Fire Triangle: Part 1 Process Playbook

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Published: 2023/11/01 By: Tom Lazenby

The intricacies of Clinical Trial Vendor Management are woven into a series of processes, these processes are managed and delivered by different people within the organisation and are often performed simultaneously in multi-disciplinary teams, so how do we ensure consistency and quality in delivery of the process?

Errors in conduct of these processes throughout the clinical trial are compounding, and inconsistencies or mis-steps if unnoticed or mismanaged can lead to issues in vendor delivery and clinical trial quality and compliance.

As we continue our exploration of the Fire Triangle, let’s focus on Processes and discover how mastering these steps ensures efficiency, quality, and compliance in clinical trial delivery.

In this blog post we will consider the following processes, their key risk and best practices:

  • Selection
  • Qualification
  • Contract Management
  • Risk Management
  • Quality Management
  • Performance Management
  • Training
  • Project Close Out

Selection

What it is: The procedure of choosing the most suitable vendor(s) for your clinical trial based on a set of defined criteria.

Step by Step Description:

  1. Identify project needs.
  2. Create a vendor shortlist.
  3. Evaluate vendor credentials and capabilities.
  4. Conduct interviews or presentations.
  5. Evaluate proposals.
  6. Select the most suitable vendor.

Objective:

To find the most competent and reliable vendor, ensuring optimal results for the trial.

Key Risk:
Bias in vendor selection due to pre-existing relationships, personal preferences, or subjective opinions which might lead to not choosing the most qualified vendor for the project.
Best Practice:
Implement a scoring system for vendor evaluation that is transparent and standardised. This system should be based on quantifiable metrics derived from the defined criteria, ensuring that vendor selection is as objective and consistent as possible. Additionally, involving a diverse team in the selection process can help in providing multiple perspectives to reduce individual biases.

Qualification

What it is: The method of ensuring a vendor possesses the requisite expertise and capabilities for the trial.

Step by Step Description:

  1. Review vendor’s past performance.
  2. Verify credentials and certifications.
  3. Conduct a site visit, if feasible.
  4. Assess technological and infrastructural capabilities.
  5. Make a final decision based on evaluations.

Objective: To ensure the selected vendor meets the quality and expertise standards required for the trial.

Key Risk:
There is a possibility of over-reliance on historical performance and credentials, which might not reflect the vendor’s current capabilities or their relevance to the specific trial at hand.
Best Practice:
Implement a scoring or grading system that weighs each step in the qualification process according to its relevance to the specific trial’s needs. This will help in getting a comprehensive view of the vendor’s suitability and will ensure that no single factor, such as past performance, unduly influences the final decision. Regularly updating the scoring criteria based on evolving trial needs and industry standards will further ensure the selection of the most suitable vendor.

Contract Management

What it is: The art and science of overseeing vendor agreements to ensure both parties fulfill their obligations.

Step by Step Description:

  1. Draft a detailed contract outlining terms and deliverables.
  2. Negotiate terms with the vendor.
  3. Sign the contract.
  4. Regularly monitor and review contract performance.
  5. Address and resolve any breaches or changes.

Objective: To provide a legal framework that ensures both parties adhere to the agreed-upon terms and conditions.

Key Risk:
The potential for misinterpretation or misunderstanding of contract terms, which can lead to non-compliance or disputes between parties.
Best Practice:
Implement a collaborative contract review process where both parties can clarify and seek consensus on ambiguous terms before finalizing. Regularly schedule contract review meetings to discuss performance, potential changes, and ensure alignment in understanding and expectations. Utilizing a centralized contract management system can also aid in tracking, monitoring, and alerting stakeholders of key milestones, renewals, or potential breaches.

Risk Management

What it is: The process of identifying, assessing, and controlling potential threats that could derail the clinical trial.

Step by Step Description:

  1. Identify potential risks.
  2. Assess the severity and likelihood of each risk.
  3. Design strategies to mitigate identified risks.
  4. Implement risk management measures.
  5. Monitor, reveiw and adjust strategies as required.

Objective: To proactively address potential challenges, ensuring smooth trial progression.

Key Risk:
Inaccurate assessment of the severity and likelihood of risks, leading to either overestimation or underestimation of potential threats, which can result in misallocation of resources or unforeseen challenges.
Best Practice:
Implement a standardised risk assessment framework that considers both qualitative and quantitative factors. This framework should be based on historical data, industry benchmarks, and expert opinions. Regularly update the risk matrix to account for new information and utilise technology solutions, such as AI or predictive analytics, to enhance the quality of risk analysis.

Quality Management

What it is: The system of ensuring consistent quality in all trial-related operations and deliverables.

Step by Step Description:

  1. Define quality standards.
  2. Implement quality assurance measures.
  3. Regularly monitor performance against standards.
  4. Conduct periodic quality audits.
  5. Implement corrective actions where needed.

Objective: To ensure the trial’s outputs meet the established quality standards and regulatory requirements.

Key Risk:
Inadequate or misaligned quality standards, which could result in the clinical trial not meeting necessary regulatory requirements or producing unreliable results.
Best Practice:
Engage in continuous stakeholder feedback loops, including input from quality experts, regulatory authorities, and trial participants, to ensure that the quality standards set are comprehensive, relevant, and aligned with both regulatory requirements and the trial’s objectives.

Performance Management

What it is: A continuous process of monitoring, reviewing, and improving vendor performance.

Step by Step Description:

  1. Define performance metrics and KPIs.
  2. Measure vendor performance against set metrics.
  3. Provide feedback and recommendations.
  4. Implement strategies for improvement.
  5. Regularly review and adjust metrics as required.

Objective: To drive excellence and ensure vendors consistently meet or exceed expectations.

Key Risk:
Lack of alignment between the performance metrics/KPIs and the strategic objectives of the organisation, leading to misdirected efforts and potentially suboptimal vendor performance.
Best Practice:
Regularly align and calibrate performance metrics and KPIs with organisational goals, ensuring they are relevant, realistic, and directly tied to desired business outcomes. This not only makes sure the vendor’s efforts are directed appropriately but also fosters a collaborative relationship between the organisation and the vendor.

Training

What it is: Equipping the vendor team with the necessary skills and knowledge to effectively conduct the trial.

Step by Step Description:

  1. Identify training needs.
  2. Design a comprehensive training program.
  3. Conduct training sessions.
  4. Monitor application of learned skills.
  5. Provide refresher courses as needed.

Objective: To ensure the vendor team is well-prepared and competent in trial-related tasks.

Key Risk:
Inadequate or outdated training content might result in vendor teams not being fully prepared or aligned with the latest clinical trial protocols, standards, and regulations. This can jeopardise the trial’s integrity, potentially compromising patient safety and data accuracy.
Best Practice:
Regularly review and update the training content based on feedback from participants, changes in clinical trial regulations, advancements in technology, and emerging best practices in the industry. Additionally, maintain a central repository of training materials, results, and feedback to ensure consistent and up-to-date training delivery across all vendor teams.

Project Close Out

What it is: The systematic procedure of winding down a clinical trial project once objectives have been met.

Step by Step Description:

  1. Confirm all project deliverables are met.
  2. Conduct a final review with the vendor.
  3. Settle any pending payments.
  4. Archive all project documents.
  5. Conduct a post-project evaluation.

Objective: To seamlessly conclude a trial, ensuring all obligations are fulfilled and learnings are captured for future projects.

Key Risk:
Incomplete or improper data archival, leading to potential data loss or regulatory non-compliance, which could compromise future trial evaluations, audits, or post-market surveillance activities.
Best Practice:
Establish a comprehensive data management and archival protocol, ensuring all data is backed up in a secure, easily retrievable format, adhering to regulatory standards. Moreover, maintain a centralized repository where all trial-related documents, data, and learnings are stored, ensuring access controls and periodic checks to confirm the integrity and availability of the data. This aids in ensuring both regulatory compliance and the ease of referencing for future projects.

Conclusion

Processes are the rules within of the Fire Triangle in Clinical Trial Vendor Management. They act as a roadmap, guiding us from the inception of a project to its successful conclusion.

By understanding, refining, and adhering to these processes, we set the stage for trials that not only meet but exceed expectations. Join us next time as we dive into the second pillar of the Fire Triangle

Tom Lazenby

Tom is the Founder and CEO of Mayet. Using his experience in streamlining operations and driving innovation in clinical research, Tom is dedicated to enhancing the efficiency, cost-effectiveness, and risk mitigation strategies for vendor management and oversight.

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