Operationalizing a complex acute clinical trial: Lessons from the BEACH study.

Purpose: To outline the workflow, challenges, and key roles involved in operationalizing a complex, acute clinical trial protocol requiring multidisciplinary collaboration. Summary: Yale University School of Medicine and the Neuroscience Intensive Care Unit (NICU) at Yale New Haven Hospital leverage interdisciplinary collaboration to successfully enroll patients into complex clinical trials, including the Biomarker and Edema Attenuation in IntraCerebral Hemorrhage (BEACH) trial (ClinicalTrials.gov identifier: NCT05020535). The research team proactively educates nursing staff and clinicians on the study protocol, in addition to facilitating communication with the investigational drug pharmacy and supporting treating physicians in screening, enrollment, and follow-up. With 24/7 access to the research team, study coordinators are present for all protocol steps, including test article infusion, biospecimen collection and processing, and participant interactions. Successful execution of the BEACH trial relies on five key domains: ensuring patient safety in a high acuity setting, optimizing screening and enrollment processes, implementing efficient workflows for pharmacokinetic sampling and test article administration, identifying signals of efficacy, and adapting to operational challenges. These domains require precise coordination, clear communication, and adaptability within dynamic patient care environments. By streamlining workflows and maintaining open communication, the research team enhances efficiency and optimizes patient enrollment while upholding the highest standards of ethical research and patient care. Conclusion: Implementation of the BEACH trial at Yale exemplifies the critical role of interdisciplinary collaboration in advancing clinical research. By integrating research into patient care, the study team not only enhances trial efficiency, but also contributes to the development of innovative treatment strategies for intracerebral hemorrhage. Moving forward, the lessons learned from operationalizing BEACH can inform best practices for future acute trials, ensuring that research continues to drive meaningful improvements in patient outcomes.