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
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Studietype
Inschrijving (Geschat)
Contacten en locaties
Studiecontact
- Naam: Thomas Castelain
- Telefoonnummer: +41263061392
- E-mail: thomas.castelain@h-fr.ch
Studie Contact Back-up
- Naam: Youcef Guechi
- Telefoonnummer: +41263063142
- E-mail: youcef.guechi@h-fr.ch
Studie Locaties
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Canton of Fribourg
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Villars-sur-Glâne, Canton of Fribourg, Zwitserland, 1752
- Werving
- Fribourg Cantonal Hospital
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Contact:
- Thomas Castelain
- Telefoonnummer: +41263061392
- E-mail: thomas.castelain@h-fr.ch
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Contact:
- Youcef Guechi
- E-mail: youcef.guechi@h-fr.ch
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Hoofdonderzoeker:
- Youcef Guechi, MD
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Bemonsteringsmethode
Studie Bevolking
Beschrijving
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.).
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
|---|---|
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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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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Total Emergency Department Length of Stay (ED LOS).
Tijdsspanne: 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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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Left without being seen (LWBS)
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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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Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Time From Triage Assessment to Disposition Decision
Tijdsspanne: Through completion of the ED visit, up to a maximum of 72 hours.
|
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
Tijdsspanne: Through completion of the ED visit, up to a maximum of 72 hours.
|
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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Medewerkers en onderzoekers
Sponsor
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Youcef Guechi, MD, Hopital Cantonal Fribourgeois (HFR)
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Andere studie-ID-nummers
- Req-2026-00230
Plan Individuele Deelnemersgegevens (IPD)
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Beschrijving IPD-plan
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
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