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

Hôpital Fribourgeois

Status: Not yet enrolling

Conditions: Non-urgent Emergencies; Health Literacy Level; Triage; Low Acuity Patients

Treatments: Other: intervention is the use of aTriage-Based Patient Redirection Using an Electronic Decision Support Toolin the emergency department (ED)

Study type: Observational

Funder types: Other

Identifiers

NCT06971419

HFR_24-09 (Other Grant/Funding Number)

2023-01655

Details and patient eligibility

About

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.

Enrollment: 450 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• 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

Exclusion criteria

• 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

Trial design

450 participants in 2 patient groups

Comparator Group (Current Practice - SETS-Based Triage and Redirection)

Description:

* Patients are triaged using the Swiss Emergency Triage Scale (SETS) * Only low-acuity patients (SETS 4) are considered for redirection * Patients who agree to redirection are referred to external medical facilities (e.g., primary care clinics)

Investigated Group (New Practice - Logibec-Assisted Triage and Redirection)

Description:

* Patients tiraged as SETS 4 and SETS 3 are further evaluated by Logibec Réorientation software which applies applies specific inclusion/exclusion criteria to determine eligibility for redirection * Eligible patients are offered redirection, with appointments scheduled through the Reorientation software by the triage nurse

Treatment:

Other: intervention is the use of aTriage-Based Patient Redirection Using an Electronic Decision Support Toolin the emergency department (ED)