Efficiency Tips: Keep the Inbox and Sent Box Empty….and Archive Emails Weekly

Outlook Folder List
This is my Outlook folder list. I try to 
keep the inbox at less than 20 items at 
all times.

Today is Wednesday. I have received/sent and processed over 300 emails. Other Clinical Operations people in my immediate working group see even more traffic in their inbox but I can conservatively say that around 120 emails per day is my typical average. A few folks in my department file nothing and just rely on the blackberry and Outlook search functions to run their email empire. However, I feel pretty panicky if my inbox goes over about 20 messages or so. I use my inbox as my tasklist and I rely on folders and flags to keep everything organized. I’ve developed a system over the years to keep my inbox slim and zen-like and today I’m going to describe it to you. I also try to review and file items in my Sent box at the conclusion of every day because I prefer to file email responses with the original thread and keep my Sent box empty (Outlook can do this automatically for any message sent from any folder rather than the inbox.  In Tools->Options->Advanced Email Options-> you can select “Save replies with original message“).

The batch process approach to filing TMF correspondence
Most site managers I know wait until they are preparing to close out an investigative study site then they go back and read several years worth of emails, print out the ones they think should be filed (2 copies, one for the TMF and one for the site), carry the big bound stack with them to the site, and slip it in to complete the correspondence file. An issue with this approach is that it wastes a ton of time and paper plus you are almost assured to introduce duplicates since the coordinator has likely done something similar. Finally, you are assuming that A) you have time for this exercise at the end of the trial and B) that you will still be around/employed to execute this action. Sorry to be such a realist, but both A and B are not exactly solid suppositions. My approach is to file my emails weekly in the eTMF.  As a result, at the end of every week, I am confident that 90% of my TMF correspondence is filed. I am never more than two weeks behind.

Keeping the inbox empty (or nearly empty…)
I strive to process every email within an hour of receipt. When something hits my inbox I 1) delete it 2) respond to it quickly (and delete it or archive it) or 3) file it. Deleting an email straight away will save you time from re-reading it again; dump it! If the email doesn’t require action from me and I am not waiting on a response, I can just file that email or delete it. I have a folder for my manager/HR/corporate stuff and travel. I have a folder called Praise where I keep thank you notes and email records of major deliverables or accomplishments (this is useful at review time or when I need a pick me up after a defeating day/week). I have a folder for each study I work on. I have a folder for all sites in a study. I have a few folders to keep vendor communications. I have a folder called #Pending (the pound makes it sort to the top of my folder list) for anything with action indicated from me and that takes more than 2-3 minutes to address. I have a folder called #Waiting for things other people are tasked with but that I want to track or follow-up on. I have a folder called #File for items that may be candidates for the TMF correspondence section (no, I don’t file every email in the TMF).

You actually have to Process #Pending #Waiting #File & Sent
I deal with everything in #Pending (at least the items flagged Overdue, Today, and Tomorrow) in the mornings when I arrive at work and in the afternoon when I am wrapping up for the day.

Use Flags
I use flags (Today, Tomorrow, This Week, Next Week) and group by flag to keep #Pending manageable.

At the end of every day (or when I have a few minutes during the day) I go to my Sent folder and I group by conversation trail or category, delete most of the thread, and move the final message to #Pending, #Waiting, #File or one of my folders. Archived in a folder = no action indicated; never to be referenced again except possibly in a future search.

I go through #Waiting at least once a week. When something in #Waiting is addressed by an incoming email message I delete the item from #Waiting or archive it in a folder.

I process #File on Fridays or anytime the folder shows that it contains more than 50 items. I group it by category or stack it by subject line or conversation. I delete everything leading up to the final thread. I typically have about 15-20 actual emails to file each week and I copy those to our TMF. I can just drag and drop from Outlook into our Clinical Trial Management System.

Outlook Features Help Me Stay Organized
I use Outlook quick steps and rules to quickly file things and/or label/categorize (if an email goes to a certain person or has a certain site name referenced in the subject then it gets a label/category automagically for that site). I use Categorize extensively (newsletter, meeting minutes, issue, login credentials, one for every PI name, specific vendor, TMF, reference, reference doc, expense report, personal). I also use search folders, too (mail received this week, mail received this month, with attachments, logins, newsletter ideas, reference, reference docs, amendment items, mail to/from specific people).

Correspondence Reconciled. Easy.
Now that you are so organized, you can actually use correspondence to prepare for your visits and write your monitoring reports. A few days before every visit, I go to the Clinical Trial Management System eTMF, select all the correspondence since my previous monitoring visit and print it to one big PDF. I open that document when I am at the site and thumb through the correspondence that has been filed by the coordinator since my last visit (the coordinator always files new stuff in front of a colored piece of paper). If the coordinator has already filed the item I delete the page from my PDF. When I am all done I email the PDF to the coordinator (remember, the only pages left are the ones the coordinator did not have filed) and ask them to print it and we file it before I leave the site.

I know this all sounds really intense but the system works for me and I have inspired several colleagues to adopt the system (at least in part). Try a #Pending #Waiting of #File folder. You might find that you have a useable and less intimidating inbox moving forward. Be warned however, the whole system falls apart though if you aren’t disciplined about reviewing your new #Pending #Waiting #File and Sent boxes at regular intervals. Please share any email efficiency tips or tricks that you find helpful.

About The Author

The Lead CRA

Nadia started The Lead CRA blog in 2007. She is now lead author for ClinOps Toolkit. Nadia is currently working as a Clinical Program Manager at a small specialty pharmaceutical company in the San Francisco Bay Area. You can reach Nadia via email at [email protected] anytime.


  • The Lead CRA

    The Lead CRA

    April 22, 2011

    Hi KL, I have one folder per study and sub-folders for each site. I hope my post helped you figure out which emails should go in the TMF. If not, please refer to this post I did a few weeks ago which should address your question.

    Also, to qualify here a bit, my job is heavy in site management and I am filing to the TMF weekly because there is a lot of correspondence. However, if I was on an International or large Phase III trial with a separate lead CRA or a country lead(s), I might be inclined just to categorize things by site and to stash all in one folder since the outlook search function works so well. The lead would be the point of contact with the sites and would be on the hook for the TMF maintenance. I would probably use contact reports or just do global correspondence and less frequently for sure rather than on a site-by-site basis. So this entire post might not be applicable to an in-house CRA who focuses on vendor management and infrequently interacts with the investigative sites.

  • Hi nadia,
    Just to say well done in keeping this blog up to date! I recently resigned and during my last few days i had a panic attack when i couldnt manage my emails. I didnt know which one to file.i know i should file the final thread but sometimes i dont know what contents should be filed.
    And im not sure if i should also tmf the Sent emails?
    So, i left a huge chunk in my email backup server before i left. I only can hope the person after me will not be in big trouble.
    I also want to ask when you said you have 1 folder for all sites for 1 study, do you mean you chuck in all the emails pertaining to that study into that folder or do you create more folders according to sites or according to tmf index?
    Pardon me for my many questions but i have been struggling with this questions for months!


  • The Lead CRA

    The Lead CRA

    April 15, 2011

    Hi TNM, I plan to tackle your comment over a series of upcoming blog posts. I probably won’t be providing a template for any specific trackers but I do have some pretty strong opinions and general thoughts on this topic and I thank you for the question. Look for an update soon. 🙂

  • TNM

    April 15, 2011

    Hello Nadia,

    Can you please provide tips, advice, or a template for making Trackers. How much info is too much or not enough when making a tracker, i.e. site trackers, document trackers, etc? Thank you.

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