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

A major gap in the care of febrile returned travellers exists in Canada. Fever in this Strengths and limitations of this study â–ª Fever in the returned traveller is a medical emergency, potentially heralding life-threatening infections such as malaria, or more benign aetiologies, some of which may self-resolve. â–ª As a clinic-based quality improvement initiative, we designed and implemented an algorithm for 'Rapid Assessment of Febrile Travelers' based on Canadian national fever assessment guidelines, and demonstrated a significant reduction in waittime to Tropical Medicine assessment and emergency department (ED) bed-usage. â–ª We also demonstrated a reduction in repeat ED visits for follow-up malaria screening after an initial negative. â–ª We did not have access to the full range of hospital administrative ED data that would permit quantification of economic savings; thus, we did not perform an economic analysis. â–ª We identified an aetiological diagnostic gap in 14% of patients, a rate that is similar to other studies of fever in the returned traveller.