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Timing of Physician Rounds for High-Risk Antepartum Patients

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Study AimThe study investigates how the timing of physician rounds affects the care and outcomes of expectant mothers who are considered high-risk.
What is being tested

Discovery Rounding

+ Standard Rounding
Behavioral
Who is being recruted

Behavior

+ Communication
Over 18 Years
See all eligibility criteria
How is the trial designed

Other Study

Interventional
Study Start: November 2025
See protocol details

Summary

Principal SponsorDuke University
Study ContactHannah Kelly, MDMore contacts
Last updated: December 11, 2025
Sourced from a government-validated database.Claim as a partner
Study start date: November 4, 2025Actual date on which the first participant was enrolled.

This research is focused on improving the hospital experience for patients with high-risk pregnancies who are staying in the hospital for a long time. These patients often need frequent visits from doctors, and the study is being conducted at Duke University Hospital. The aim is to find out if changing the timing of doctor visits can make these hospital stays better by improving how patients feel about the communication they have with their healthcare team. By potentially increasing satisfaction with communication, the study hopes to enhance the overall care experience for these patients. Participants in the study will experience one of two types of doctor visit schedules. In the standard schedule, doctors visit patients twice: an early morning visit at the bedside followed by a team discussion later. In the new approach being tested, called "discovery rounding," doctors will visit just once, later in the morning, after the team has reviewed all clinical data. This study is designed to see if having just one later visit makes patients feel better about how information is communicated to them. The research does not mention specific risks or benefits, but it focuses on measuring patient satisfaction with communication as an important outcome.

Official TitleEffect of Timing of Physician Rounds on Hospital Experience for High-Risk Antepartum Patients: A Randomized Controlled TrialTiming of Physician Rounds for Antepartum Patients 
NCT07215507
Principal SponsorDuke University
Study ContactHannah Kelly, MDMore contacts
Last updated: December 11, 2025
Sourced from a government-validated database.Claim as a partner

Protocol

This section provides details of the study plan, including how the study is designed and what the study is measuring.
Design Details
200 patients to be enrolledTotal number of participants that the clinical trial aims to recruit.
Other Study
Some studies explore topics that don't fall into a specific category. These might include innovative research, new technologies, or emerging healthcare areas.

How participants are assigned to different groups/arms
In this clinical study, participants are placed into groups randomly, like flipping a coin. This ensures that the study is fair and unbiased, making the results more reliable. By assigning participants by chance, researchers can better compare treatments without external influences.

Other Ways to Assign Participants
Non-randomized allocation: Participants are assigned based on specific factors, such as their medical condition or a doctor's decision.
None (Single-arm trial): If the study has only one group, all participants receive the same treatment, and no allocation is needed.

How treatments are given to participants
Participants are divided into different groups, each receiving a specific treatment at the same time. This helps researchers compare how well different treatments work against each other.

Other Ways to Assign Treatments
Single-group assignment: Everyone gets the same treatment.
Cross-over assignment: Participants switch between treatments during the study.
Factorial assignment: Participants receive different combinations of treatments.
Sequential assignment: Participants receive treatments one after another in a specific order, possibly based on individual responses.
Other assignment: Treatment assignment does not follow a standard or predefined design.

How the effectiveness of the treatment is controlled
In a non placebo-controlled study, no participants receive an inert substance (placebo) to compare outcomes. Instead, all participants receive either the experimental treatment or an alternative treatment (often the Standard of Care). This method allows researchers to compare the effects of the experimental treatment with those of a different active intervention, rather than a placebo.

Other Options
Placebo-Controlled: A placebo is used to compare the effects of the experimental treatment with those of an inert substance, isolating the true treatment effect.

How the interventions assigned to participants is kept confidential
Participants, researchers, and outcome assessors do not know which treatment is being given. This helps reduce bias not just during the study, but also when the results are being evaluated.

Other Ways to Mask Information
Open-label: Everyone knows which treatment is being given.
Single-blind: Participants do not know which treatment they are receiving, but researchers do.
Double-blind: Neither participants nor researchers know which treatment is given.
Quadruple-blind: Participants, researchers, outcome assessors, and care providers all do not know which treatment is given.

Eligibility

Researchers look for people who fit a certain description, called eligibility criteria: person's general health condition or prior treatments.
Conditions
Criteria
FemaleBiological sex of participants that are eligible to enroll.
Over 18 YearsRange of ages for which participants are eligible to join.
Healthy volunteers not allowedIf individuals who are healthy and do not have the condition being studied can participate.
Conditions
Pathology
Behavior
Communication
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

Study Plan

Find out more about all the medication administered in this study, their detailed description and what they involve.
Treatment Groups
Study Objectives
2 intervention groups 

are designated in this study

This study does not include a placebo group 

Treatment Groups
Group I
Experimental
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.

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 II
Active Comparator
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.

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 Objectives
Primary Objectives

The CAT measures patients' perceptions of physician communication across 15 specific behaviors, such as listening carefully, showing respect, explaining information clearly, and spending sufficient time with the patient. Each item is rated on a 5-point Likert scale ranging from "Poor" to "Excellent." By focusing on the frequency of "Excellent" ratings, the CAT provides a robust, patient-centered measure of the effectiveness and impact of physician communication during hospitalization.
Secondary Objectives

A 10-item self-report questionnaire, validated for both postpartum and antepartum use, in which each item is scored 0-3 (total 0-30), with higher scores indicating greater depressive symptoms and a common cut-off of ≥13 suggesting possible clinical depression.

Study Centers

These are the hospitals, clinics, or research facilities where the trial is being conducted. You can find the location closest to you and its status.
This study has 2 locations
Recruiting
Duke University HospitalDurham, United StatesSee the location
Recruiting soon
Duke University HospitalDurham, United States
Recruiting
2 Study Centers