Treat Your Sites Like Customers (to boost enrollment)

Over the past few years, we’ve heard much about “patient-centricity” in our industry.  However, this year’s trend is “site-centricity”.

This article dives into treating study sites likes customers as a patient recruitment strategy.

Companies in other industries have worked under this mindset for years.  Familiar examples are Zappos, Amazon, Trader Joe’s, and Apple.  It’s no coincidence they’re all successful and loved by customers.

But what exactly is customer-centricity and how can we apply it to clinical trial sites?  After all, a clinical trial is a research project – not a business transaction.

Forbes defines customer-focused companies as having these 10 traits:

1. Focused on Client Experience
2. Engaged in Client Thought Process
3. Engaged Leadership
4. Engaged Workforce
5. Collaborative w/Clients
6. Responsive
7. Creative
8. Innovative
9. Individual Attention
10. Social Conscientiousness

Reading down the list, applying these traits to study site management doesn’t seem so far fetched after all!

Site supporting activities for your Clinical Operations team:

Some of these activities are standard, but usually done in a rote way.  Teams may want to redesign they ones they’ve already implemented to better address sites’ perspective.

• Biweekly phone calls (study coordinator) – Divvy up the sites among your team for a 10 minute call.  Ask the following (and action input where possible).  Log this valuable feedback in a tracker and meet regularly to discuss/action.
  • What do you like about working on our study?
  • What do you not like?
  • How’s enrollment?  Are there challenges?
  • How can we help you with enrollment?
  • Are there any helpful tools we can create for you?
• Monthly phone calls (PI) – Remember #3 in the above list?
  • Ask your medical monitor to make the same call, but to ask specifically about protocol challenges and inclusion/exclusion criteria clarity.
• Sponsor oversight visits -These aren’t trainings (like PSVs and SIVs), but 1-2 hour meetings to engage sites mid-study.  You can also share data and updates.
  • Divvy up the regions among your team and do a whistle stop tour.
  • Ask your medical monitor to cover a region or two.
  • You can also conduct these as needed for non-compliant sites.
• Webinars
  • Many sponsors already hold webinars to train sites on protocol amendments and EDC enhancements
  • However, not many sponsors present study data.   Study coordinators and PIs love seeing the big picture.  And positive data is motivating!
  • Always drive the webinar agenda and prompt related discussion with specific questions.  Don’t be afraid to call out attendees.  Typically, just asking “are there any questions” into the ether will result in silence.
• Newsletters – These are standard, but not always read by sites.  Want to increase your chances?  3 words: short, novel, and clear.  For all content or prizes, remember to solicit guidance from your Legal and/or Clinical Compliance groups.
  • Short:  1-2 pages max.  If you need to communicate more information, increase frequency, not length.
  • Clear:  Make it eye catching and easy to read.  You can create a professional, well designed, and organized newsletter in minutes using a drag/drop app like Canva. 
  • Novel:  We’ve all seen newsletters that are essentially the same reminders week after week.  Your site will learn to ignore anything repetitive.  If you must include, keep these in a small “reminders corner”.  Better content ideas:
    • Announcement of recently achieved study milestones,
    • Critical study changes (e.g. amendment) and their explanation (remember, people want the “why”)
    • Patient/site interviews
    • Enrollment or study conduct tips from successful sites
    •  Issue trends
    •  Contest announcements (see below)
• Contests with prizes – Bring out your sites’ competitive spirit by announcing a monthly or quarterly enrollment contest.  Top 3 enrolling sites get small prizes or a newsletter feature.
• Protocol Tools – Mini slide trainings, laminated cards and other items summarizing/clarifying study procedures are helpful to sites.  Solicit ideas from your biweekly study coordinator calls (see above).
• Recruitment Tools – You can provide advertisement language, social media tips, or access to a sponsor’s patient recruitment vendor.  Of course, everything must first be approved by each site’s IRB. 
• Site website (portal) – If you’re up for it, create a password protected study-specific portal for your sites.  You can upload newsletters, study tools, and “how-to” videos.
  • Drag/drop website builders such as Squarespace make it easy.  You’ll also need to dedicate a Clin Ops resource, preferably one who’s enthused by the challenge.

You can brainstorm even more ideas with your team.  You may choose to double down on calls or visits for slow enrolling or very non-compliant sites.

Even if you use a great CRO, sponsor teams must drive these activities and be the face of the calls and visits.  Sponsor engagement is important to sites.

I’ve seen Clinical Operations teams come alive to use creativity and design skills for these projects.  People love unleashing their potential on high-impact, high-visibility, tangible goals.  Site interactions are also a nice way of breaking up a spreadsheet and document-filled day.

Putting it all together:

You can organize your site-centric strategy within a Site Management Plan.  In it, outline:

• Activities
• Activity frequency
• Activity start date
• Activity triggers (e.g. sponsor oversight visit for sites with no enrollment 30 days past activation date)
• Responsible parties.

Conclusion

Of course, some studies enroll themselves, and some sites will never enroll briskly despite how you engage them.  Careful site selection can mitigate the latter.  But even then, it’s important to understand that site selection is just the beginning of a relationship.  And all relationships need nurturing.

Unfortunately, many companies skip site-centric activities that can boost recruitment because they just don’t have time.  At Seascape Clinical, our mission is to help teams reclaim time to run studies efficiently and strategically.  To learn more, visit us at www.seascapeclinical.com

Sources

• https://www.forbes.com/sites/williamcraig/2018/04/10/10-traits-of-a-client-focused-company/#13ae6e4324c
• https://acrpnet.org/2020/01/14/leave-no-site-behind-how-sites-sponsors-and-cros-can-speed-clinical-research-together/
• https://forteresearch.com/news/recruitment-efforts-fail-enroll-enough-patients/