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Monday, February 21, 2011

Motivating your Study Coordinators

As monitors, we rely on the Study Coordinators (SC) to assist us in site management activities like record-keeping and re-supply.  We ask them to keep us informed of progress at the study site through reporting, screening/enrollment logs, issue identification, etc.  We have them prepare the CRFs, complete data-entry, attend trainings, review newsletters/correspondence/memos, answer emails, fax in documents, and answer queries.  On top of everything else, we insist that they organize and prepare for our monitoring visits.  During the monitoring visits, we request that they are available to resolve any issues that are identified or to complete additional training.  This ongoing administrative burden during study conduct is all in addition to the primary requirements that they assist the Principal Investigator in executing the study according to the protocol and monitor the safety of all study participants.

In short, we ask a lot.  Many coordinators have several studies competing for their time and attention and one of the most important skills for a CRA is to motivate the SC to focus and respond to the demands of the trial at hand.  For the most part, my coordinators are prepared for my visits; I owe that to a mix of luck, experience, and the following techniques:

Establish and Maintain Rapport - Whether you meet your coordinator for the first time at an Investigator's Meeting or a pre-study or initiation visit, every interaction is a chance to build the relationship.  Answer your voicemails and emails promptly and invite your coordinators to reach out to you with their concerns. If you can listen and empathize, your coordinator will trust you more and keep you informed if they are falling behind.  If your coordinator feels respected and valued they will put in the time to get the work done properly.

Communicate the Timelines and Study Status - Share the study progress through regular site contacts or a newsletter and ensure that study staff know the timelines and overall picture of the trial.  Review site performance regularly and let coordinators and investigators know how they are doing compared to other sites.  You can set goals and make comparisons in terms of recruitment, enrollment, data entry/query resolution, and monitoring completion; sites find this extremely motivating if you can deliver the message and metrics in a non-confrontational way.  SCs are juggling so many competing priorities that they may not be working on something you need just because they don't realize it is "on fire" at the moment, that is way regular site contact and effective communication is so important.

Recognize Good Performance - When your site completes a required task or important milestone let them know you appreciate this and thank them for their contributions. I am constantly complimenting my sites; they are not perfect but they do lots of things well and I think they deserve that recognition.  I produce a monthly newsletter and I try to include a regular "Site Profile" section where I introduce the site, highlight their study accomplishments, and discuss their tips for success. It is a bit corny but my sites are always flattered and this seems to produce great results.
Don't be afraid to submit to bribery.
Understand and adhere to your company's
policy on gifts. Typically a non-material
small appropriate token such as a box of
donuts or pastries will do a lot to "butter-up"
and endear you to your coordinator
without the risk of appearing coercive.

Partner with your Coordinator - Convince your coordinator that you are a team and that you want them to be successful, "I know you have a lot on your plate, so let's get through this so I can get out of your hair."  Ask your coordinator, "What are the obstacles preventing you from getting your work done? Would you find it helpful if the sponsor, the Project Leader, or I spoke to the PI?"

Break out the Big Guns - All of the techniques I mentioned above will keep your study sites on track and foster a productive and collaborative working relationship.  At the end of the day however, if the work just isn't getting done you may explore alternative less positive methods of motivation.  Expose the deficiencies to the Principal Investigator or withhold site payments pending completion of the work.

Above All, Be Patient - See a related post where I discuss how issues outside of work can sometimes distract coordinators: What is up with this coordinator?

Please comment to let me know if there are other tips or techniques I should highlight in regards to motivating study coordinators.

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TNM said...

Thanks again for a very informative topic! Even when no one comments, best believe we are all taking notes!

Nadia said...

Thanks, TNM. You are motivating me to keep posting more regularly. Glad you enjoy the blog!

Lainey said...

Great blog, Nadia! One item to keep in mind when bribing with food is to be aware of your SC's eating habits or intolerances/allergies. Buying a box of delish pastries for someone who is a vegan or gluten intolerant does not accomplish the goal. I speak from experience, as I brought a Starbucks frappacino drink to an SC who doesn't drink caffeine, ever.

Nadia said...

@Lainey, how about a sausage biscuit for a Muslim? Yikes, you raise an excellent point! Tread carefully here blog readers. :)

Anonymous said...

Dear Nadia

I can never thank you enough for your great sharing. God bless you.

LEFTY said...

Awesome job keep up the hard work!

Re-search said...

Hi Nadia, really liked all your articles; kudos to you!!

Just wanted to add that the technical trainings for a CRA are offered in several training institutes and CRO's. But a pre-requisite that one must possess to be a good monitor is the abundance of soft skills - handling the SC's & PI's and getting the work done so as to meet timelines! This is something we gotta inculcate on our own...!

Re-search said...

Also, would like to add that it helps when we do not put unnecessary pressure on regular days on the SC, so that when we actually persuade them when the work is on high priority, they will take it up with due regards!!

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