Risk-based quality management in daily CRC practice
Apply risk-based quality management principles from ICH E6(R3) Annex 1, Section 3.10 to daily CRC practice, including identifying critical-to-quality factors, contributing to quality tolerance limit monitoring, and integrating proportionate quality thinking into routine site operations.
The coordinator who changed her morning
A coordinator at a multi-study research site arrives at 7:45 AM on a Tuesday. She has 14 active participants across three trials, a monitoring visit scheduled for Thursday, and a stack of tasks that could fill two working days. She opens her task list and begins working from the top, in the order the items were added -- data entry for a routine vital signs assessment, then filing a lab report for a screening failure, then resolving an EDC query about a missed concomitant medication entry, then reviewing a consent form for a participant whose eligibility is in question.
Six months later, the same coordinator arrives at the same time. Her task list is just as long. But she does not start at the top. She scans the list and asks a question she did not used to ask: Which of these tasks, if I get it wrong, could harm a participant or compromise the reliability of the trial's results? The consent form for the participant with questionable eligibility moves to the top. The EDC query about concomitant medications -- flagged by centralized monitoring as part of a pattern across multiple sites -- moves to second. The routine vital signs data entry, where the values are straightforward and the risk of transcription error affecting a clinical decision is minimal, stays on the list but drops in priority. The filing of the screening failure lab report, important for completeness but carrying no safety risk, she will do when she has a break.
The coordinator's workload has not changed. Her hours have not changed. But the quality of her work has improved measurably, because she is allocating her best attention to the activities that matter most. This is not a time management technique. It is risk-based quality management applied to the daily practice of clinical research coordination -- and it is, in my view, the single most important professional evolution a coordinator can make.