 The National Centre for Advancing Translational Science, NCATS, Sponsored Clinical and Translational Science Award, CTSA, program and other NIH institutes and centers have developed the Trial Innovation Network, TIN, which seeks to improve the efficiency and quality of clinical trials by providing a centralized review board, contracting agreements, and other tools. The TIN has already received over 100 submissions from 40 different CTSA institutions and eight non-CTSA institutions with projects associated with 12 different NIH institutes and centers. Additionally, the TIN has launched a national-scale single, central IRB system master contracting agreements, quality by design approaches, novel recruitment support methods, and evidence-based strategies to recruitment and patient engagement. This article was offered by Gordon R. Bernard, Paul A. Harris, Jill M. Pooley, and others.