ArticleDeutsches Arzteblatt international2024
Evaluation of an Automated Decision Aid for the Further Referral of Emergency Room Patients—A Prospective Cohort Study.
Article in Deutsches Arzteblatt international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed.
- [Efficiency of streaming and integrated care models for low acuity patients in acute and emergency care-results from a prospective cohort study].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026Article
- [Patient navigation to cooperation practices : Experiences from pilot projects on redirecting emergency department patients].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Article
- [Predictability of patient disposition from emergency medical services triage categories: exploratory analysis of routine data].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Article
- [Combination of Manchester Triage System and chief complaint: development and internal validation of a new algorithm for patient flow management in integrated emergency centres].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Article
- Follow-Up of Low-Acuity Patients After Redirection From a Swiss Emergency Department Using an Electronic Triage Application: Protocol for a Single-Center Prospective Cohort Study.JMIR research protocols · 2026Observational
- Artificial intelligence to improve patient care in emergency medicine: a workflow-based analysis.Internal and emergency medicine · 2026Article
- [Quo vadis: Streaming in emergency and acute care? : Results of an online survey on current models of patient streaming and integrated care in emergency departments in Germany].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Article
- Article
- In Reply.Deutsches Arzteblatt international · 2025Article
- No Improvement.Deutsches Arzteblatt international · 2025Article
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6 authors.
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Abstract
backgroundInstruments for the initial evaluation of emergency room patients as an aid to their onward referral to ambulatory care structures are a matter of current interest. In this study, we assess the safety of the software application SmED-Kontakt+ for this purpose. SmED is an abbreviation for Strukuturierte Medizinische Ersteinschätzung Deutschland, "structured initial medical evaluation in Germany."
methodsIn this prospective cohort study, we compared the recommendations of SmED-Kontakt+ concerning the time and place of further care with those of the treating physicians. The subjects were adult patients who were able to walk and had presented themselves to the emergency room. Whenever SmED-Kontakt+ assessed the situation less critically than the physicians, and in 5% of the remaining cases, the potential endangerment of patient safety was assessed by an expert panel (expected value <1%).
resultsIn a total of 1840 cases, SmED-Kontakt+ agreed with the physicians' assessment in 353 (19%). The assessment of SmEDKontakt+ was more critical in 1221 cases (66%) and less critical in 266 (15%; potential undertriage). There was potential endangerment in 49 cases (2.7%; 95% confidence interval [2.0; 3.5]). Potential endangerment was less common among patients in the more urgent recommendation categories [0.1; 2.6] and more common in the categories of a recommended outpatient phy - sician visit or telephone consultation within or beyond 24 hours [2.4; 17.2].
conclusionSmED-Kontakt+ generally assessed these patients' needs for further care as more urgent than the treating physicians did. Nevertheless, the percentage of potentially endangered patients was higher than expected. We conclude that further care should be provided in timely fashion with an obligatory appointment. The sites of further ambulatory care should be immediately accessible and properly equipped. Patients should not be referred for further care at later times on the basis of an SmEDKontakt+ assessment.
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