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
調査の概要
状態
研究の種類
入学 (推定)
連絡先と場所
研究連絡先
- 名前：Thomas Castelain
- 電話番号：+41263061392
- メール：thomas.castelain@h-fr.ch
研究連絡先のバックアップ
- 名前：Youcef Guechi
- 電話番号：+41263063142
- メール：youcef.guechi@h-fr.ch
研究場所
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Canton of Fribourg
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Villars-sur-Glâne、Canton of Fribourg、スイス、1752
- 募集
- Fribourg Cantonal Hospital
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コンタクト：
- Thomas Castelain
- 電話番号：+41263061392
- メール：thomas.castelain@h-fr.ch
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コンタクト：
- Youcef Guechi
- メール：youcef.guechi@h-fr.ch
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主任研究者：
- Youcef Guechi, MD
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
サンプリング方法
調査対象母集団
説明
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.).
研究計画
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
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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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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Total Emergency Department Length of Stay (ED LOS).
時間枠：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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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Left without being seen (LWBS)
時間枠：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
時間枠：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
時間枠：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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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Time From Triage Assessment to Disposition Decision
時間枠：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
時間枠：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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協力者と研究者
スポンサー
捜査官
- 主任研究者：Youcef Guechi, MD、Hopital Cantonal Fribourgeois (HFR)
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- Req-2026-00230
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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