Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT01931553
Other study ID # RoundingUCSF
Secondary ID
Status Completed
Phase N/A
First received August 16, 2013
Last updated May 14, 2015
Start date September 2013
Est. completion date December 2014

Study information

Verified date May 2015
Source University of California, San Francisco
Contact n/a
Is FDA regulated No
Health authority United States: Institutional Review Board
Study type Interventional

Clinical Trial Summary

Attending morning rounds take place at teaching hospitals every day. They are the primary mechanism for patient care delivery, supervision and education of trainees, and communication with patients, families, and staff. However, they are done with little standardization or widely recognized best practices.

The objective of this quality improvement (QI) initiative is to evaluate the adherence to and impact of implementing standardized attending morning rounds on medicine teams at our institution. A standardized rounding intervention has been developed which includes specific guidance on completing the following activities during morning rounds: (1) Pre-rounds discretion; (2) Pre-rounds huddle; (3) Bedside registered nurse (RN) integration; (4) Patient-centered rounding; (5) Real-time order writing.

This trial will randomize half of the investigators' medicine teams at University of California San Francisco to this rounding intervention whilst the other half will be randomized to continue with usual unstandardized rounding practices.

The investigators will compare medicine teams randomized to undertake standardized rounding to those teams undertaking usual practice. Outcomes assessed will relate to the patient (e.g. satisfaction), providers (e.g. satisfaction), efficiency (e.g. total morning round time) as well as adherence to the intervention .

The investigators' study hypotheses are that patient satisfaction scores will be higher for those patients receiving standardized bedside rounds compared to the usual care group. The investigators also hypothesize that total attending morning rounds time and interns length of workday will be shorter and that the number of consultations ordered before noon will increase for those teams undertaking standardized bedside. Further, the investigator hypothesize higher levels of nurse participation, physician and medical student satisfaction with standardized bedside rounding.


Recruitment information / eligibility

Status Completed
Enrollment 1200
Est. completion date December 2014
Est. primary completion date February 2014
Accepts healthy volunteers No
Gender Both
Age group 18 Years and older
Eligibility Inclusion Criteria:

- All attending physicians, residents, interns and medical students of Medicine teams A through H

- All patients admitted to Medicine teams A through H

- All nurses on the Medicine floors

Exclusion Criteria:

Study Design

Allocation: Randomized, Intervention Model: Single Group Assignment, Masking: Single Blind (Subject), Primary Purpose: Health Services Research


Intervention

Other:
Standardized attending morning rounds


Locations

Country Name City State
United States University of California San Francisco Medical Center San Francisco California

Sponsors (1)

Lead Sponsor Collaborator
University of California, San Francisco

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Other Number of discharges before noon Daily during the 3-month trial No
Other Cost of care per patient Average cost of care per patients for each group for entire 3-month study period For entire 3 month study period No
Other Length of stay Average length of stay for each group for entire 3-month study period For entire 3 month study period No
Other 30-day readmission rate Average readmission rate for each group for entire 3-month study period For entire 3 month study period No
Other Adherence to the intervention Adherence to the standardized intervention will be recorded throughout the trial to determine the uptake of this intervention in everyday practice. Daily during the 3-month trial No
Primary Patient satisfaction with morning rounds Patient satisfaction with morning ward rounds. This inpatient assessment will occur after day one of hospitalization before the patient is discharged from hospital. This time point will ensure that patients have experienced rounds at least once before completing a patient satisfaction survey. Once, after day one of hospitalization and before patient is discharged. No
Primary Patient satisfaction with provider communication Post-discharge assessment will be sent by a commercial Vendor (Press Ganey) within a month of discharge following hospitalization Once, within one month of hospital discharge No
Secondary Interns total length of workday The interns total length of workday will be recorded daily. Over the course of the trial the average length of workday will be determined including any duty hour violations. Daily during the 3-month trial No
Secondary Number of consultations ordered before noon The number of consultations ordered before noon will be recorded daily. Over the course of the trial the average number of consultations ordered before noon will be calculated. Daily during the 3-month trial No
Secondary Resident satisfaction Resident satisfaction and perceptions of with morning rounds (e.g. efficiency, organization, educational value) Once during the last week of their rotation on a given team No
Secondary Attending physician satisfaction Attending physician satisfaction and perceptions of with morning rounds (e.g. efficiency, organization, educational value) Once during the last week of their rotation on a given team No
Secondary Medical student satisfaction Medical student satisfaction and perceptions of with morning rounds (e.g. efficiency, organization, educational value) Once during the last week of their rotation on a given team No
Secondary Nurse participation in morning rounds The presence of RN during morning ward rounds will be recorded daily. Daily during the 3-month trial No
Secondary Nurse satisfaction Nurse satisfaction and perceptions of with morning rounds (e.g. efficiency, organization, team work) Once during the last week the trial No
Secondary Intern satisfaction Intern satisfaction and perceptions of with morning rounds (e.g. efficiency, organization, educational value) Once during the last week of their rotation on a given team No
Secondary Total morning rounding time Total morning rounding time will be recorded daily for each team. Over the course of the trial the average length of morning rounds will be determined. Daily during the 3-month trial No
See also
  Status Clinical Trial Phase
Completed NCT03297567 - Physical Therapy Guidelines For Hospitalized Elderly N/A
Terminated NCT03825497 - The WALK-Copenhagen Trial (WALK-Cph): a Mixed Methods Study N/A
Completed NCT06293768 - Continuous Wireless Monitoring for Patients in the Internal Medicine UOC. Randomized Controlled Trial (GreenLineH-T) N/A
Completed NCT03296423 - Bacillus Calmette-guérin Vaccination to Prevent Infections of the Elderly Phase 4
Not yet recruiting NCT05550272 - Hospitalizations in Neonatal Period and Early Discharge of Maternity
Completed NCT02614638 - Evaluation of the Impact of the Presence of a Pharmacy Technician on the Quality and Cost of Drug Therapy N/A
Completed NCT00527774 - Effect of HCV Infection on Insulin Resistance and Malnutrition-inflammation Complex Syndrome in Regular Hemodialysis Patients N/A
Completed NCT02598115 - Impact of Collaborative Pharmaceutical Care on Hospital Admission Drug Prescriptions for Patients 65 Years of Age and Older N/A
Recruiting NCT05366075 - The Preventing Functional Decline in Acutely Hospitalized Older Patients (PREV_FUNC) Study Phase 3
Not yet recruiting NCT05522647 - Detection of Risk Behaviors: Pilot Observational Study With Bedridden and Agitated Patients.
Terminated NCT04257422 - Intentional Rounding in Internal Medicine N/A
Completed NCT00244673 - Randomized Study of Not Giving Diphteria-tetanus-pertussis Vaccination With or After Measles Vaccination Phase 4
Completed NCT00370916 - Reducing Transition Drug Risk N/A
Recruiting NCT04078334 - Personalized Exercises Program Prescription to Prevent Functional Decline Throughout Older Adults Hospitalization N/A
Active, not recruiting NCT04235374 - Implementation of Function Focused Care in Acute Care N/A
Recruiting NCT03651414 - Safety Issues and SurvIval For Medical Outliers
Completed NCT05247060 - Orthostatic Hypotension in Hypertensive Patient Hospitalized in Internal Medicine
Terminated NCT05518474 - Self-proning and Repositioning in COVID-19 Outpatients at Risk of Complicated Illness N/A
Recruiting NCT04033718 - Inpatient Package to Reduce HIV and AIDS-related Death in Zambia N/A
Recruiting NCT05036824 - Intensive Dose Tinzaparin in Hospitalized COVID-19 Patients