Managing an efficient, well-organized start-up phase is critical to overall study success. While IRB review is just one element of the study start-up process, the IRB can play a crucial role in reaching key study milestones in multisite clinical trials for sponsors, CROs, and research sites. By partnering early and communicating openly with your IRB, researchers and study sponsors can see a significant reduction in time spent on the initial IRB review process, which can influence and improve overall study start-up timelines and success.