Morning RoundsNCT01931553
A Pragmatic Cluster Randomized Controlled Trial to Standardize Attending Morning Rounds in Medicine
A study testing Standardized attending morning rounds in people with Morning Rounds and Teaching Rounds, run by University of California, San Francisco at 1 site in United States.
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. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Morning Rounds, Teaching Rounds, Hospitalization
- What is being tested?
- Standardized attending morning rounds
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 1,200 participants
- Where
- 1 siteUnited States
- Study dates
- Sep 2013to Dec 2014
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 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
Who cannot join
- None
Trial locations and contacts
1 site in 1 country.
United States1 site
University of California San Francisco Medical Center
San Francisco, California, 94143
About this study
Official title: Back to Bedside: A Pragmatic Cluster Randomized Controlled Trial to Standardize Attending Morning Rounds in Medicine
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.
Read more
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.
- Being tested
- Standardized attending morning rounds
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Standardized attending morning roundsOther
| Study group | Role | What they receive |
|---|---|---|
| Standardized attending morning rounds | Experimental | 1. Pre-rounds discretion
2. Pre-rounds huddle
3. Bedside RN integration
4. Patient-centered rounding
5. Real-time order writing Receives: Other: Standardized attending morning rounds |
| Usual rounding practice | No intervention | Usual rounding practice (as defined by each clinical team) |
What is being measured
The primary outcome is the main question the study is designed to answer.
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.
Measured: Once, after day one of hospitalization and before patient is discharged.
Patient satisfaction with provider communication
Post-discharge assessment will be sent by a commercial Vendor (Press Ganey) within a month of discharge following hospitalization
Measured: Once, within one month of hospital discharge
Secondary outcomes (9)
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.
Measured: Daily during the 3-month trial
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.
Measured: Daily during the 3-month trial
Resident satisfaction
Resident satisfaction and perceptions of with morning rounds (e.g. efficiency, organization, educational value)
Measured: Once during the last week of their rotation on a given team
Attending physician satisfaction
Attending physician satisfaction and perceptions of with morning rounds (e.g. efficiency, organization, educational value)
Measured: Once during the last week of their rotation on a given team
Medical student satisfaction
Medical student satisfaction and perceptions of with morning rounds (e.g. efficiency, organization, educational value)
Measured: Once during the last week of their rotation on a given team
Nurse participation in morning rounds
The presence of RN during morning ward rounds will be recorded daily.
Measured: Daily during the 3-month trial
Nurse satisfaction
Nurse satisfaction and perceptions of with morning rounds (e.g. efficiency, organization, team work)
Measured: Once during the last week the trial
Intern satisfaction
Intern satisfaction and perceptions of with morning rounds (e.g. efficiency, organization, educational value)
Measured: Once during the last week of their rotation on a given team
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.
Measured: Daily during the 3-month trial
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Aug 2013 (estimated)
- Study startSep 2013
- Primary completionFeb 2014
- Study completionDec 2014
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Morning RoundsStudies of the same condition, open and under way.
- More trials run by University of California, San FranciscoThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 1,200 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of California, San Francisco
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Brad Monash, MD, Principal investigator, University of California, San FranciscoNader Najafi, MD, Principal investigator, University of California, San FranciscoJames D Harrison, PhD, Principal investigator, University of California, San Francisco
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01931553
- Sponsor's protocol ID
- RoundingUCSF
- Status last verified
- May 2015
- First submitted
- 16 Aug 2013
- Last updated
- 18 May 2015
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Monash B, Najafi N, Mourad M, Rajkomar A, Ranji SR, Fang MC, Glass M, Milev D, Ding Y, Shen A, Sharpe BA, Harrison JD. Standardized Attending Rounds to Improve the Patient Experience: A Pragmatic Cluster Randomized Controlled Trial. J Hosp Med. 2017 Mar;12(3):143-149. doi: 10.12788/jhm.2694.
PubMed 28272589
Study at a glance
From the registry record, last updated by the sponsor on 18 May 2015. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Back to Bedside: A Pragmatic Cluster Randomized Controlled Trial to Standardize Attending Morning Rounds in Medicine
- ClinicalTrials.gov ID
- NCT01931553
- Acronym / sponsor ID
- RoundingUCSF
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,200 participants (actual)
- Lead sponsor
- University of California, San FranciscoUniversity, hospital or other
- Study start
- Sep 2013
- Primary completion
- Feb 2014 (actual)
- Study completion
- Dec 2014 (actual)
- First posted
- 29 Aug 2013 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Single group
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Standardized attending morning rounds | Experimental | Other: Standardized attending morning rounds1. Pre-rounds discretion 2. Pre-rounds huddle 3. Bedside RN integration 4. Patient-centered rounding 5. Real-time order writing |
| Usual rounding practice | No intervention | –Usual rounding practice (as defined by each clinical team) |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- 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
Key exclusion criteria (1 listed)
- None
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Standardized attending morning rounds | Other | Standardized attending morning rounds |
Primary outcome
Patient satisfaction with morning rounds
Time frame: Once, after day one of hospitalization and before patient is discharged.
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.
Patient satisfaction with provider communication
Time frame: Once, within one month of hospital discharge
Post-discharge assessment will be sent by a commercial Vendor (Press Ganey) within a month of discharge following hospitalization
9 secondary outcomes
Interns total length of workday
Time frame: Daily during the 3-month trial
Number of consultations ordered before noon
Time frame: Daily during the 3-month trial
Resident satisfaction
Time frame: Once during the last week of their rotation on a given team
Attending physician satisfaction
Time frame: Once during the last week of their rotation on a given team
Medical student satisfaction
Time frame: Once during the last week of their rotation on a given team
Nurse participation in morning rounds
Time frame: Daily during the 3-month trial
Nurse satisfaction
Time frame: Once during the last week the trial
Intern satisfaction
Time frame: Once during the last week of their rotation on a given team
Total morning rounding time
Time frame: Daily during the 3-month trial
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 May 2015.
- Derived from this study: PubMed 28272589Monash B, Najafi N, Mourad M, Rajkomar A, Ranji SR, Fang MC, Glass M, Milev D, Ding Y, Shen A, Sharpe BA, Harrison JD. Standardized Attending Rounds to Improve the Patient Experience: A Pragmatic Cluster Randomized Controlled Trial. J Hosp Med. 2017 Mar;12(3):143-149. doi: 10.12788/jhm.2694.
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Brad Monash, MD principal investigator
University of California, San Francisco
Nader Najafi, MD principal investigator
University of California, San Francisco
James D Harrison, PhD principal investigator
University of California, San Francisco
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Standardized attending morning rounds in people with Morning Rounds and Teaching Rounds, run by University of California, San Francisco at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 18 May 2015. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Patient satisfaction with morning rounds (time frame: Once, after day one of hospitalization and before patient is discharged.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01931553, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 May 2015.