Evaluation of a programme for ‘Rapid Assessment of Febrile Travelers’ (RAFT): a clinic-based quality improvement initiative

Jazuli, Farah; Lynd, Terence; Mah, Jordan; Klowak, Michael; Jechel, Dale; Klowak, Stefanie; Ovens, Howard; Sabbah, Sam; Boggild, Andrea K

Over the first 22 months of implementation, 198 patients were referred to the RAFT clinic and 154 (78%) were assessed, while 44 patients referred to the RAFT clinic failed to present to the clinic as instructed. Of those who did not come to the clinic on referral, 19 (43%) were contacted and rescheduled, 9 (20%) felt completely well and did not want an appointment and 13 (30%) were lost to follow-up, though not seen again in the ED for their presenting illness. Of the 154 patients referred and assessed in the RAFT clinic, 68 (44%) were men and 86 (56%) were women. Median age was 36 years (range 16-78 years). English was the first language of 81% (n=124). Median time between presentation to the ED and evaluation by an ED physician was 76 min (range 9-359 min; 90th centile 168 min), compared to a provincial median of 60 min and 90th centile of 180 min (Ovens, unpublished data). Median time between initial presentation to the ED and to the first malaria screen was 105 min (range 0-911 min). Median time between initial presentation to the ED and to final disposition was 290.5 min (range 32-936 min; 90th centile 537.8 min), compared to a provincial median of 180 min and 90th centile of 420 min (Ovens, unpublished data).