Timing of Physician Rounds for Antepartum Patients

NCT ID: NCT07215507

Last Updated: 2025-11-04

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 200 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-11-04
• Study Completion Date: 2026-02-20

Brief Summary

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.

Conditions

Physician Rounds; Communication

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: TRIPLE

Study Groups

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.

Group Type: ACTIVE_COMPARATOR

Standard Rounding

Intervention Type: 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.

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.

Group Type: EXPERIMENTAL

Discovery Rounding

Intervention Type: 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.

Interventions

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.

Intervention Type: BEHAVIORAL

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.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• Pregnant women greater than 20 weeks gestation admitted to the antepartum list at Duke University Hospital

Exclusion Criteria

• Stillbirth
• ICU admission
• Admission to off-service unit
• Active magnesium sulfate administration
• Active severe hypertension or initiation of anti-hypertensive pathway within past 8 hours
• Category II fetal heart rate tracing
• Other pregnancy/delivery complication precluding delayed rounding
• Unstable/unsuitable condition per overnight team or attending physician
• Previously enrolled/on active board >1 day at morning rounds
• Postpartum readmission
• Antepartum admission within the last 4 weeks

• Minimum Eligible Age: 18 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

Duke University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Hannah Kelly, MD

Role: STUDY_DIRECTOR

Duke University Hospital

Rachel Wood, MD

Role: PRINCIPAL_INVESTIGATOR

Duke University Hospital

Locations

Duke University Hospital

Durham, North Carolina, United States

Site Status: NOT_YET_RECRUITING

Duke University Hospital

Durham, North Carolina, United States

Site Status: RECRUITING

Countries

United States

Central Contacts

Hannah Kelly, MD

Role: CONTACT

hannah.kelly@duke.edu

832-967-7998

Rachel Wood, MD

Role: CONTACT

rachel.wood@duke.edu

Facility Contacts

Caroline Oviedo

Role: primary

caroline.oviedo@duke.edu

786-301-2944‬

Caroline Oviedo

Role: primary

caroline.oviedo@duke.edu

786-301-2944‬

Hannah Kelly, MD

Role: backup

hannah.kelly@duke.edu

832-967-7998

Other Identifiers

Pro00118226

Identifier Type: -

Identifier Source: org_study_id