Optimizing clinical research in a regional cancer center network: A multidepartment survey-based approach.
Authors: Preeshagul Isabel Ruth , Syldor Angemael , Terzulli Stephanie Lucia , Gordon Ruth Ann , Evans Lauren A. , Moran Solange , Gelblum Daphna Y. , Bartlett Edmund , Kaley Thomas Joseph , Brockway Julia P. , Eng Juliana , Rao Devika , Momtaz Parisa , Joshi Smita Suhas , Daly Robert Michael , Riely Gregory J. , Reidy Diane Lauren 
Published: September 2024

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Background:
Memorial Sloan Kettering Cancer Center’s (MSKCC) regional care network (RCN) encompasses 6 sites across NY and NJ. Further expansion of clinical research (CR) in the RCN provides an opportunity to bring clinical research closer to patients. The CR RCN leadership group was created to identify and address barriers to research operations in the RCN.
Methods:
A survey was conducted among Medical, Surgical, Neurologic and Radiation Oncologists at the RCN sites (February 2022-April 2024) to assess perspectives on research-related challenges. The 23-question survey included multiple-choice, open-ended, and ranking questions regarding protocol availability, consenting processes, and staffing support. Results were used to inform interventions to address barriers in the RCN.
Results:
92/108 (85%) medical oncologists, 16/31 (52%) radiation oncologists, 7/9 (77%) neurologists and 28/70 (40%) surgeons completed the survey, revealing three key challenges: 1) Limited protocol availability: Only 47% of the time was there a suitable medicine trial available in the RCN. Identified barriers to opening desired medicine protocols (n=23 in total) included trials that were closed to accrual, pending amendments, and sponsor approval issues. 2) Inadequate investigator representation: 278 medicine protocols lacked RCN physicians listed as consenting providers. 3) Insufficient research staff. Only 33% were satisfied with the research support, and 62% of physicians identified lack of clinical research support staff as the biggest barrier to accrual. 71% reported delays of more than one week in screening eligible patients due to insufficient support. Following these results, interventions were implemented across departments to overcome these challenges. Appropriate RCN physicians were added to the 278 protocols, and an analysis of staffing needs increased clinical trial nursing and administrative staff. Therapeutic and non-therapeutic accruals in the Department of Medicine rose by 10.5%, and total research visits increased by 21.4% compared to the previous year. Thirteen of the 23 studies in medicine, that were previously only open at main campus, were opened to accrual in the RCN. This survey highlighted research portfolio gaps in multiple departments that are now being addressed.
Conclusions:
This multi departmental survey-based approach identified key barriers to CR within MSKCC's RCN, and in turn, informed interventions that increased research activity. These findings offer a potential roadmap for optimizing research in similar networks by enhancing protocol accessibility, addressing staffing needs, and fostering collaboration. Further investigations are ongoing to address additional challenges and improve workflows across departments.