Beyond Transactions: What Site Ambassadorship Really Means

Jimmy Bechtel sits down with Kimberly Staeck, Head of Global Site Partnerships and Trial Enablement Solutions at Syneos Health, to dig into what it really means to treat sites as partners rather than execution engines.

Kimberly brings two decades of operational and partnership experience to a conversation that gets honest about where the industry falls short. They cover why sites have learned to tell the difference between being heard and actually listened to, what closing the feedback loop looks like in practice, and why early site involvement in protocol development is a risk mitigation strategy, not a delay. Kimberly also makes a case for shifting away from activity-based metrics and toward shared outcomes that reflect the real health of a partnership.

The throughline is simple: when sites feel valued and supported, patients get better care, staff stay in the field longer, and trials perform. If your organization is serious about moving from transactional to transformational site relationships, this one is worth your time.

Transcript

Jimmy Bechtel 0:00

Hello, and welcome to SCRS Talks, provided by the Society for Clinical Research Sites. I'm Jimmy Bechtel, the chief site success officer with the Society, and today I'm joined by Kimberly Staeck, the head of global site partnerships and trial enablement solutions with Syneos Health, here to talk about what it means to be part of site ambassadorship. kim, it's great to have you, and I'm really excited to, speak with you on this topic in particular, and the relationships that our CRO partners have with the sites. But before we get into that, if you wouldn't mind, we'd love to hear a little bit more about you

Kimberly Staeck 0:33

Sure. Thanks Jimmy, so much for having me. And on behalf of Syneos Health, thank you so much for this opportunity to be present and talk a little bit more about what it is I do, what my team does, and how we're building the bridge and hopefully changing the industry in how we're connecting with our sites more effectively. I've been in the industry about 20 years in a variety of operational and partnership focused roles. And one of the things that's remained clear for me is that relationships, particularly with our sites, are really at the center of everything we do. And so with my role right now at Syneos Health, our team's focus is on really strengthening and expanding our site relationships and partnerships globally. modifying our current relationships and engagements to be less transactional and more focused on other elements. Really making sure their voices are representative, and creating partnership models that are really more collaborative versus kind of the standard industry, and how our history has sort of performed to date.

Jimmy Bechtel 1:35

Great. that's excellent, and it's always good to hear, the investment that our partners are making into the site relationship, which is really a lot of what we're here to talk about today, and, diving into that. And there's, Kim, a lot of discussion are across the industry around moving beyond this sort of transactional relationship with the site and moving into, like we've said, this concept of site ambassadorship. So can you share a little bit about what that means to you and why this shift is so important now?

Kimberly Staeck 2:03

Yeah. So I think historically and typically, you know, we've always viewed our sites as with an operational lens. You know, what they can deliver for us, what are their activation timelines, what are their enrollment numbers and overall study abilities. And it's a transaction. We give you a study, and they perform. And while that absolutely matters and is needed, site ambassadorship really begins with recognizing our sites as experts in research delivery and more than what I kind of am referring to as like an execution engine. So there are care teams who understand the patient populations and build that trust with their patients, and they understand the operational realities with managing complex protocols. And therefore, they can see some of the barriers to participation and deliveries in a way that we as outsiders and as our sponsors can't see So for me and, and for Syneos Health, site ambassadorship really means actively carrying their voices, their realities, and their priorities into the decisions we make. And it's shifting that mindset and serving more as an advocate, a translator, a navigator, and sometimes even a protector on their behalf. And we need to recognize that every sponsor strategy, every process that we design, and any other operational decisions eventually make their way to their desks. And if we don't understand what those impacts are, we're not really partnering. The reason this matters more now than ever is because we're facing increased sets of challenges, right? We talk about this all the time at meetings and conversations and conferences. Our protocols are more complex. Our technology is so much more of a focus. And unfortunately, often from site feedback, increases burdens rather than really reducing them. And our site teams are continuing to experience resource challenges, and our overall expectations for enrollment diversity, patient retention, study quality, et cetera, continue to increase. And so site ambassadorship really means that we're helping our sites navigate those challenges and complexity and more creating an environment where there's collaborations that help drive the success and not just giving them a study to deliver. So I don't know about you, Jimmy, but the best relationships I feel I have are ones where I'm valued, right? Whether it's a personal relationship, a work relationship, I wanna be valued, I wanna be respected and understood, even at times when someone might disagree with me, which of course can happen quite often. But we need to treat and engage our sites kind of in that similar way. We want them to feel valued, respected, and supported. And if we do that, I think naturally their performance and engagement will naturally improve. So I think ultimately, if we want better studies, better outcomes, and a stronger sort of research ecosystem as a whole, we have to invest in their experience and the success of the people that are actually delivering the research to us. And so for me and to Syneos Health, that's really what site ambassadorship is about

Jimmy Bechtel 5:04

Thanks, Kim. It helps to kind of contextualize that answer there, and because you're exactly right. Our CRO partners are oftentimes the operational arm of the clinical trial, and executing, working with the sites to execute that. And, you know, I wanna tease out that concept of value there, because a lot of organizations, say that they value site feedback, right? I mean, I would venture to guess that any of the partners at SCRS have value site feedback. But sites, on the contrary, unfortunately often feel that their input doesn't actually lead into any meaningful change as a result. So what does... how do we address that? What does true engagement look like in practice, and how can sponsors and CROs avoid this, trap of performative listening?

Kimberly Staeck 5:52

I think it's a really interesting question, and I think we w- are limiting our sites because I, I feel they've become very good at recognizing the difference between being heard and actually listened to. And so many organizations collect feedback, such as Syneos Health and others, through our surveys, advisory boards, interviews, site councils. And all of these engagements have value, and they're important for data collection and for information. But I don't think collecting input is really the same as actual engagement. And so when we hear this performative listening, and I've had many conversations with our partners and sites regarding this, it typically happens when we're asking for feedback after decisions have been made, you know? Or we're gathering input without really identifying the responsible parties for action or where that's going to go. there's a lack of communication following that feedback, so it goes into a black hole, and they never hear results or what occurs thereafter. Or, we're asking the same questions without addressing the same concerns over and over again, and we expect the answer to be different. And so I feel sites begin to feel as though they're just participating in a regular exercise rather than actively helping shape change and transform the areas they're being asked for input on. And true engagement in that aspect, and what I'm looking to try to produce with my team and here with our team at Syneos Health, is trying to close that feedback loop. We might ask. We listen. We evaluate. We act. And then we communicate all of those outcomes to all of the relevant stakeholders so there's not even awareness, but there's an understanding of what actions were taken and why certain recommendations may or may not have been implemented. I think you'll hear a lot of sites don't necessarily mind if the answer is no or not right now or not in this way. They just wanna understand why, and they wanna have that feedback closed for them so that they're not constantly wondering if it's made a difference or if it's made an impact. And I feel, again, if you go back to a relationship you've had, if you've ever been in a relationship and you've had someone end it with you, you may not like or agree with the decision, but you'd always rather have an answer or a reason why instead of wondering what went wrong or what the issue was. And so I think with any relationship and partnership, that transparency, honesty, and feedback is key. We demonstrate that respect to them, and in return, that builds that credibility and reliability as partners. And so at the end of the day, listening isn't really the finish line. It's actually the starting point to true engagement and how we're engaging with their sites. And that engagement happens when sites can see what is heard, what action was taken, and why that action was taken the way that it was

Jimmy Bechtel 8:39

Yeah, I think it's excellent, point and, and something I'll use probably, Kim. The listening is the starting point. It's not the finish line. It's not even the midpoint. It really is where things start. And this, I talk a lot about the feedback loop and how it kind of tends to break down the further we get into it, ending at implemented and communicated. you hit that on the head as well. Letting the sites know when something has been done to change, or being able to demonstrate that through, the new, a new operational process or procedure is really where the buck, the finish line tends to be. and then we start back over with continued feedback. So excellent points there. I also want to talk about, moving away from something that you mentioned, shifting from activity-based metrics, right? This kind of concept of checking the box into this, era of shared outcomes. And maybe you share, Kim, some examples of the outcomes that matter most, what we should focus on first or most importantly even when building sustainable high-performing site partnerships.

Kimberly Staeck 9:41

I think that in the past and even as we do now, we're tracking activity on how we're engaging with our partnerships, which is number of touch points, number of meetings, how many visits we're conducting. But those are more of a measure of effort and not necessarily a measure of that value and what builds a sustainable partnership. And so I think we need to focus on outcomes that matter to all stakeholders, which are, as we are aware, enrollment success, partnership retention, protocol adherence and data quality, and, and how our sites are delivering studies faster and being able to execute them. But I think those elements are still somewhat transactional and delivery focused, and they're not focused more on the reflection of the site and the patient's experience. And so I think the mindset needs to be shifted to focusing on questions that more of how are our sites managing these workloads and the protocol complexities, and is this sustainable? Are the current staffing models in place that these sites have appropriate with how the industry continues to change? You know, how are they evolving their abilities to produce and support? Are we, with all of the changes, are we truly reducing unnecessary burden with becoming more and more technical and trying to advance to be faster, or are we just adding to it? And I think, you know, those are common questions that we're asking, but we're not really doing anything to address them. And I think at the end of the day, you know, if, if we're a patient and we're participating in some of these clinical trials, if we're in their shoes, would we wanna participate in something like this? And if the answer is probably not, then maybe that's something we need to begin to evaluate and have conversations about to be able to support. So we think those are key indicators of a partnership's health, but I think other elements that are more, again, relationship driven with this focus is on, what is the responsiveness back and forth? What's the ease of doing business with a site or with a CRO or sponsor? How are we resolving issues effectively, and is there a desire to work together again? If it doesn't matter how well someone is performing or what opportunities they bring you, if you don't really wanna work with them, like, does it really matter? And I think we forget about those sort of standardized questions of, of if we're willing to engage with someone, is that an opportunity for sustainability? And I think those are those elements that give an indication of what a future partnership looks like and the health of a partnership and if that's sustainable and creates those sort of shared outcomes. Because if you truly wanna partner with someone, you wanna work with them again, they're easy to work with, they're pleasant to work with, and they deliver well, those are the relationships that ultimately become high-performing and are long-term investments

Jimmy Bechtel 12:24

Several excellent points there, Kim. And, you know, what I really value and I'm sure the, the listeners will as well, is how we tie all of that back ultimately to patient care. And listening to the sites and the, having that relationship with them can directly affect the outcomes and the work that we do on behalf of and with our patients, because the sites are the ones, they're treating them every single day. So opening those channels up and receiving that feedback and, and having, like you said, having that conversation at the times that matter most with the sites can really be the difference between enabling the patients on the trial and providing them a successful and valuable experience, and, being met with adversity and challenge and non-success as a result of that. Part of that process is that sites are being asked to be involved earlier and earlier in study planning and protocol development. We consider this a great thing. It's something SCRS has advocated for since probably before our inception. so how can the industry then better incorporate those insights upfront? How can we continue to do this while still maintaining the contradiction to this is that development speed and the operational efficiencies, right? The, the customization and the conversations oftentimes yield, us to need to slow down. So how do we, how do we find that balance?

Kimberly Staeck 13:40

I think there's this inherent condition in our industry that early site engagement could be delaying strategy, and that involving them earlier might add time up front. But in all honesty, I think early site engagement is more of a risk mitigation and an ability to s- accelerate. You know, our sites are uniquely positioned to identify and share potential operational challenges before they're even activated. You know, they have the ability because of how they are positioned to flag recruitment concerns, understand a visitor patient burden because of those conversations they're having daily with their patients. They're able to understand and see how protocol complexities might actually lead to potential workflow issues. And so their perspective could make very subtle or small changes that could potentially help avoid significant amendments or unrealistic eligibility criteria, so six months down the line, you know, our studies are not facing challenges with recruitment because there isn't the right patient population or, asking patients to go off a medication is not sustainable for them, And so, you know, our sites are able to help us anticipate those risks before we even get started, rather than addressing them later on when it might be too challenging to turn around. And as you said, you know, our sites wanna share their input and experience, and so why not leverage them for that practical insight on the protocol design, real world patient considerations, and the procedural burden that they're anticipating? We can ask them on input on the technology that they're expecting and training expectations and the practicality of using all that technology in flux on a daily basis with these trials and these patients. And so I don't think involving them earlier translates to a challenge, and I don't think it also means you have to involve them in every decision. I think it means being intentional with that engagement, intentional representation that you can repeat, and then that repeated engagement can be used to gather critical insight at decision points that could ultimately impact the overall delivery. And there are some things that I've been exploring and talking about internally with teams and a lot of our network partners and site partners on what are some elements and how we can bring that engagement earlier. And so I'm excited to see, maybe some of those things come into play later on as we continue to build. But I think ultimately, we're sitting at, at a crossroads where we're constantly asking our sites to rescue studies or save us, and really what I think we should be doing is use them to help us build better studies and better engagement and activities. So it's not if we involve sites, it's really when.

Jimmy Bechtel 16:16

It's a really strong perspective, Kim, and one that I appreciate as well, because it's this concept of, like, slowing down to speed up, in a way. and like you said- Mm-hmm it might not even necessarily need to be slowing down. If we intentionally and thoughtfully incorporate site feedback into protocol and trial execution and development conversations, then it has the potential to yield more efficient execution down the road of that protocol and of that trial. So it's really understanding how that will happen, and then taking the time to gather sort of the data and the ROI and the inference around that, as opposed to just assuming that it's gonna slow things down. But if we can prove, and, you know, use these as case studies to, to build some of that momentum, then it, it really naturally kind of translates into, success in that. So it's great to hear, again, Syneos, and the emphasis on incorporating that into the process. And I will share with the community, s- Syneos Health has had a site advocacy group, in place for a number of years- Mm doing exactly this, bringing the SCRS community into protocol development and execution operational conversations. So wanna talk about putting, putting, the figurative money where the mouth is here. Syneos has been, employing this practice for a very long time, so kudos to you all. Thank you. last question here as we kind of begin to conclude our conversation, Kim. When we see partnership between sponsors, CROs, and sites working well, what impact does that have? give us some kind of anecdotal or evidentiary insight into not only the operational impact, but also, again, for most importantly the patients, things like workforce sustainability and really the future of clinical trials.

Kimberly Staeck 17:58

I think when we have strong partnerships, that sort of multiplies across a variety of elements, as really the trust becomes the foundation. So with that, our performance is better. I think there's people that are more engaged. There's more responsiveness and transparency, and our patients get better care, treatment, and access. So that overall leads to initial operational impacts, right? Our ability to deliver faster study startups, better and more predictable enrollment, performance and delivery, stronger patient retention, higher data quality and ultimately fewer escalations. For patients, I think their participation becomes less burdensome, so they get better communication engagement and more targeted areas that will help support them that can be better engaged in their daily lives. So they're not feeling as though they have to put their daily lives on hold to participate in a clinical trial that is supposed to help bring them support and better their health. And I think that then becomes a better trial experience, so their trust in research increases, and what that does for them increases. And that ultimately starts the pipeline down. It encourages more participation. And as the word continues to spread and as people advocate for support of engaging in clinical trial research, we get more diversity and representation of different populations, so we're able to maximize more strongly the patient populations that, that are going to be treated and can be treated with these treatments we're developing. And, you know, ultimately our patients are the ones that are entering the studies primarily through the site teams and through those engagements they have with their sites. So if we're supporting our sites in all of these ways, we're ultimately supporting the patients, and that's who, at the end of the day, we're all working for, right? I think then for the workforce as a whole, there's less burnout and there's a greater satisfaction that occurs when you're making a more magnified impact. We see that with more staff retention. You see more individuals that wanna join clinical research. There's more career pathways and opportunities for them to engage in what that looks like. And so as a whole, we're positioning all of our organizations to be stronger and more apt to be able to advance research and deliver those outcomes that are so important. And, one thing that I'll say and leave our listeners with is that, you know, partnership isn't something that, I say and that Syneos Health says. It's something we want our sites to experience. And I think that the organizations that are really going to lead the future of where clinical research is going are the ones that are starting to consistently demonstrate the respect for our site's expertise, act on their feedback, and aligned with those shared outcomes. And I think if everybody works together in this space as true partners, everyone benefits, especially the patients, and that has far and more long-reaching outcomes overall. And I think ultimately, my team's responsibility and our overall responsibilities as site ambassadors is to ensure that because our sites are closest to the patients and then closest... they're closest to the solution. So we need to ensure that their voices aren't just heard, they're used to help shape what comes next and how that can be changed better for the future.

Jimmy Bechtel 21:14

I couldn't agree more, Kim. I think that's an excellent spot for us to end our conversation today in a really good message. So thank you. thank you to Syneos Health for continued, strategic alignment with the investment into the site and patient relationship. I'm excited to continue to see that develop and deepen, with the team at Syneos. So thank you, and thank you for being here with us today.

Kimberly Staeck 21:37

Thank you so much for having me. It was a pleasure as always.

Jimmy Bechtel 21:40

And for those that are still with us, make sure that you check out other site-focused resources like other podcasts and opportunities to hear from our partners through webinars, news articles, and SCRS events on our website, myscrs.org. For those listening, thanks for tuning in, and until next time.