RecruitingNot ApplicableNCT07215507

Timing of Physician Rounds for Antepartum Patients

Effect of Timing of Physician Rounds on Hospital Experience for High-Risk Antepartum Patients: A Randomized Controlled TrialTiming of Physician Rounds for Antepartum Patients

Sponsor

Duke University

Enrollment

200 participants

Start Date

Nov 4, 2025

Study Type

INTERVENTIONAL

Conditions

Communication Physician Rounds

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.

Eligibility

Sex: FEMALEMin Age: 18 Years

Inclusion Criteria1

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

Exclusion Criteria11

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

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Interventions

BEHAVIORALDiscovery 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.

BEHAVIORALStandard 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.