FOllow-up of LOW-acuity Patients After REdirection From a Swiss Emergency Department Using an Electronic TRIage Application

Официальное название

FOllow-Up of LOW-Acuity Patients After REdirection From the Emergency Department at Fribourg Cantonal Hospital in Switzerland Using an Electronic TRIage Application: a Monocentric, Prospective Observational Study

Обзор

Emergency department (ED) overcrowding is a growing issue, affecting patient safety, healthcare quality, and hospital efficiency. One strategy to manage low-acuity patients is triage-based redirection, where patients with non-urgent conditions are offered the option to receive care at external medical facilities instead of the ED. This monocentric, prospective observational study will be conducted at Fribourg Cantonal Hospital, Switzerland, and evaluates the impact of a new electronic triage and redirection system (Logibec Réorientation). The study compares two triage processes: Current practice - Redirection based on the Swiss Emergency Triage Scale (SETS), limited to low-acuity patients (SETS 4). New practice - Redirection using the Logibec software, allowing redirection of both low-acuity (SETS 4) and semi-urgent (SETS 3) patients based on predefined criteria. The primary objective is to assess whether the new triage-based redirection reduces the number of ED consultations per patient within 48 hours of their initial visit. Secondary outcomes include: Number of consultations in the ED or other medical facilities within 7 days Rate of hospital admissions within 7 days Patient satisfaction with redirection Evolution of health literacy over 6 months Number of ED visits over 6 months Participants are adult patients (≥18 years old) classified as SETS 3-4 and identified as eligible for redirection by the Logibec software. Data will be collected through phone interviews and questionnaires over a 6-month follow-up period. This study aims to improve triage efficiency, patient flow management, and healthcare accessibility, while ensuring patient safety in the redirection process.

Вмешательства

• Другое intervention is the use of aTriage-Based Patient Redirection Using an Electronic Decision Support Toolin the emergency department (ED)
  Name: Logibec Réorientation software-assisted triage and redirection Type: Decision support system for emergency triage Implementation: * Applied during patient triage in the emergency department * Assists in identifying low-acuity (SETS 4) and semi-urgent (SETS 3) patients eligible for redirection * Uses standardized inclusion/exclusion criteria to guide redirection decisions Comparator: Standard nurse-led triage and redirection based only on the Swiss Emergency Triage Scale (SETS) Key Dis

Первичные конечные точки

• Number of Emergency Department Consultations per Patient Within 48 Hours After Initial Visit [Срок оценки: From initial emergency department visit to 48 hours post-visit]

Вторичные конечные точки (5)

• the number of consultations per patient in the ED or other medical services within 7 days after the first ED visit [Срок оценки: From initial emergency department visit to 7 days post-visit]
• the proportion of patients who need hospitalization related to initial complaint within 7 days [Срок оценки: From initial emergency department visit to 7 days post-visit]
• the proportion of patients satisfied with the redirection process [Срок оценки: At day 2 and day 7 post-visit]
• the mean number of ED consultations after 1 month, 3 months and 6 months per patient [Срок оценки: From initial emergency department visit to 6 month post-visit]
• the evaluation of the health literacy and its evolution within 6 months of visit [Срок оценки: At day 7 post-visit and 6 months post-visit]

Критерии участия

Критерии включения

• Age ≥18 years old
• Triage level SETS 3 or SETS 4 (classified as semi-urgent or low-acuity)
• Identified as eligible for redirection by the Logibec electronic triage system
• Able to speak and read French or German (for informed consent and follow-up)
• Provides informed consent: Oral consent at Day 2 and Signed informed consent sent by post after inclusion

Критерии исключения

• Inability to provide informed consent (e.g., cognitive impairment, language barrier without translation support)
• Inability to comply with study procedures, such as: Severe hearing impairment without hearing aids; Acute psychiatric conditions preventing participation; Not available for follow-up phone calls within the next 6 months

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Да

Дизайн исследования

Модель наблюдения

Когортное

Центры проведения

Швейцария · 1 центр

• HFR-Fribourg — Fribourg

Идентификаторы

NCT: NCT06971419 · 2023-01655 · HFR_24-09

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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