This study analyzes the strategic role of public healthcare organizations in promoting clinical research, through a case
study of the Pisan University Hospital (AOUP). Using a qualitative methodology based on interviews and institutional data, the dual role of AOUP is highlighted ‒ both in coordinating competitive projects and in managing sponsored clinical studies, whether for-profit or non-profit. The results show a progressive consolidation of the organization’s scientific, regulatory, and managerial capacities, enhancing its appeal as a research partner. The integration of healthcare, education, and research emerges as an enabling factor for generating value, innovation, and institutional relationships. The study offers insights for defining sustainable models of research governance within healthcare organizations.