Emergency department (ED) overcrowding is a growing issue, affecting patient safety, healthcare quality, and hospital efficiency. One strategy to manage low-acuity patients is triage-based redirection, where patients with non-urgent conditions are offered the option to receive care at external medical facilities instead of the ED.

This monocentric, prospective observational study will be conducted at Fribourg Cantonal Hospital, Switzerland, and evaluates the impact of a new electronic triage and redirection system (Logibec Réorientation). The study compares two triage processes:

Current practice - Redirection based on the Swiss Emergency Triage Scale (SETS), limited to low-acuity patients (SETS 4).

New practice - Redirection using the Logibec software, allowing redirection of both low-acuity (SETS 4) and semi-urgent (SETS 3) patients based on predefined criteria.

The primary objective is to assess whether the new triage-based redirection reduces the number of ED consultations per patient within 48 hours of their initial visit.

Secondary outcomes include:

Number of consultations in the ED or other medical facilities within 7 days Rate of hospital admissions within 7 days Patient satisfaction with redirection Evolution of health literacy over 6 months Number of ED visits over 6 months Participants are adult patients (≥18 years old) classified as SETS 3-4 and identified as eligible for redirection by the Logibec software. Data will be collected through phone interviews and questionnaires over a 6-month follow-up period.

This study aims to improve triage efficiency, patient flow management, and healthcare accessibility, while ensuring patient safety in the redirection process.

Inclusion Criteria:

• Age ≥18 years old
• Triage level SETS 3 or SETS 4 (classified as semi-urgent or low-acuity)
• Identified as eligible for redirection by the Logibec electronic triage system
• Able to speak and read French or German (for informed consent and follow-up)
• Provides informed consent: Oral consent at Day 2 and Signed informed consent sent by post after inclusion

Exclusion Criteria:

• Inability to provide informed consent (e.g., cognitive impairment, language barrier without translation support)
• Inability to comply with study procedures, such as: Severe hearing impairment without hearing aids; Acute psychiatric conditions preventing participation; Not available for follow-up phone calls within the next 6 months

Participants will be selected from adult patients (≥18 years old) seeking care at the Emergency Department (ED) of Fribourg Cantonal Hospital, Switzerland.

This population consists of patients who:

• present diverse medical complaints typically classified as with low-acuity (SETS 4) or semi-urgent (SETS 3) conditions as determined by the Swiss Emergency Triage Scale (SETS).
• Are evaluated for potential redirection by ED triage nurse using the Logibec electronic triage system and may benefit from this triage-based redirection rather than hospital-based emergency care
• Require non-urgent medical care that can be managed outside the hospital setting
• French- or German-speaking individuals (for informed consent and follow-up participation)

Individual participant data (IPD) will not be shared. Due to patient confidentiality regulations, all data will be securely stored in a protected research database (REDCap), with access restricted to authorized study investigators. Only de-identified, aggregated results will be published in peer-reviewed journals and presented at scientific conferences. Identifiable patient information will not be shared outside the study team. Researchers may request summary-level data through formal collaboration agreements. This ensures compliance with data protection regulations while promoting scientific transparency.