A Quick Re-Cap
I am Dr. Jeff Kingsley and this is another edition of Riding in Cars With Researchers! Today we are going to continue our conversation of balanced scorecards for research sites and we will specifically talk today about the enrollment metric. The enrollment metric is the most important metric you need to be following if you are a site. We will get into why, how you can track it, and what you can do about it.
First, a quick recap, a balanced scorecard is the sweet spot where you are paying attention to all of the needs of all of the stakeholders. I’ve talked about EQTCS – Enrollment, Quality, Timelines, and Customer Service. That’s what our customers (Sponsors/CROs) need of us. That’s what they need of sites. Your balanced scorecard is those things, plus the needs of all of your other stakeholders – employee satisfaction, physician engagement, the financial health of your research site.
The most important metric that our customers care about is enrollment. Did we put in the number of patients that we could put in? Did we enroll as well as the other sites did on the same research protocol? Why is it they are the most important? Because it’s the only way to get to the end of their trial. If the enrollment metrics are off it changes everything. It makes their trial more expensive and it makes their trial take longer. They have to open up additional sites which costs a lot of money. The length of time until “closed to enrollment” ends up much, much longer. The current metric on “closed to enrollment” is that it takes twice as long as they thought it would. It’s that bad. The enrollment metric is that critical.
How do you track it? Here’s how I track it: I track percent attainment of Sponsor enrollment goal and I track it as a leading indicator. A leading indicator is a metric that when you get the number you can still do something about it. A lagging indicator is when you get the number, you can no longer do anything about it. If I promise to put 10 patients into a given research trial, and the research trial is going to enroll for 10 months, I should be putting in about one patient a month. If I’m 4 months into the trial and I’ve enrolled 5 patients, I am above-goal and I am on-target on my rate to achieve Sponsor enrollment goal. However, if I’m 4 months in and I’ve only enrolled 3 patients into the trial, then I’m below the rate. It means that right now there is a greater probability that I am not going to hit Sponsor enrollment goal. Because I’m tracking it as a rate in real-time, we can then do something about it. If we are 4 months in and we are below goal for enrollment we can pull out all the stops. We can add to our marketing dollars, we can contact additional physician offices, we can pull some additional lists out of EMRs, and do whatever it takes in an attempt to get back on target so we are serving our customer on enrollment.
The lagging indicator that we also track is how we did when the trial closes to enrollment. Once I know that number, I can’t do anything about it, but it is the final score. It’s the final score as in my baseball analogy I’ve used in the past. At the end of the day, what was our percent attainment to enrollment goal – not as a rate but as an absolute?
What do Sponsors tend to check on us? I’m amazed that they tend not to track percent attainment of Sponsor goal. They tend not to look at how we did against what we said we’d do at the beginning of the trial. Rather, what they tend to track on us, is at the end of a given trial, how did we do against our peers. I can see why they track it. It adjusts for the nuances of every individual research protocol and that makes it nice. But it’s a lagging indicator of how we did against our peers at the end of a protocol. So by the time they know the number they can’t do anything about it. By the time we know the number, if in fact we ever knew the number, we can’t do anything about it. The other issue is there is a strong lack of transparency and they never share that number with us which means we can’t adjust our performance in the future for that Sponsor and we don’t know that that Sponsor has information on us that they consider a detractor. Those are issues.
A Balanced Scorecard
Trust me – balanced scorecards are a must for research sites! Enrollment is a critical key performance indicator. It’s a critical aspect of your balanced scorecard that you must check as a research site and perform against because it has a ripple effect on the needs of your customers. Pay attention to it! They are paying attention to it, and it’s a must.
There you go! Today’s issue is balanced scorecards at sites and specifically your enrollment metrics.
Thanks for riding along!
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