A clinical trial manager at a rare disease company calls me, voice tight with concern. Their leading research site, the linchpin for meeting their study timelines, hasn’t enrolled a single patient in weeks. The CTMS confirms the situation: there’s been a sharp decline in screening and enrollment activity. The study coordinator and the PI? MIA. The study lead? The manager was desperate for a progress update.

This scenario might sound all too familiar, right? But here’s the kicker: Our default response tends to be throwing more money at patient recruitment. It’s like we’re Pavlov’s dogs, conditioned to react a certain way to the same old problem. But what we often overlook is that slow enrollment isn’t always about a shortage of eligible patients. More often than not, it’s about the overwhelming workload suffocating
research sites.

In my two decades of experience with site management, I’ve learned that slow enrollment can often be a symptom of site overload, not a dearth of willing participants. These sites are juggling many variables beyond their control, without sophisticated forecasting tools to help them anticipate the ups and downs of demand. Sometimes they’re forced to hit pause on enrolling new patients just to catch up with the backlog of visits for existing ones. To exacerbate the problem, the decline in enrollment gets slapped onto the site’s performance report like a scarlet letter.

How do we break free from this cycle? Well, for starters, let’s do these two things:

Rethink the metrics we’re using. Instead of fixating on enrollment rates in isolation, we should focus on:

  1. outsourcing administrative tasks to lighten the load,
  2. embracing digital solutions like remote consent and home visits, and/or
  3. bringing in contractors to beef up site teams.

Get innovative with how we manage talent and skills. It’s all about having a Plan B (and maybe even a Plan C) ready to roll when things hit the fan. That could mean:

  1. understanding the effort required by different types of resources to complete the protocols,
  2. evaluating the availability of resources at our site,
  3. and understanding the impact of a streamlined study design on enrollment.

When we implemented these measures, not only did we ease the immediate pressure for greater enrollment, but we also saw improvements in staff and patient retention rates. It turns out that aligning activities with team strengths and needs can do wonders for trial efficiency.

Patient recruitment has been the bane of our existence for decades, but let’s not allow it to become the scapegoat for every hiccup we encounter. If we truly want to streamline study efficiency, we’ve got to roll up our sleeves and diagnose the real issues at hand. In this case, it wasn’t a shortage of patients but rather a misalignment of talent deployment. Sure, a dashboard can help flag a problem, but we’ve got to dig deeper into the efficiency of our studies before we start doling out solutions.

It’s all about recognizing that what appears to be a recruitment shortfall often masks deeper capacity issues. By pinpointing these challenges and deploying resources accordingly, we can empower research sites to reach their full potential. If you’re ready to untangle the knots and optimize your site’s performance, reach out to us today. Let’s tackle this together. Get in touch.