Accepted for/Published in: JMIR Research Protocols
Date Submitted: Aug 11, 2025
Date Accepted: Feb 23, 2026
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
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:
The primary objective of this study is to investigate the safety and efficiency of redirection of low-acuity patients using an electronic clinical decision support system. As a secondary and exploratory aim, we will 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:
This study is funded by an internal grant by Hôpital Fribourgeois. Recruitment began on the 20th of June 2025, with a total of 35 patients enrolled as of August 2025. Data analysis will begin after recruitment and 6-month follow-up of 300-420 patients is completed, which we expect to be in November 2026. We hope to publish results in December 2026.
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. Clinical Trial: ClinicalTrials.gov NCT06971419
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