Table 4 The D2d hybrid budget management model: lessons learned

 • Encourage multi-disciplinary teamwork that engages the Principal Investigator, Coordinating Center, Research Administration at the prime, subaward institutions, and the funding agency.

 • Allocate resources based on results, not just effort.

 • Maintain open-mindedness and flexibility when addressing sites’ concerns.

 • Provide Core support and sufficient resources for study start-up.

 • Accept that sites will be discontinued and sites will be added.

 • Project that recruitment will take longer and the outcome event rate may be lower than predicted.

 • Reinforce the model’s principles to site staff.