Digital Anticipatory Protocols at Triage to Improve ED Flow.
Implementing Digital Anticipatory Protocols at Triage to Improve Emergency Department Flow: A Before-After Study Protocol
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Tipo di studio
Iscrizione (Stimato)
Contatti e Sedi
Contatto studio
- Nome: Thomas Castelain
- Numero di telefono: +41263061392
- Email: thomas.castelain@h-fr.ch
Backup dei contatti dello studio
- Nome: Youcef Guechi
- Numero di telefono: +41263063142
- Email: youcef.guechi@h-fr.ch
Luoghi di studio
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Canton of Fribourg
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Villars-sur-Glâne, Canton of Fribourg, Svizzera, 1752
- Reclutamento
- Fribourg Cantonal Hospital
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Contatto:
- Thomas Castelain
- Numero di telefono: +41263061392
- Email: thomas.castelain@h-fr.ch
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Contatto:
- Youcef Guechi
- Email: youcef.guechi@h-fr.ch
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Investigatore principale:
- Youcef Guechi, MD
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Metodo di campionamento
Popolazione di studio
Descrizione
Inclusion Criteria:
- All patients over 18 years who registered at the admission desk during the study period.
Exclusion Criteria:
- Arrival by emergency medical services (ambulance or helicopter)
- Patient trajectory bypassing the standard nurse-led triage process
- Patient directly referred to another service of the hospital after triage (gynecology, ophthalmology, etc.).
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
Coorti e interventi
Gruppo / Coorte |
Intervento / Trattamento |
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Phase 1 - Pre-intervention
Patients presenting to the emergency department between May 1st and July 31st, 2026.
Patients undergo standard triage assessment performed using the revised Swiss Emergency Triage Scale (SETS).
Disposition decisions are monitored using a digital tag in the electronic health records.
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Phase 2 - Post-intervention
Patients presenting to the emergency department between May 1st and July 31st, 2027.
Patients undergo triage with the addition of a new digital anticipatory protocol.
Disposition decisions continue to be monitored using the same digital tag.
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The intervention consists of adding digital checkboxes to the electronic triage system.
This provides nurses with formalized options for anticipated management based on patient acuity, aiming to encourage and document anticipatory actions while stimulating clinical reasoning.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Total Emergency Department Length of Stay (ED LOS).
Lasso di tempo: Through completion of the ED visit, up to a maximum of 72 hours.
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The time interval from the completion of the patient's administrative registration to their physical departure from the ED
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Through completion of the ED visit, up to a maximum of 72 hours.
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Left without being seen (LWBS)
Lasso di tempo: Through completion of the ED visit, up to a maximum of 72 hours.
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Proportion of patients who registered at the ED admission desk and left before receiving a medical screening exam or an evaluation by a physician
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Through completion of the ED visit, up to a maximum of 72 hours.
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30-day mortality
Lasso di tempo: Up to 30 days post-ED visit
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Assessed through institutional medical records to evaluate safety
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Up to 30 days post-ED visit
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Intesive Care Unit (ICU) transfers
Lasso di tempo: Up to 7 days post-ED visit
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Proportion of patients transferred to the Intensive Care Unit (ICU) immediately and within 7 days after the ED visit
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Up to 7 days post-ED visit
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Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Time From Triage Assessment to Disposition Decision
Lasso di tempo: Through completion of the ED visit, up to a maximum of 72 hours.
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The time interval, measured in minutes, elapsed from the beginning of the nursing triage assessment to the exact moment a definitive disposition decision (e.g., discharge, admission) is entered by the emergency physician. A disposition decision is operationally defined as the precise moment the attending emergency physician determines that active emergency care is complete. This includes the decision to transfer the patient to a hospital ward (for admissions) or the conclusion of clinical management (for discharges), even if the patient remains in the emergency department awaiting purely logistical arrangements, such as medical transport or family arrival. The measurement tool used to assess and timestamp this outcome is a standardized digital disposition decision tag integrated into the electronic health record. |
Through completion of the ED visit, up to a maximum of 72 hours.
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Time From Treatment Room Placement to Disposition Decision
Lasso di tempo: Through completion of the ED visit, up to a maximum of 72 hours.
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The time interval, measured in minutes, elapsed from when the patient is placed in an ED treatment room to the exact moment a definitive disposition decision (e.g., discharge, admission) is entered by the emergency physician. A disposition decision is operationally defined as the precise moment the attending emergency physician determines that active emergency care is complete. This includes the decision to transfer the patient to a hospital ward (for admissions) or the conclusion of clinical management (for discharges), even if the patient remains in the emergency department awaiting purely logistical arrangements, such as medical transport or family arrival. The measurement tool used to assess and timestamp this outcome is a standardized digital disposition decision tag integrated into the electronic health record. |
Through completion of the ED visit, up to a maximum of 72 hours.
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Collaboratori e investigatori
Sponsor
Collaboratori
Investigatori
- Investigatore principale: Youcef Guechi, MD, Hopital Cantonal Fribourgeois (HFR)
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Studia le date principali
Inizio studio (Effettivo)
Completamento primario (Stimato)
Completamento dello studio (Stimato)
Date di iscrizione allo studio
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Altri numeri di identificazione dello studio
- Req-2026-00230
Piano per i dati dei singoli partecipanti (IPD)
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Descrizione del piano IPD
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