Clinical trial NCT06971419: FOllow-up of LOW-acuity Patients After REdirection From a Swiss Emergency Department Using an Electronic TRIage Application
Official title: 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
Study type: OBSERVATIONAL
Overall status: NOT_YET_RECRUITING
Conditions: Triage
Low Acuity Patients
Health Literacy Level
Non-urgent Emergencies
Keywords: Patient Satisfaction
emergency department triage
patient redirection
healthcare system efficiency
Referral and Consultation
electronic decision support tool
patient flow
Emergency overcrowding
Lead sponsor: Hôpital Fribourgeois
Sponsor class: OTHER
Collaborators: name: University of Fribourg
First posted: 2025-05-14
Enrollment: 450
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Participants will be selected from adult patients (≥18 years old) seeking care at the Emergency Department (ED) of Fribourg Cantonal Hospital, Switzerland.

This population consists of patients who:

* present diverse medical complaints typically classified as with low-acuity (SETS 4) or semi-urgent (SETS 3) conditions as determined by the Swiss Emergency Triage Scale (SETS).
* Are evaluated for potential redirection by ED triage nurse using the Logibec electronic triage system and may benefit from this triage-based redirection rather than hospital-based emergency care
* Require non-urgent medical care that can be managed outside the hospital setting
* French- or German-speaking individuals (for informed consent and follow-up participation)

Brief summary: 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.


Eligibility criteria: 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

Primary outcomes:
measure: Number of Emergency Department Consultations per Patient Within 48 Hours After Initial Visit
timeFrame: From initial emergency department visit to 48 hours post-visit
Secondary outcomes:
measure: the number of consultations per patient in the ED or other medical services within 7 days after the first ED visit
timeFrame: From initial emergency department visit to 7 days post-visit
measure: the proportion of patients who need hospitalization related to initial complaint within 7 days
timeFrame: From initial emergency department visit to 7 days post-visit
measure: the proportion of patients satisfied with the redirection process
timeFrame: At day 2 and day 7 post-visit
measure: the mean number of ED consultations after 1 month, 3 months and 6 months per patient
timeFrame: From initial emergency department visit to 6 month post-visit
measure: the evaluation of the health literacy and its evolution within 6 months of visit
timeFrame: At day 7 post-visit and 6 months post-visit
Other outcomes:
Locations:
city: Fribourg
country: Switzerland
facility: HFR-Fribourg
Study officials:
affiliation: HFR-Fribourg Emergency Department, University of Fribourg
name: Vincent Ribordy, Prof.
role: STUDY_DIRECTOR
References: