Get Beyond Low-Hanging Fruit to Achieve Meaningful Change in Clinical Development

Low-Hanging Fruit

In a LinkedIn article called, “Perpetual Piloting: Addressing the endless “one-off” approach to innovating within clinical development,” Steve Shevel, vice president, operations, clinical development and quality at Hawthorne Effect, Inc., advocates the idea of taking advantage of change through innovation by not  relying on the old, risk-averse model of piloting. Instead of taking small steps that only yield a little bit of progress, he believes that taking risks and ruffling feathers will be worthwhile in the long run.


Shevel defines piloting as trying something new but only under specific, tightly controlled conditions. They include: picking a trial or project that is not pivotal or important; taking a very conservative approach to implementation by embedding entrenched procedures and practices that are borne from our current modus operandi; assigning a few people to the project that are not involved in, or critical to, the highest priority projects; getting nominal support from executive management with the caveat that this will not impact day-to- day operations; and treating this initiative as a “one-off” that could be expanded more broadly and pursuing it through that lens.


Although these stipulations are logical ways to manage risk, they may not get much accomplished. Projects that are not given a high priority have less credibility. Staying in the comfort zone distorts benefits and limits the scope of achievements. Not using the best people in the company for high-priority projects will keep those people from championing the projects if they get adopted. Executive management needs to provide total support to a project. Innovation should be treated as a high priority, not something to be tried occasionally and then abandoned.


According to Shevel, “Perhaps the most damaging (unintended) consequence of perpetual piloting is that it sours the concept of innovation within the broader workforce, especially for those, once starry-eyed individuals who were assigned to previous pilot projects. These initially enthusiastic individuals expended enormous amounts of personal and political capital to move an initiative forward and strove to attain broad company support, only to witness those efforts drowned out or marginalized in the end.”

Sometimes, efforts at innovation could achieve real progress if they are given a chance to succeed. Unless they get that chance, the people involved in the projects will probably be less enthusiastic the next time they are asked to work on a new initiative. Their colleagues will be less excited as well.


Shevel wants to “avoid this cyclical journey of perpetual piloting.” To break the cycle, he recommends that it has to hurt at least a little if a company does not succeed and that companies “have to be willing to ruffle not just some, but a lot of feathers.” Executive support is critical to any innovation. There must be “leadership and/or input from people with the right mixture of knowledge and soft skills that can help knit all the threads together and know where and when to pull and push to get the right support,” Shevel says. He concludes that innovation requires “a level of risk tolerance at the executive level” to not put everything on the line but to make some sacrifices in the name of progress.

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