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.
Study Type
OBSERVATIONAL
Enrollment
450
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 Distinction: * The investigated group receives Logibec-assisted triage and redirection. * The comparator group follows traditional nurse-led triage without electronic support, limiting redirection to SETS 4 patients only.
HFR-Fribourg
Fribourg, Canton of Fribourg, Switzerland
Number of Emergency Department Consultations per Patient Within 48 Hours After Initial Visit
This measure refers to the total number of emergency department (ED) visits per patient within 48 hours following their initial presentation to the ED. The first consultation at the ED is counted as the initial visit. 1. Any subsequent unplanned return visits to the ED within 48 hours of the initial visit are included in the count. 2. Data collection is conducted through electronic health records (EHR) review and patient follow-up phone calls. This outcome aims to assess whether electronic triage-assisted redirection is effective, by providing service through alternative health care providers ,without patients needing further ED care
Time frame: From initial emergency department visit to 48 hours post-visit
the number of consultations per patient in the ED or other medical services within 7 days after the first ED visit
Time frame: From initial emergency department visit to 7 days post-visit
the proportion of patients who need hospitalization related to initial complaint within 7 days
Time frame: From initial emergency department visit to 7 days post-visit
the proportion of patients satisfied with the redirection process
Patient satisfaction as assessed by satisfaction questionnaire
Time frame: At day 2 and day 7 post-visit
the mean number of ED consultations after 1 month, 3 months and 6 months per patient
Time frame: From initial emergency department visit to 6 month post-visit
the evaluation of the health literacy and its evolution within 6 months of visit
Health literacy as evaluated by EU-HLS-Q16 questionnaire
Time frame: At day 7 post-visit and 6 months post-visit
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