I have watched regulatory coordinators at busy sites receive an IND Safety Report, scan the first page, decide it "looks important," and immediately route it to the principal investigator with a sticky note saying "FYI -- please review." That is not triage. That is forwarding. And forwarding everything with equal urgency accomplishes two things, both destructive: it overwhelms the investigator with undifferentiated noise, and it creates the illusion that the RC has processed the communication when, in fact, no processing has occurred.

Real triage is a structured decision process. It produces a documented, defensible record of what the RC determined about each communication and why. It routes some communications for immediate investigator review and flags others as routine acknowledgments. It identifies which communications trigger IRB reporting obligations and which do not. And it catches the small but critical subset of communications that require consent revisions -- the ones that, if missed, mean your participants are enrolled under a consent document that no longer accurately describes the study's risks.

This lesson builds the triage methodology. Four gates. Explicit criteria at each one. A documented decision at every step. By the end, you will have a repeatable process that works whether you are processing three communications on a quiet Tuesday morning or 17 during a safety signal cascade on a Friday afternoon.

I have watched regulatory coordinators at busy sites receive an IND Safety Report, scan the first page, decide it "looks important," and immediately route it to the principal investigator with a sticky note saying "FYI -- please review." That is not triage. That is forwarding. And forwarding everything with equal urgency accomplishes two things, both destructive: it overwhelms the investigator with undifferentiated noise, and it creates the illusion that the RC has processed the communication when, in fact, no processing has occurred.

Real triage is a structured decision process. It produces a documented, defensible record of what the RC determined about each communication and why. It routes some communications for immediate investigator review and flags others as routine acknowledgments. It identifies which communications trigger IRB reporting obligations and which do not. And it catches the small but critical subset of communications that require consent revisions -- the ones that, if missed, mean your participants are enrolled under a consent document that no longer accurately describes the study's risks.

This lesson builds the triage methodology. Four gates. Explicit criteria at each one. A documented decision at every step. By the end, you will have a repeatable process that works whether you are processing three communications on a quiet Tuesday morning or 17 during a safety signal cascade on a Friday afternoon.