Education, MedicalNCT04754828
A Study of Bedside Versus Hallway Rounding
A study testing Assigned to a rounding style in people with Education, Medical, run by Brigham and Women's Hospital at 1 site in United States.
Trial summary
The purpose of this study is to compare bedside rounding with hallway and conference room rounding on the neurology inpatient ward service at an academic hospital and identify best practices associated with educational and patient care outcomes. Read more about this study
- Who is it for?
- Ages 18 to 100 years
- Conditions the study is for
- Education, Medical
- What is being tested?
- Assigned to a rounding style
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 81 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Feb 2020to 31 Mar 2020
- 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 to 100 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- new admission to neurology team
Who cannot join
- comfort measures as sole treatment goal
Trial locations and contacts
1 site in 1 country.
About this study
Official title: A Study of Bedside Versus Hallway Rounding for Neurology Inpatient Teams
The purpose of this study is to compare bedside rounding with hallway and conference room rounding on the neurology inpatient ward service at an academic hospital and identify best practices associated with educational and patient care outcomes. Specifically, this study will determine which rounding practices are associated with a positive educational experience for learners, greatest patient and care team communication, and time efficiency.
Read the detailed description
This study will evaluate the efficacy of bedside rounding and compare it to hallway and conference room rounding on the neurology ward service at the Brigham and Women's Hospital (BWH). The neurology ward service consists of two teams, each with 10-15 vascular neurology and general neurology patients. The teams perform daily attending rounds.
Each team consists of an attending physician, a senior supervisory resident, two junior residents, several rotating residents and interns from other departments, medical students, as well as a physician assistant who alternates daily between the teams. Neurology attendings spend two weeks at a time on a team.
During a two-week attending rotation, we plan to designate one of the teams as the "bedside rounding team" and the other team as the "hallway rounding team", which will serve as the control group. The bedside rounding team will carry out patient presentations at the bedside, with a focus on the patient, while ensuring nursing involvement in each patient's room. The hallway rounding team ("the usual method") will present patients outside of the patient's room, without an added emphasis on nurse participation. Halfway through the two-week rotation, the team designation will switch in a crossover fashion, so that the initial bedside rounding team will become the hallway rounding team, and vice versa. Our planned study period is Monday through Friday for a consecutive 6-8 week period, and we anticipate including about 150-200 patients in our study.
To evaluate staff educational experience, patient and interprofessional communication, and clinical care outcomes of these two rounding approaches, we plan to survey patients, resident trainees, attendings, and nurses on both teams. For collection of data, a student observer or research assistant familiar with the study purpose and methods will accompany a neurology team during weekday morning rounds and record data about the composition and timing of rounds.
Eligible participants include adult patients and providers (nurses; physicians, including residents and attendings; and ancillary providers) involved in the inpatient neurology service at BWH. Patients whose primary language is English will be included in the study with notation of this feature. Observations will focus on activities of the physician providers. Surveys for medical education will involve physician participants who give consent. Surveys of patient care and communication will involve patients and nurses who give consent.
- Conditions
- Education, Medical
- Being tested
- Assigned to a rounding style
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Assigned to a rounding styleOther
Team rounded on new admissions either in hallway or at the bedside
| Study group | Role | What they receive |
|---|---|---|
| Bedside | Active comparator | The bedside rounding team will perform patient presentations at the bedside, with a focus on the patient, and will ensure nursing involvement when rounding on each patient, Receives: Other: Assigned to a rounding style |
| Hallway | Active comparator | The hallway rounding team will present patients outside of the patient's room, without an emphasis on nurse participation. Receives: Other: Assigned to a rounding style |
What is being measured
The primary outcome is the main question the study is designed to answer.
Mean patient rounding time as assessed by time-motion analysis
The first primary outcome measure will be mean rounding time in minutes per patient in the bedside and hallway groups.
Measured: 90 days
Mean rounding proportion spent at the patient's bedside as assessed by time-motion analysis
The second primary outcome measure will be mean rounding proportion in percent spent at the patient's bedside in the bedside and hallway groups
Measured: 90 days
Mean rounding proportion spent on various rounding activities as assessed by time-motion analysis
The third primary outcome measure will be mean rounding proportion in percent spent on history taking, review of data such as imaging, physical exam, answering patient questions, teaching, and discussion of plan in the bedside and hallway groups
Measured: 90 days
Secondary outcomes (1)
Patient, nurse, resident, and attending physician satisfaction with rounds as assessed by surveys
The secondary outcome will be patient, nurse, resident, and attending physician satisfaction with and perception of rounds as assessed by surveys using a 5-point Likert scale with 5 being the highest satisfaction.
Measured: 90 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted15 Feb 2021
- Study start1 Feb 2020
- Primary completion31 Mar 2020
- Study completion31 Mar 2020
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 Education, MedicalStudies of the same condition, open and under way.
- More trials run by Brigham and Women's HospitalThe 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
- Other
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Enrolment
- 81 participants (actual)
Sponsor and investigators
- Lead sponsor
- Brigham and Women's Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Tracey Milligan, Brigham and Women's Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04754828
- Sponsor's protocol ID
- 2019P002584
- Status last verified
- Feb 2021
- First submitted
- 5 Feb 2021
- Last updated
- 15 Feb 2021
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Solomon JM, Bhattacharyya S, Ali AS, Cleary L, Dibari S, Boxer R, Healy BC, Milligan TA. Randomized Study of Bedside vs Hallway Rounding: Neurology Rounding Study. Neurology. 2021 Aug 31;97(9):434-442. doi: 10.1212/WNL.0000000000012407. Epub 2021 Jun 22.
PubMed 34158383
Study at a glance
From the registry record, last updated by the sponsor on 15 Feb 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Study of Bedside Versus Hallway Rounding for Neurology Inpatient Teams
- ClinicalTrials.gov ID
- NCT04754828
- Acronym / sponsor ID
- 2019P002584
- Conditions
- Education, Medical
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 81 participants (actual)
- Lead sponsor
- Brigham and Women's HospitalUniversity, hospital or other
- Study start
- 1 Feb 2020 (actual)
- Primary completion
- 31 Mar 2020 (actual)
- Study completion
- 31 Mar 2020 (actual)
- First posted
- 15 Feb 2021 (actual)
- 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.
The purpose of this study is to compare bedside rounding with hallway and conference room rounding on the neurology inpatient ward service at an academic hospital and identify best practices associated with educational and patient care outcomes. Specifically, this study will determine which rounding practices are associated with a positive educational experience for learners, greatest patient and care team communication, and time efficiency.
Detailed description
This study will evaluate the efficacy of bedside rounding and compare it to hallway and conference room rounding on the neurology ward service at the Brigham and Women's Hospital (BWH). The neurology ward service consists of two teams, each with 10-15 vascular neurology and general neurology patients. The teams perform daily attending rounds.
Each team consists of an attending physician, a senior supervisory resident, two junior residents, several rotating residents and interns from other departments, medical students, as well as a physician assistant who alternates daily between the teams. Neurology attendings spend two weeks at a time on a team.
During a two-week attending rotation, we plan to designate one of the teams as the "bedside rounding team" and the other team as the "hallway rounding team", which will serve as the control group. The bedside rounding team will carry out patient presentations at the bedside, with a focus on the patient, while ensuring nursing involvement in each patient's room. The hallway rounding team ("the usual method") will present patients outside of the patient's room, without an added emphasis on nurse participation. Halfway through the two-week rotation, the team designation will switch in a crossover fashion, so that the initial bedside rounding team will become the hallway rounding team, and vice versa. Our planned study period is Monday through Friday for a consecutive 6-8 week period, and we anticipate including about 150-200 patients in our study.
To evaluate staff educational experience, patient and interprofessional communication, and clinical care outcomes of these two rounding approaches, we plan to survey patients, resident trainees, attendings, and nurses on both teams. For collection of data, a student observer or research assistant familiar with the study purpose and methods will accompany a neurology team during weekday morning rounds and record data about the composition and timing of rounds.
Eligible participants include adult patients and providers (nurses; physicians, including residents and attendings; and ancillary providers) involved in the inpatient neurology service at BWH. Patients whose primary language is English will be included in the study with notation of this feature. Observations will focus on activities of the physician providers. Surveys for medical education will involve physician participants who give consent. Surveys of patient care and communication will involve patients and nurses who give consent.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Bedside | Active comparator | Other: Assigned to a rounding styleThe bedside rounding team will perform patient presentations at the bedside, with a focus on the patient, and will ensure nursing involvement when rounding on each patient, |
| Hallway | Active comparator | Other: Assigned to a rounding styleThe hallway rounding team will present patients outside of the patient's room, without an emphasis on nurse participation. |
Who may qualify
- Ages
- 18 to 100 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (1 listed)
- new admission to neurology team
Key exclusion criteria (1 listed)
- comfort measures as sole treatment goal
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 |
|---|---|---|
| Assigned to a rounding styleTeam rounded on new admissions either in hallway or at the bedside | Other | Bedside, Hallway |
Primary outcome
Mean patient rounding time as assessed by time-motion analysis
Time frame: 90 days
The first primary outcome measure will be mean rounding time in minutes per patient in the bedside and hallway groups.
Mean rounding proportion spent at the patient's bedside as assessed by time-motion analysis
Time frame: 90 days
The second primary outcome measure will be mean rounding proportion in percent spent at the patient's bedside in the bedside and hallway groups
Mean rounding proportion spent on various rounding activities as assessed by time-motion analysis
Time frame: 90 days
The third primary outcome measure will be mean rounding proportion in percent spent on history taking, review of data such as imaging, physical exam, answering patient questions, teaching, and discussion of plan in the bedside and hallway groups
1 secondary outcome
Patient, nurse, resident, and attending physician satisfaction with rounds as assessed by surveys
Time frame: 90 days
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 15 Feb 2021.
- Derived from this study: PubMed 34158383Solomon JM, Bhattacharyya S, Ali AS, Cleary L, Dibari S, Boxer R, Healy BC, Milligan TA. Randomized Study of Bedside vs Hallway Rounding: Neurology Rounding Study. Neurology. 2021 Aug 31;97(9):434-442. doi: 10.1212/WNL.0000000000012407. Epub 2021 Jun 22.
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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.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Assigned to a rounding style in people with Education, Medical, run by Brigham and Women's Hospital 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 1 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 15 Feb 2021. 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?
Mean patient rounding time as assessed by time-motion analysis (time frame: 90 days). The study lists 3 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 NCT04754828, 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 15 Feb 2021.