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

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.

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