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Table 7 Involving multiple specialties in recruitment to future orthopaedic surgical trials

From: Embedding qualitative research in randomised controlled trials to improve recruitment: findings from two recruitment optimisation studies of orthopaedic surgical trials

Suggestion for involving multiple specialties in the recruitment of patients to future orthopaedic RCTs

Encourage inter-specialty collaboration through associate principal investigators (PIs)

Appointing clinical trainees as associate PIs may encourage inter-specialty collaboration, optimise recruitment and provide study support. Trial teams should provide manuals to support associate PIs and encourage professional benefits to individuals for adopting these roles such as Continuing Professional Development (CPD) (ACTIVE, PRESTO)

Name clinicians from specialties not involved in recruitment on delegation logs.

Ensuring surgeons from other key specialties and particularly registrars are on delegation logs to ‘intercept the pathway’ and account for the fact that treatment decisions are often made quickly. (PRESTO)

Raise awareness of trials through regular presentations and posters at trial sites.

To account for staffing changes and junior doctor rotation, regular presentations and briefings about studies that are open for recruitment are important. (PRESTO) Trial teams should distribute posters to study sites for display in all departments where potentially eligible patients are assessed and/or admitted. (ACTIVE)

Use technology to encourage communication between clinical and research teams.

Creating a WhatsApp group for clinical and research staff to improve communication and ensure that patients are approached to take part in studies as soon as is appropriate after admission. (PRESTO)

Provide opportunities for research staff to discuss potentially eligible patients.

Research staff attending handover meetings in person or receiving daily handovers from specialties involved in recruitment is important to ensure no potentially eligible patients are missed. (PRESTO)

Encourage the involvement of on-call staff in recruitment

Ensure on-call staff are aware of study recruitment criteria and have access to the study team’s contact details (ACTIVE)

Ensure mechanisms for communication between key specialties and PIs at trial sites are established and known.

Asking specialties to directly call the PI or study team as soon as a patient is identified, so they can be screened and an appointment arranged immediately. (PRESTO)

Involve the Emergency Department (ED) in recruitment

Involving ED staff in recruitment and ensuring ED is being screened daily is important to avoid missing potentially eligible patients. Out of hours support for research staff, is particularly important for units that ‘encroach on ED’ to accommodate for out of hours admissions. Having an open clinic for patients to be booked into from ED may be of benefit. (PRESTO)

Use electronic systems where possible to identify eligible patients

Sites should consider searching electronic systems where these are available to identify all eligible patients (ACTIVE)