Timing of Physician Rounds for Antepartum Patients

Conditions

• Communication
• Physician Rounds

Eligibility Criteria

Sex

FEMALE

Age

18 Years - N/A

Healthy Volunteers

Not accepted

Interventions

• Discovery Rounding — BEHAVIORAL
  For certain patients with appropriate clinical risk factors, our service has adopted a policy of "discovery rounding". This method involves solely electronic health record chart review prior to the 8am attending-led Antepartum team discussion where the patient's overnight events are "discovered", clinical courses discussed, and daytime plans proposed. "Discovery rounding" consolidates bedside physician-patient encounters to one mid-morning interaction, forgoing early morning disturbances.
• Standard Rounding — BEHAVIORAL
  The current standard of rounding on the Antepartum service involves a preliminarily bedside encounter with patients between 5-7am by a resident +/- medical student before an attending physician-led Antepartum team discussion from 8-9am. The patient is then rounded on for a second time in the late morning by the entire Antepartum team where patient concerns are heard and care plans for the day are relayed/reiterated/cemented.

Study Details

This study will include patients admitted to the Antepartum service at Duke University Hospital, many of whom are managing high-risk pregnancies that require extended hospital stays and frequent physician interactions. Currently, two rounding methods are used interchangeably for patients who do not have pregnancy or delivery complications that would preclude participation in delayed daytime rounding. This randomized controlled trial will compare two rounding models: the standard model, in which patients receive two rounds (an early morning bedside encounter and a later team discussion), and the intervention model, which consolidates both rounds into a single, later-morning bedside encounter following the team's review of clinical data. The primary objective is to assess whether consolidating physician rounds into a single, later-morning encounter-referred to as discovery rounding-improves patient satisfaction with communication.

Key Dates

Start date

Nov 4, 2025

Status verified

Nov 2025

Primary completion

Jan 30, 2027

Completion

Feb 20, 2027

Study Design

Enrollment

200 participants (estimated)

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

OTHER

Arms

• Active Comparator: Standard Rounding
  The current standard of rounding on the Antepartum service involves a preliminarily bedside encounter with patients between 5-7am by a resident +/- medical student before an attending physician-led Antepartum team discussion from 8-9am. The patient is then rounded on for a second time in the late morning by the entire Antepartum team where patient concerns are heard and care plans for the day are relayed/reiterated/cemented.
• Experimental: Discovery Rounding
  For certain patients with appropriate clinical risk factors, our service has adopted a policy of "discovery rounding". This method involves solely electronic health record chart review prior to the 8am attending-led Antepartum team discussion where the patient's overnight events are "discovered", clinical courses discussed, and daytime plans proposed. "Discovery rounding" consolidates bedside physician-patient encounters to one mid-morning interaction, forgoing early morning disturbances.

Primary Outcome Measure

Proportion of items rated as "Excellent" on the Communication Assessment Tool (CAT) [ Time Frame: One of the following timepoints (whichever comes first for that patient); Hospital day 6 or the immediate postpartum period: postpartum day 0 or 1, depending on the time of delivery ]

Central Contacts

• Hannah Kelly, MD
  832-967-7998
  [email protected]
• Rachel Wood, MD
  [email protected]

Locations (2)

Find similar trials in Durham, NC

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