Why Strong Research Sites Still Struggle to Win Studies

Many new and growing research sites assume that strong patient access, motivated investigators, and clinical expertise will naturally translate into awarded studies. While these elements are essential, they are rarely sufficient on their own.

In today’s clinical research environment, sponsors and CROs are reviewing dozens and often hundreds of potential sites under compressed timelines and increasing operational pressure. Sites that are not clearly positioned, easy to understand, or consistently visible are frequently overlooked regardless of their underlying quality.

For newer organizations, recognizing this reality early is critical. The gap between capability and selection is often not performance. It is positioning.

Why Quality Often Goes Unnoticed

High performing sites frequently struggle to secure studies because their strengths are not communicated in a way that supports sponsor decision making. Sponsors cannot select sites they are unaware of, and they cannot confidently select sites they cannot quickly evaluate.

For new or growing sites, this challenge is compounded by limited brand recognition, fragmented outreach, or inconsistent messaging. The quality exists, but the signal does not.

What this means for new sites:

• Performance matters only when it is visible

• Being good is not enough. Being clear is essential

• Sponsors prioritize predictability, organization, and confidence alongside experience

Business Development Best Practice: Build Visibility Before You Need It

Visibility should be established well before feasibility requests arrive. Sites that wait until opportunities appear often find themselves reacting rather than being considered.

Effective visibility is not about constant outreach. It is about consistency and clarity.

Best practices for new and growing sites:

• Maintain a clear, current site profile that reflects actual capabilities

• Establish consistent and reliable points of contact for sponsors and CROs

• Ensure core information such as therapeutic focus, patient populations, experience, and infrastructure is easy to find and easy to understand

Sponsors are not looking for perfection. They are looking for sites that are easy to evaluate and easy to trust.

Business Development Best Practice: Treat Feasibility as a Strategic Tool

For many sites, feasibility questionnaires are handled reactively or inconsistently. For sponsors and CROs, feasibility responses are a primary decision making input.

Timely, accurate, and realistic feasibility submissions signal operational maturity, even for newer sites.

Best practices for new and growing sites:

• Respond promptly, even if internal coordination is still underway

• Ensure feasibility data is consistent, accurate, and defensible

• Assign clear ownership for completion, review, and follow up

A strong feasibility response can often offset a limited track record by demonstrating organization, preparedness, and accountability.

Business Development Best Practice: Develop a Clear Site Narrative

New and growing sites often struggle to articulate what differentiates them. Without a defined narrative, sites risk blending into a crowded selection pool.

A clear site narrative allows sponsors to quickly understand where a site fits and why it should be shortlisted.

Best practices for new and growing sites:

• Clearly define therapeutic strengths and realistic enrollment advantages

• Be transparent about experience while highlighting operational support and structure

• Align your narrative with the types of studies you are best positioned to execute

Clarity builds confidence, especially when experience is still developing.

Business Development Best Practice: Treat Business Development as a Leadership Function

In early stage sites, business development is often informal or delegated to already overextended staff. While understandable, this approach frequently results in inconsistent outreach, missed follow ups, and misaligned growth.

Treating business development as a defined leadership responsibility, even on a small scale, creates focus, discipline, and continuity.

Best practices for new and growing sites:

• Assign clear ownership of business development activities

• Align outreach with operational capacity and staffing readiness

• Track outreach efforts, sponsor responses, and outcomes over time

Even modest structure can dramatically improve consistency and results.

Positioning Is the Foundation of Sustainable Growth

At Healthcare Business Associates, we work with many new and growing research sites that are capable, motivated, and clinically strong but lack clear positioning. In nearly every case, growth accelerates when sites move from reactive outreach to intentional and strategic business development.

Business development is not about chasing volume. It is about making it easy for sponsors and CROs to understand your value, trust your readiness, and envision a long term partnership.

For new and growing research sites, the earlier this foundation is built, the stronger and more sustainable growth becomes.