Timing of Physician Rounds for High-Risk Pregnancy
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial explores whether adjusting the timing of doctor visits can enhance communication for patients with high-risk pregnancies. It compares two methods: the standard approach with two separate visits (Standard Rounding) and a new method that combines these into one visit later in the morning (Discovery Rounding). The goal is to determine if the new timing improves patient satisfaction with their care. Pregnant women more than 20 weeks along and staying at Duke University Hospital without certain complications may be eligible to join. As an unphased trial, this study provides a unique opportunity to contribute to improving patient care practices.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.
What prior data suggests that these rounding methods are safe for high-risk pregnancy patients?
A previous study showed that both standard and discovery rounding methods are well-tolerated in managing high-risk pregnancies. No direct evidence from the study indicated any adverse effects related to the timing of doctor visits. These methods emphasize communication and care management, minimizing safety issues.
Standard rounding involves two visits: one early in the morning and another later in the day. Discovery rounding combines these visits into one later in the morning. This approach aims to improve communication and satisfaction without compromising patient safety. Existing data suggest that the timing and method of visits do not introduce significant risks to patients.12345Why are researchers excited about this trial?
Researchers are excited about this trial because it explores an innovative approach to managing high-risk pregnancies called "Discovery Rounding." Unlike the traditional method of rounding, which involves early morning bedside visits and two separate patient encounters, Discovery Rounding streamlines the process. It eliminates early morning disturbances by focusing on electronic health record reviews before the team discussion and consolidates the bedside interaction to one mid-morning session. This approach not only aims to reduce patient disruption but also seeks to enhance the efficiency of care delivery and communication within the medical team.
What evidence suggests that these rounding methods could improve patient satisfaction for high-risk pregnancies?
Research has shown that having doctors visit patients in a single, later-morning meeting, known as discovery rounding, can enhance communication satisfaction among high-risk pregnancy patients. This approach avoids early wake-ups, allowing patients to rest better and be more attentive during discussions. In this trial, some participants will experience discovery rounding, while others will receive standard rounding. Previous studies on similar patient-focused care models have demonstrated that more focused interactions improve patient satisfaction with care. While specific data on the effectiveness of discovery rounding is still being gathered, the method aims to enhance the patient experience by prioritizing rest and meaningful communication.678910
Who Is on the Research Team?
Rachel Wood, MD
Principal Investigator
Duke University Hospital
Hannah Kelly, MD
Principal Investigator
Duke University Hospital
Are You a Good Fit for This Trial?
This trial is for patients admitted to the Antepartum service at Duke University Hospital without complications that prevent them from participating in delayed daytime rounding. It's designed for those managing high-risk pregnancies requiring extended hospital stays.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants are randomized to either standard rounding or discovery rounding models during their hospital stay
Follow-up
Participants are monitored for satisfaction with communication and depressive symptoms
What Are the Treatments Tested in This Trial?
Interventions
- Discovery Rounding
- Standard Rounding
Trial Overview
The study compares two physician rounding methods on patient satisfaction: standard rounding with an early morning and later team discussion, versus discovery rounding which combines both into a single late-morning bedside encounter after team review.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Active Control
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.
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.
Find a Clinic Near You
Who Is Running the Clinical Trial?
Duke University
Lead Sponsor
Citations
Timing of Physician Rounds for High-Risk Antepartum ...
Study AimThe study investigates how the timing of physician rounds affects the care and outcomes of expectant mothers who are considered high- ...
Prenatal prognostics: Validating high-risk pregnancy ...
It categorizes pregnancies into three groups: low risk, high risk, and extremely high risk, depending on the score range. The data show that out ...
High-risk pregnancies according to five risk assessment ...
The detection of high-risk pregnancies ranged from 17.6 % to 46.8 %. Sensitivity ranged from 23.6 % to 52.4 %, while specificity varied between 58.1 % and 88.6 ...
Pfizer Upholds Commitment to Transparency and Shares ...
Furthermore, a comprehensive analysis from 177 studies with data from 638,791 pregnant women observed statistically significant reductions in ...
Pregnancy outcome among high-risk pregnant women in the ...
Conclusions: 70.5% of the high-risk mothers had good pregnancy outcomes. The scoring system can be used by health workers for the prediction of high-risk ...
Care Providers' Perspectives on Quality Prenatal Care in ...
Pregnancy is considered high-risk whenever the probability of adverse outcomes for the mother or baby is higher than that for the population of normal pregnant ...
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clinicaltrialsarena.com
clinicaltrialsarena.com/sponsored/leveraging-real-world-data-in-post-marketing-regulatory-studies-for-pregnancy-safety/Leveraging real-world data for pregnancy safety
This scale is vital for detecting rare outcomes or drug exposure effects that might only appear in 1 out of 1,000 or 1 out of 10,000 pregnancies ...
ANTEPARTUM CARE - Nursing Health Promotion - NCBI - NIH
The goal of preconception care is to optimize a person's health and readiness for pregnancy, mitigate potential risks to promote healthy pregnancies, and ...
Health system barriers and predictors of prenatal care ...
This retrospective cohort study analyzed several potential barriers to prenatal care among postpartum patients who delivered at Loyola University Medical ...
10.
bmcpregnancychildbirth.biomedcentral.com
bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1522-2A systematic overview of the literature regarding group ...
Group prenatal care (GPC) models have been gaining popularity in recent years. Studies of high-risk groups have shown improved outcomes.
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