Most site selection decisions still come down to a relationship with a familiar principal investigator, a promising feasibility call, and a gut feeling. It works often enough that teams keep doing it, until it doesn't: an underperforming site discovered three months into enrollment, after the budget and timeline are already locked in.
Why a checklist isn't enough
A feasibility checklist tells you whether a site meets minimum requirements. It doesn't tell you whether Site A is a better bet than Site B when both look qualified on paper. That comparison needs weighted criteria, not a pass/fail list, because patient population, staff experience, and prior enrollment performance don't carry equal weight for every protocol.
What to weight, and why
Four variables consistently separate sites that hit enrollment targets from sites that don't: eligible patient volume against realistic screen-failure rates, PI and coordinator experience with the specific therapeutic area, historical enrollment-to-target ratio on comparable studies, and start-up speed based on IRB and contracting turnaround on past trials. Competing interest in the same indication and staff turnover are worth tracking too, but they should adjust a score, not anchor it.
Turn the questionnaire into a decision
The feasibility questionnaire is an input, not the output. Once responses come back, scoring every candidate site against the same weighted criteria turns a folder of PDFs into a ranked shortlist you can actually defend to a sponsor or steering committee, and it gives you a documented rationale if a site underperforms later.
Where this fits in start-up
Site selection is one stage in a longer start-up sequence that also includes essential document collection, activation tracking, and risk logging. Our Site Feasibility & Selection Scorecard builds this weighted scoring directly into a ready-to-use Excel tracker, and it's also included as one of eleven templates in the Clinical Trial Start-Up Toolkit, alongside a fully worked example so your team can see exactly how each score should be filled in.