-28" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1096783" "palabras" => array:3 [ 0 => "Intensive Medicine" 1 => "Strategic Plan" 2 => "FEPIMCTI" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1096782" "palabras" => array:3 [ 0 => "Medicina Intensiva" 1 => "Plan estratégico" 2 => "Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The Pan-American and Iberian Federation of Critical Medicine and Intensive Therapy, A.C. (FEPIMCTI), has prepared its Strategic Plan for the next 5 years. In this Plan, it defines its course towards the future, establishes its long-term objectives and works to achieve success. Its strategic objectives are framed in consolidating the legal, fiscal and administrative structure, the updating of its statutes, the implementation of a process management system encompassed in a quality culture, the implementation of committees of experts, achieving academic excellence by developing training programs and giving visibility to the Federation. Their main values refer to equity, professionalism, respect and social solidarity. The implementation of the Strategic Plan in a collaborative manner must serve as a driving force for change to position FEPIMCTI as a relevant Scientific Society in the Critical Medicine of its member countries.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva, A.<span class="elsevierStyleSmallCaps">C</span>. (FEPIMCTI), ha elaborado su plan estratégico para los próximos 5 años. En este plan define su rumbo hacia el futuro, establece sus objetivos a largo plazo y trabaja para alcanzar el éxito. Sus objetivos estratégicos se enmarcan en consolidar la estructura legal, fiscal y administrativa, la actualización de sus estatutos, la implantación de un sistema de gestión de procesos englobados en una cultura de calidad, la puesta en marcha de comités de expertos, lograr la excelencia académica mediante la elaboración de programas formativos y dar visibilidad a la Federación. Sus principales valores hacen referencia a la equidad, profesionalismo, respeto y solidaridad social. La implantación del plan estratégico de forma colaborativa debe servir de motor de cambio para posicionar a la FEPIMCTI como sociedad científica relevante en la Medicina Crítica de los países miembros.</p></span>" ] ] "NotaPie" => array:2 [ 0 => array:3 [ "etiqueta" => "1" "nota" => "<p class="elsevierStyleNotepara" id="npar0010"><a class="elsevierStyleCrossRef" href="#sec0010">Appendix A</a> includes the members from the Ad Hoc Task Force for the design of the FEPIMCTI Strategic Plan and the observers who collaborated in the design of the plan.</p>" "identificador" => "fn0005" ] 1 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Raimondi N, Quintero Villareal A, Valdivia Nuñez A, Martín Delgado MC y Grupo de Trabajo ad hoc para la formulación del Plan Estratégico de la FEPIMCTI. La Federación Panamericana e Ibérica de Medicina Crítica y Terapia Intensiva elabora su plan estratégico. Med Intensiva. 2019;43:176–179.</p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:3 [ "apendice" => "<p id="par0135" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Participants in the Ad Hoc Task Force for the design of FEPIMCTI Strategic Plan:</span> Néstor Raimondi (Argentina); Agamenón Quintero Villarreal (Colombia); Rolando A. Gimbernat (Argentina); José Luis Vergara Centeno (Ecuador); Alfredo A. Matos (Panamá); Sebastián Ugarte U. (Chile); Gloria Rodríguez-Vega (United States); María Cruz Martín (Spain); Guillermo Castorena Arellano (Mexico); Víctor Manuel Sánchez Nava (Mexico); Ignacio Previgliano (Argentina); Alfredo A. Sierra Unzueta (Mexico).</p> <p id="par0140" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Observers:</span> Humberto Arenas Márquez (president of the Latin American Federation of Nutritional Therapy, Clinical Nutrition and Metabolism [FELANPE]); Diego Arenas Moya (secretary of the Latin American Federation of Nutritional Therapy, Clinical Nutrition and Metabolism [FELANPE]).</p>" "etiqueta" => "Appendix A" "identificador" => "sec0010" ] ] ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1821 "Ancho" => 3167 "Tamanyo" => 551306 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">2017–2022 Strategic Summary from the Pan American and Iberian Federation of Critical Medicine and Intensive Therapy (FEPIMCTI).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Desarrollo del cuidado intensivo en Latinoamérica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E. Celis-Rodríguez" 1 => "S. Rubiano" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Todo Hosp" "fecha" => "2007" "paginaInicial" => "97" "paginaFinal" => "100" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0050" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The practice of intensive care in Latin America: a survey of academic intensivists" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Latin-American Intensive Care Network – LIVEN (ww***w.redliven.org)" "etal" => true "autores" => array:6 [ 0 => "R. Castro" 1 => "N. Nin" 2 => "F. Ríos" 3 => "L. Alegría" 4 => "E. Estenssoro" 5 => "G. Murias" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/s13054-018-1956-6" "Revista" => array:5 [ "tituloSerie" => "Crit Care" "fecha" => "2018" "volumen" => "22" "paginaInicial" => "39" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29463310" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0055" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Organizational issues, structure, and processes of care in 257 ICUs in Latin America: a study from the Latin America Intensive Care Network" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Latin-American Intensive Care Network (LIVEN)" "etal" => true "autores" => array:6 [ 0 => "E. Estenssoro" 1 => "L. Alegría" 2 => "G. Murias" 3 => "G. Friedman" 4 => "R. Castro" 5 => "N. Nin Vaeza" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Crit Care Med" "fecha" => "2017" "volumen" => "45" "paginaInicial" => "1325" "paginaFinal" => "1336" "itemHostRev" => array:3 [ "pii" => "S0140673609614926" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0060" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Documento sobre la situación del modelo español de Medicina Intensiva. Plan estratégico SEMICYUC 2018-2022" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Grupo de Trabajo de Planificación, Organización y Gestión de la Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (GTPOG-SEMUCYUC)" "etal" => false "autores" => array:6 [ 0 => "P.M. Olaechea Astigarraga" 1 => "M. Bodi Saera" 2 => "M.C. Martin Delgado" 3 => "M.S. Holanda Peña" 4 => "A. García de Lorenzo y Mateos" 5 => "F. Gordo Vidal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medin.2018.04.008" "Revista" => array:2 [ "tituloSerie" => "Med Intensiva" "fecha" => "2018" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0065" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La planificación estratégica en las organizaciones sanitarias" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F. Rodríguez Perera" 1 => "M. Peiró Posadas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Esp Car" "fecha" => "2012" "volumen" => "65" "paginaInicial" => "749" "paginaFinal" => "754" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0070" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "What is strategy?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M.E. Porter" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Harv Bus Rev" "fecha" => "1996" "paginaInicial" => "4" "paginaFinal" => "21" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0075" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Plan estratégico de la Sociedad Catalana de Medicina Intensiva y Crítica (SOCMIC)" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Grupo de trabajo ad hoc para la formulación del Plan Estratégico de la SOCMIC" "etal" => false "autores" => array:4 [ 0 => "M.C. Martín" 1 => "J. Ruiz" 2 => "L. Blanch" 3 => "E. Díaz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med Intensiva" "fecha" => "2003" "volumen" => "27" "paginaInicial" => "32" "paginaFinal" => "41" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0080" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The rise and fall of strategic planning" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. Mintzeberg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Harv Bus Rev" "fecha" => "1994" "paginaInicial" => "107" "paginaFinal" => "111" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack400698" "titulo" => "Acknowledgments" "texto" => "<p id="par0130" class="elsevierStylePara elsevierViewall">We wish to thank the engineer Mr. Abel Valdivia Nuñez (México) for his contribution as a consultant during the design of the plan. Also, we wish to thank the Mexican College of Critical Care Medicine (COMMEC) and the Panamá Association of Critical Care and Intensive Therapy (APMCTI) for their contribution making the workshops possible.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/21735727/0000004300000003/v1_201903300628/S2173572719300177/v1_201903300628/en/main.assets" "Apartado" => array:4 [ "identificador" => "409" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Special article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735727/0000004300000003/v1_201903300628/S2173572719300177/v1_201903300628/en/main.pdf?idApp=WMIE&text.app=https://medintensiva.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173572719300177?idApp=WMIE" ]
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