Diagnostic Tests, Emergency Department Crowding, Emergency Department Patient, Emergency Department Triage, Length of Stay, Nurses, Workflow
Conditions
Brief summary
This study aims to evaluate a pre-post intervention adding an early management decision at the end of the triage process to improve patient throughput. The intervention consists of adding digital checkboxes to the electronic triage system, providing nurses with formalized options for anticipated management based on patient acuity. The study compares a pre-intervention phase (May 1st to July 31st, 2026) with a post-intervention phase (May 1st to July 31st, 2027) to naturalize seasonal confounders. The primary outcome is the total Emergency Department Length of Stay (ED LOS).
Interventions
PROCEDUREDigital Anticipatory Protocols at Triage
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.
Sponsors
Hôpital Fribourgeois
University of Fribourg
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
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.).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total Emergency Department Length of Stay (ED LOS). | Through completion of the ED visit, up to a maximum of 72 hours. | The time interval from the completion of the patient's administrative registration to their physical departure from the ED |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Left without being seen (LWBS) | Through completion of the ED visit, up to a maximum of 72 hours. | Proportion of patients who registered at the ED admission desk and left before receiving a medical screening exam or an evaluation by a physician |
| 30-day mortality | Up to 30 days post-ED visit | Assessed through institutional medical records to evaluate safety |
| Intesive Care Unit (ICU) transfers | Up to 7 days post-ED visit | Proportion of patients transferred to the Intensive Care Unit (ICU) immediately and within 7 days after the ED visit |
Countries
Switzerland
Contacts
CONTACTThomas Castelain
CONTACTYoucef Guechi
PRINCIPAL_INVESTIGATORYoucef Guechi, MD
Hopital Cantonal Fribourgeois (HFR)
Outcome results
None listed