Protocol amendments arrive constantly, and each one can trigger a cascade of rework across the budget, coverage analysis, consent form, calendar, and contract. This session looks at how to absorb amendments without losing activation momentum. We will discuss triage, meaning how to determine which amendments actually change the financial or billing picture, along with version control, parallel processing, and pre-negotiated amendment terms that avoid reopening the entire budget. The session also covers metrics for measuring amendment turnaround and the true cost of rework. Attendees will leave with practical tactics for turning amendment handling from a bottleneck into a routine process.