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Substantial evidence has now been provided that stakeholder involvement is essential for management effectiveness in clinical research and implementation of new proposals.

Feedback from stakeholders has critical value for research managers in as much as it alerts them to the social, environmental, and ethical implications of research activities.

Additionally, those who are directly affected by program development and clinical research, the patients, their families, and others, almost universally have a strong motivation to be involved in the planning and execution of new program changes. Stakeholders are the customers, suppliers, the general public, and any other group, which are likely to be affected by the organization's ultimate decisions.

The process of incorporating the ideas and input from these groups has been termed "stakeholder engagement." It reflects an increasingly accepted attitude that organizations not only have an ethical obligation to involve the participation of stakeholders in their collective activity but also in so doing their overall organizational effectiveness will be enhanced (Pandi-Perumal, Akhter, Zizi, Jean-Louis, Ramasubramanian, Freeman, & Narasimhan, 2015). The process of identifying, engaging stakeholders must begin well in advance so that dialog is seen to play an important part of project implementation; no decisions should be already made before commencing stakeholder engagement on project-related issues.

Stakeholder engagement is intended to help administrators fully realize the benefits of applying community and patient interest in hospital programs, and to ensure that research and program changes benefit those who are most directly affected. The stakeholder focus group is a communication medium through which the opinions of individuals or groups of individuals who are impacted by the research can be elicited.

Focus groups can also serve to clarify each stakeholder's role and responsibilities, as well as promoting an overall understanding of the project requirements. Such processes also provide stakeholders with an environment in which they can express their opinions and feel that they have been heard (Pandi-Perumal, Akhter, Zizi, Jean-Louis, Ramasubramanian, Freeman, & Narasimhan, 2015).

Pandi-Perumal, S. R., Akhter, S., Zizi, F., Jean-Louis, G., Ramasubramanian, C., Freeman, R., & Narasimhan, M. (2015). Project Stakeholder Management in the Clinical Research Environment: How to Do it Right. Frontiers in Psychiatry, 6, 71.