The COVID-19 pandemic has forced most clinical trial sites to throw their plans for 2020 out the window. Teams have been reduced in size due to necessary furloughs as case numbers have spiked and dipped in waves across the United States. However, confronting a growing demand for new clinical trials, sites are being forced to adapt yet again as they attempt to rebuild their teams on the fly. 
Employees may be asked to return to a familiar workplace, but they will almost certainly be faced with unfamiliar challenges. This includes an increased study workload, an expectation of flexibility in task type and the need to quickly learn new technologies and therapeutic areas. 
How can sites prepare for the looming trial boom while protecting their teams from burnout? The answer might lie in the response our team observed from one community hospital. In the beginning stages of the COVID-19 outbreak in the United States, the greater Seattle area represented the country’s epicenter. Months later, the area is a leading example in creative recovery efforts. Here’s how Seattle’s Evergreen Health rallied in the face of the crisis, partnered with public health officials to flatten the region’s pandemic curve and brought testing and treatment to patients in record time.

Tip #1: Redeploy Furloughed Staff 

Furloughs enable companies to reduce staffing costs while sidestepping layoffs, and are especially helpful during times when many industries are at a near stand-still. Furloughed employees either work a schedule of reduced hours or, as is more common now, are put on leaves that can last as long as the company needs. Evergreen Health was able to avoid staff layoffs by hiring from other areas of the hospital that had been forced to shut down amid the growing crisis. Approximately twenty individuals who had been furloughed or otherwise offboarded from other departments were brought on. Now, there was a new challenge. How do you train a team that has zero exposure to research projects?
By reaching out to managers to ask key questions, the team was able to triage the labor pool in an efficient manner. Nurses and medical assistants were able to be trained on GCP and ethics guidelines. Nurses with clinical research experience were strategically chosen from departments where research was already happening or planned to be happening. This helped allow for on-the-ground training for future COVID-19 and non-COVID research at the hospital. Evergreen was able to provide pay for low census employees to perform chart review studies in order to determine the best course of action for treatment and trials.

Tip #2: Ask Sponsors for Help

Archana Sah, a pharma industry leader, recently said on the SCRS Oncology FireSide Chat webinar series that sponsors appreciate sites thinking outside of the box to offer solutions2.  We are all in the industry to help people.  Do not hesitate to ask sponsor partners for help!  Other sites are likely to have similar struggles and you can leverage experiences and resources.  For example, for COVID-19 vaccine and treatment trials, rapid patient enrollment and data entry are critical for population health.  Do not shy away from asking for additional labor support to assist with these trials.

Tip #3: Use Contingent Staffing

According to WCG CenterWatch, 10 percent of sites complain of not having enough employees to restart sites3. As sites begin to reopen and reactivate after months of studies being on hold, the ability of sites to be flexible with hiring is also contingent on revenue. There is a balance between being able to hire employees directly while wondering if you will have consistent work for them. Utilizing a contract workforce allows sites to scale hiring with the number of trials and enrollment expectations.
Partnering with staffing vendors also allows sites to work around organizational hiring freezes by utilizing contract workforce that is not employed directly with the site. This provides an option for busy departments like Clinical Research to hire the support they need while not violating the directives of the organization. Given the necessity and priority of clinical research, especially in relation to COVID-19 treatment and vaccine trials, having adequate staffing is essential to hit aggressive timelines and alleviate the pressure of a workforce with health concerns of their own. 

Lessons Learned

As the clinical research professionals look ahead to an uncertain future, there are lessons to be learned from sites that have found strength in flexibility. In many ways, this means getting creative to build the best team possible. Redeploying furloughed employees, asking sponsors for help and tapping into a contingent workforce are three ways sites can do just that. An event like COVID-19 affects all of us, and it requires the full resources of our organizations to reach a sustainable solution for employees, patients and the communities they call home. 
Note: This article originally appeared in the Fall 2020 edition of SCRS InSite: The Global Journal for Clinical Research Sites. 

  1. Jamula, A.CCRC, Research Director, Evergreen Health  (April, 2020). Phone interview. 
  2. SCRS. “Oncology Webinar Series – The Shift in Oncology Trials during Stay at Home – A Fireside Chat.” (August, 2020)
  3. WCG Clinical. “Resource Center: COVID-19 and Clinical Trial Operations, COVID-19 Trial Insights.” (August, 2020)

About the Author
Nicole Mills is Director of Clinical Research at Medix and currently works in our Scottsdale, Arizona office.