Improved diagnostic policy for respiratory tract infections essential for patient management in the emergency department

Poelman, Randy; van der Meer, Johan; van der Spek, Corina; Riezebos-Brilman, Annelies; Knoester, Marjolein; Leer-Buter, Coretta Van; Friedrich, Alexander W; Niesters, Hubert G

AIM: Establishing an optimal diagnostic policy for patients with respiratory tract infections, at the emergency department (ED) of a university hospital in The Netherlands. METHODS: Adult patients were sampled at admission, during the respiratory season (2014–2015). The FilmArray-RP was implemented at the clinical virology laboratory. Diagnostics were provided from 8 am to 10 pm, weekends included. RESULTS: 436/492 (89%) results were available while patients were still at the ED. Median TAT from admission to test result was 165 min (IQR: 138–214). No antibiotics were prescribed in 94/207 (45%) patients who tested positive for a virus. 185/330 (56%) hospitalized patients did not need admission with isolation measures. The value-based measure, expressed in euro–hour (€h), increased to tenfold compared with previous policy. CONCLUSION: An optimal policy is essential for patient management, by providing timely, reliable diagnostics.