What type of study is this?

This is a Observational study (also classified as: Pre-Registered Trial).

August 17, 2025

Follow-up of Low-Acuity Patients After Redirection From a Swiss Emergency Department Using an Electronic Triage Application (Fo-low-RETRI): Protocol for a Monocentric, Prospective Cohort Study (Preprint)

Key Points

Redirection of low-acuity patients from the emergency department shows promise for improving healthcare efficiency and safety.
The primary endpoint is unexpected returns to healthcare services within 48 hours of triage, with secondary endpoints including patient satisfaction and health literacy.
This prospective cohort study involves two groups of low-acuity patients evaluated for redirection using an electronic support system to enhance care.
If successful, this study may influence strategies to manage emergency department overcrowding and optimize patient pathways.

Abstract

BACKGROUND Emergency department (ED) overcrowding threatens healthcare systems internationally. This poses risks to patient safety, lowers quality of care as well as patient satisfaction. Patient input, defined as the caseload of patients presenting to the ED, is one of the factors contributing to overcrowding. Redirecting patients presenting with non-urgent complaints to external healthcare services could help alleviate ED workload. OBJECTIVE In this study, we will investigate the safety and efficiency of redirection of low-acuity patients using an electronic clinical decision support system. We aim to assess the impact of this intervention on subsequent health care use, patient satisfaction and health literacy over a 6-month follow-up period. METHODS A single center, observational study with 2 consecutive cohorts of low acuity patients presenting to the ED will be conducted. The first cohort will be triaged and offered redirection according to current practice. In the second cohort, after triage, low-acuity patients will be evaluated by an electronic clinical support system to determine eligibility to redirection. If eligible for redirection, an appointment at a nearby clinic will be arranged through the system. The primary endpoint are any unexpected returns to health care services within 48 hours of triage. Secondary endpoints are patient satisfaction as well as the number of unexpected consultation and evolution of health literacy during a 6-month follow-up period. RESULTS We aim to include 300-420 patients from June to October 2025 CONCLUSIONS We expect the redirection process of low-acuity patients to other healthcare facilities using an electronic clinical support system to be safe and efficient. If results are positive, application of this reproductible strategy could reduce the number of patients treated in emergency departments and provide alternative healthcare pathways to low-acuity patients. CLINICALTRIAL ClinicalTrials.gov NCT06971419

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