Digital Anticipatory Protocols at Triage to Improve ED Flow.

NCT07726108 | Recruiting

• 1 other identifier: Req-2026-00230
• Study Type: observational
• Target: 15,500
• Locations: 1 country
• Sites: 1

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).

Conditions

Length of Stay; Emergency Department Patient; Emergency Department Triage; Nurses; Workflow; Diagnostic Tests; Emergency Department Crowding

Outcome Measures

Primary Outcomes (1)

• Total Emergency Department Length of Stay (ED LOS).

  The time interval from the completion of the patient's administrative registration to their physical departure from the ED

  Through completion of the ED visit, up to a maximum of 72 hours.

Secondary Outcomes (3)

• Left without being seen (LWBS)

  Through completion of the ED visit, up to a maximum of 72 hours.

• 30-day mortality

  Up to 30 days post-ED visit

• Intesive Care Unit (ICU) transfers

  Up to 7 days post-ED visit

Other Outcomes (2)

• Time From Triage Assessment to Disposition Decision

  Through completion of the ED visit, up to a maximum of 72 hours.

• Time From Treatment Room Placement to Disposition Decision

  Through completion of the ED visit, up to a maximum of 72 hours.

Study Arms (2)

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.

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.

Procedure: Digital Anticipatory Protocols at Triage

Interventions

Digital Anticipatory Protocols at Triage PROCEDURE

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.

Phase 2 - Post-intervention

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population comprises all adult patients (over 18 years old) presenting to the emergency department of the cantonal hospital in Fribourg (HFR), Switzerland, during the predefined study periods (Phase 1 and Phase 2). The HFR is a university teaching and research hospital that manages approximately 41,000 ED visits annually.

You may qualify if:

• All patients over 18 years who registered at the admission desk during the study period.

You may not qualify if:

• 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.).

Sponsors & Collaborators

• Hôpital Fribourgeois: lead
• University of Fribourg: collaborator

Study Sites (1)

Fribourg Cantonal Hospital

Villars-sur-Glâne, Canton of Fribourg, 1752, Switzerland

RECRUITING

Study Officials

• Youcef Guechi, MD

  Hopital Cantonal Fribourgeois (HFR)

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Thomas Castelain

CONTACT

+41263061392; thomas.castelain@h-fr.ch

Youcef Guechi

CONTACT

+41263063142; youcef.guechi@h-fr.ch

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 30 Days
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 14, 2026
• First Posted: July 24, 2026
• Study Start: May 1, 2026
• Primary Completion (Estimated): July 31, 2027
• Study Completion (Estimated): August 31, 2027
• Last Updated: July 24, 2026

Record last verified: 2026-07

Locations

CH (1)