Evaluation of a programme for ‘Rapid Assessment of Febrile Travelers’ (RAFT): a clinic-based quality improvement initiative
| Autor: | Howard Ovens, Stefanie Klowak, Jordan Mah, Terence Lynd, Dale A. Jechel, Farah Jazuli, Michael Klowak, Sam Sabbah, Andrea K. Boggild |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Program evaluation medicine.medical_specialty Adolescent Fever Referral 030231 tropical medicine Vital signs Ambulatory Care Facilities Communicable Diseases 03 medical and health sciences 0302 clinical medicine Global health Humans Medicine 030212 general & internal medicine Intensive care medicine Referral and Consultation Aged Travel Tropical Climate business.industry Research TROPICAL MEDICINE INFECTIOUS DISEASES General Medicine Emergency department Middle Aged medicine.disease Quality Improvement Virus Diseases Tropical medicine Ambulatory Emergency Medicine Female business Sentinel Surveillance Malaria Program Evaluation |
| Zdroj: | BMJ Open |
| ISSN: | 2044-6055 |
| DOI: | 10.1136/bmjopen-2015-010302 |
| Popis: | Background Fever in the returned traveller is a potential medical emergency warranting prompt attention to exclude life-threatening illnesses. However, prolonged evaluation in the emergency department (ED) may not be required for all patients. As a quality improvement initiative, we implemented an algorithm for rapid assessment of febrile travelers (RAFT) in an ambulatory setting. Methods Criteria for RAFT referral include: presentation to the ED, reported fever and travel to the tropics or subtropics within the past year. Exclusion criteria include Plasmodium falciparum malaria, and fulfilment of admission criteria such as unstable vital signs or significant laboratory derangements. We performed a time series analysis preimplementation and postimplementation, with primary outcome of wait time to tropical medicine consultation. Secondary outcomes included number of ED visits averted for repeat malaria testing, and algorithm adherence. Results From February 2014 to December 2015, 154 patients were seen in the RAFT clinic: 68 men and 86 women. Median age was 36 years (range 16–78 years). Mean time to RAFT clinic assessment was 1.2±0.07 days (range 0–4 days) postimplementation, compared to 5.4±1.8 days (range 0–26 days) prior to implementation (p |
| Databáze: | OpenAIRE |
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