The Clinical Trials Transformation Initiative (CTTI) is a public-private partnership to develop and drive adoption of practices that will increase the quality and efficiency of clinical trials. We envision a high quality clinical trial system that is patient-centered and efficient, enabling reliable and timely access to evidence-based prevention and treatment options. To realize this vision, CTTI convenes a diverse cross-section of stakeholders in the clinical trials enterprise to innovate through collaboration. The results of our workshops, expert meetings and other collaborative efforts take many forms, including academic publications, official recommendations and changes in practice.