Clinical Trials Enterprise at Large Research Academic Medical Center - Somehow, all these smart people are most impressed by how we use Monday.com!

We use Monday.com as our central system for daily operations tracking across clinical research administrative units. We use it as a ticketing/demand management system for service requests relating to clinic, coordinators, biostatistics, MRI, pharmacy, etc. We use it as a project portfolio management tool to focus our efforts and distributed assignments.
We started using it 5 years ago as a project management tool, and bit by bit it has grown to use throughout the entire organization. As a strategic initiatives group, we listen to other units and their operational challenges. So often, a Monday.com board is an efficient and user friendly solution for their problem. Its quick to deploy and looks great. The sharp, colorful look cannot be overestimated.
It solves integration problems for data, repetitive tasks, notifications, collaboration, change management, and countless administrative challenges in a clinical research enterprise.

It's been mostly great, with a couple of rare instances of automations suddenly disappearing or boards not being accessible. We had an instance where having many automations slowed things down. There is potential to create a hierarchy of automations to help with this, along with a search feature to sort through them better.
So for an organization like ours, uptime is fine. If we had totally mission critical processes (like patient facing, hospital type data) then we'd need a new SLA.