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

NCT ID: NCT06971419

Last Updated: 2025-05-14

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Total Enrollment: 450 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2025-06-15
• Study Completion Date: 2026-06-30

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.

Conditions

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

Study Design

• Observational Model Type: COHORT
• Study Time Perspective: PROSPECTIVE

Study Groups

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

• 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)

No interventions assigned to this group

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

• 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

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

Intervention Type: OTHER

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.

Interventions

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 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.

Intervention Type: OTHER

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

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

University of Fribourg

OTHER

Sponsor Role: collaborator

Hôpital Fribourgeois

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Vincent Ribordy, Prof.

Role: STUDY_DIRECTOR

HFR-Fribourg Emergency Department, University of Fribourg

Locations

HFR-Fribourg

Fribourg, Canton of Fribourg, Switzerland

Countries

Switzerland

Central Contacts

Youcef Guechi, MD

Role: CONTACT

youcef.guechi@h-fr.ch

+41263063112

Ludovic Galofaro, MD

Role: CONTACT

ludovic.galofaro@unifr.ch

+41263063112

Facility Contacts

Youcef Guechi, MD

Role: primary

youcef.guechi@h-fr.ch

+41263063060

Other Identifiers

HFR_24-09

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2023-01655

Identifier Type: -

Identifier Source: org_study_id