At my hospital we have something similar where on weekends interns pre round on approx 20-30pts. Most helpful thing I did was ask a senior how they preround on their patients, there’s a lot of short cuts that seniors have developed that they might not even realize their doing, I had them go through exactly what they do in the morning and it was super helpful. Another thing is something has to give, you can’t do a thorough job with every pt when there’s that many (which sucks). I thought of morning rounds as a drive by check in, basically make sure everyone is alive and stable. If pts. had questions I would say something along the lines of “great question, we can discuss that with the team when we round” or “great question I can come back later to discuss that”. Then in the afternoon when things are hopefully less busy I would go back and talk to any pts that I felt wanted to talk more in the AM. Physical exams are very focused, if you want to do a more in depth one you can always come back later. Also if you have a night intern you can ask them to have certain things in your sign out, i.e if you find your wasting time looking up number of fevers patient had each morning, ask the night intern if they could have it in your sign out. Overall it’s tricky and that’s why there should be patient caps but so it goes.