Stage movement
Compare how many referrals enter each stage with how many reach the next one. A noticeable drop is a reason to look closer, not proof of the cause.
Enrollment Performance
Improve Enrollment Performance Without Increasing Referrals
This article is for a specific situation: enough potential participants appear to be entering the pathway, and the site wants to understand what is happening with those referrals before buying more volume. Start with the work already in front of the team. Look at how many referrals reach each stage, how long they stay there, which records remain unresolved, what follow-up has occurred, whether ownership and next actions are clear, whether handoffs need clarification, and what ultimately happened after site review. The goal is not to assume where the problem is. It is to make the current pathway visible enough to decide what deserves attention.
When More Referral Volume May Not Be the First Question
When More Referral Volume May Not Be the First Question
When generating more interest does not appear to be the immediate need, more referral volume may simply add work before the site understands how current referrals are moving. The practical first step is to review the work already happening and identify where records are moving cleanly, where they are waiting, and where the team needs better visibility.
Time in stage
Look at how long records remain in intake, preliminary prescreening, follow-up, or handoff. Longer waits may be worth reviewing in the context of the study and site.
Unresolved records
Identify records that do not yet have a clear disposition. Check what is still needed, who owns the next step, and whether a follow-up action is visible.
Follow-up and ownership
Review what follow-up has occurred, whether the next action is clear, and whether records can move from one person or team to another without losing context.
Handoff and site outcome
Check whether the site receives the information it expects and what ultimately happened after site review. That helps connect early enrollment work with site-controlled downstream outcomes without treating either as the sole cause.
Where to Look Within the Existing Pathway
Look at the pathway one step at a time. The goal is to see where records are moving, where they are waiting, what information is missing, and what the team knows about the next step.
Referral Intake
Start with the basics: what came in, whether the required information is present, who owns the record, and what should happen next.
Preliminary Prescreening
Check whether site-approved questions were completed, candidate-reported responses were documented, and unresolved items are easy for the site to see. This step organizes information; it does not determine eligibility.
Follow-Up
Review the contact history, timing, next action, and current status. If a record is still open, the team should be able to see why and who owns it.
Site Handoff
Look at whether the handoff contains the agreed information and whether the site routinely has to ask for missing context or reconstruct what happened.
After Site Review
Record the site-reported outcome when available. Screening, eligibility, informed consent, and randomization remain site-controlled, but those outcomes help complete the picture of how current referrals progressed.
Where Consent2Randomize May Support the Existing Pathway
When the review shows that the work after interest is an area the site wants help with, Consent2Randomize can support agreed intake, site-approved preliminary prescreening, follow-up, scheduling coordination, documentation, escalation, and handoff.
If the study also needs additional patient interest, recruitment can be scoped separately or alongside that support.
Intake Structure
Define the agreed information, ownership, status, routing, and next operational step for inquiries and referrals.
Preliminary Prescreening Support
Collect candidate-reported information through site-approved questions, document unresolved items, and prepare information for site review without determining eligibility.
Coordinator Workflow Support
Handle agreed non-clinical enrollment work before site review when the site wants additional capacity around intake, follow-up, coordination, documentation, or handoff.
Referral Handoff
Prepare a structured handoff with the agreed candidate-reported information, contact history, unresolved items, permitted scheduling context, escalation notes, and current status.
Performance Visibility
Track how many referrals reach each stage, how long records remain there, what follow-up has occurred, which items remain unresolved, and what site-reported outcomes are available.
Turn the Review Into a Next Action
Once the current pathway is visible, decide what the study’s own information actually supports.
That may be additional recruitment, clearer ownership, better follow-up visibility, a handoff change, added operational support, another study-specific response, or no change yet.
The point is not to change every stage. It is to identify the next change that the study’s own information can justify.
Who This Page Is For
Research Sites
Review how current referrals are moving before deciding whether more volume is needed.
Site Networks
Compare referral handling, ownership, follow-up, and handoff across multiple locations.
Sponsors
Understand whether the study’s current evidence points to additional recruitment, operational support, or another response.
CRO and Enrollment Partners
Review how referral generation connects with the work that follows before site review.
Frequently Asked Questions
Common questions about reviewing the current enrollment pathway before adding referral volume.
Related Resources
Keep Reading
Schedule a brief call
If enough potential participants are already entering the pathway and the site wants a clearer view of what is happening next, a brief conversation can help review the current workflow and decide what deserves attention.
The goal is to understand the study-specific situation before deciding whether recruitment, post-interest support, both, another response, or no change is appropriate.