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
Studieoversikt
Status
Forhold
Intervensjon / Behandling
Studietype
Registrering (Antatt)
Kontakter og plasseringer
Studiekontakt
- Navn: Thomas Castelain
- Telefonnummer: +41263061392
- E-post: thomas.castelain@h-fr.ch
Studer Kontakt Backup
- Navn: Youcef Guechi
- Telefonnummer: +41263063142
- E-post: youcef.guechi@h-fr.ch
Studiesteder
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Canton of Fribourg
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Villars-sur-Glâne, Canton of Fribourg, Sveits, 1752
- Rekruttering
- Fribourg Cantonal Hospital
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Ta kontakt med:
- Thomas Castelain
- Telefonnummer: +41263061392
- E-post: thomas.castelain@h-fr.ch
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Ta kontakt med:
- Youcef Guechi
- E-post: youcef.guechi@h-fr.ch
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Hovedetterforsker:
- Youcef Guechi, MD
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Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
- Eldre voksen
Tar imot friske frivillige
Prøvetakingsmetode
Studiepopulasjon
Beskrivelse
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.).
Studieplan
Hvordan er studiet utformet?
Designdetaljer
Kohorter og intervensjoner
Gruppe / Kohort |
Intervensjon / Behandling |
|---|---|
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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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Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Total Emergency Department Length of Stay (ED LOS).
Tidsramme: 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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Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Left without being seen (LWBS)
Tidsramme: 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
Tidsramme: 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
Tidsramme: 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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Andre resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
|
Time From Triage Assessment to Disposition Decision
Tidsramme: 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
Tidsramme: 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.
|
Samarbeidspartnere og etterforskere
Sponsor
Samarbeidspartnere
Etterforskere
- Hovedetterforsker: Youcef Guechi, MD, Hopital Cantonal Fribourgeois (HFR)
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Andre studie-ID-numre
- Req-2026-00230
Plan for individuelle deltakerdata (IPD)
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IPD-planbeskrivelse
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