Scholarlink

Background <p>Integrated emergency centers (INZ) in Germany use centralized initial assessment units to triage patients with structured digital tools and allocate them to the appropriate care setting (emergency department vs. out-of-hours primary care clinic). At the University Medical Center Freiburg, an INZ has operated routinely since October 2023. We evaluated the clinical decision support system <i>TriageClient</i> (Blackpine Medical GmbH, Freiburg, Germany) regarding safety, effectiveness, efficiency, and timeliness.</p> Methods <p>Anonymized routine data of all emergency presentations in 2024 were analyzed. Primary endpoints were 7‑day in-hospital mortality and tracer diagnoses. The secondary endpoint was hospital admission ≥ 24 h. Efficiency was measured as sector switches from the primary care clinic into the emergency department, and effectiveness as concordance with family-practice-sensitive conditions. Noninferiority was assessed against external references. Timeliness was quantified as defects per million opportunities (DPMO) for a&#xa0;triage duration &gt; 10 min.</p> Results <p>Of 67,552 presentations, 50,047 (74.1%) self-presenting patients were assessed with <i>TriageClient</i>. Final allocation was 38.5% to the primary care clinic and 61.5% to the emergency department. In Emergency Severity Index (ESI) levels&#xa0;4/5 and in the primary care sector, mortality and tracer diagnoses were lower than in higher-acuity cohorts. Noninferiority/superiority was achieved for primary endpoints. The secondary endpoint met these criteria only after final nurse allocation. The sector-switch rate was 12.3%. DPMO for triage duration &gt; 10 min was 1.36% (13,573 DPMO).</p> Conclusion <p>Digital initial assessment with <i>TriageClient</i> showed high safety, efficiency, effectiveness, and timeliness in routine INZ operation. Multicenter studies should validate these findings.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Evaluation des digitalen Entscheidungsunterstützungssystems TriageClient zur sektoralen Zuweisung von Notfallpatienten in ein INZ

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月19日

查看全文
  • Anna Slagman,
  • Michael C. Röttger,
  • Jan Krug,
  • Matthias Kühn,
  • Matthias Roth,
  • Hans-Jörg Busch,
  • Sarah Eschbacher,
  • Felix P. Hans,
  • Leo Benning

摘要

Background

Integrated emergency centers (INZ) in Germany use centralized initial assessment units to triage patients with structured digital tools and allocate them to the appropriate care setting (emergency department vs. out-of-hours primary care clinic). At the University Medical Center Freiburg, an INZ has operated routinely since October 2023. We evaluated the clinical decision support system TriageClient (Blackpine Medical GmbH, Freiburg, Germany) regarding safety, effectiveness, efficiency, and timeliness.

Methods

Anonymized routine data of all emergency presentations in 2024 were analyzed. Primary endpoints were 7‑day in-hospital mortality and tracer diagnoses. The secondary endpoint was hospital admission ≥ 24 h. Efficiency was measured as sector switches from the primary care clinic into the emergency department, and effectiveness as concordance with family-practice-sensitive conditions. Noninferiority was assessed against external references. Timeliness was quantified as defects per million opportunities (DPMO) for a triage duration > 10 min.

Results

Of 67,552 presentations, 50,047 (74.1%) self-presenting patients were assessed with TriageClient. Final allocation was 38.5% to the primary care clinic and 61.5% to the emergency department. In Emergency Severity Index (ESI) levels 4/5 and in the primary care sector, mortality and tracer diagnoses were lower than in higher-acuity cohorts. Noninferiority/superiority was achieved for primary endpoints. The secondary endpoint met these criteria only after final nurse allocation. The sector-switch rate was 12.3%. DPMO for triage duration > 10 min was 1.36% (13,573 DPMO).

Conclusion

Digital initial assessment with TriageClient showed high safety, efficiency, effectiveness, and timeliness in routine INZ operation. Multicenter studies should validate these findings.