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

Through implementation of a RAFT programme, we have been able to provide more timely care to ambulatory febrile returned travellers and, in doing so, fill a gap in care faced by such travellers prior to implementation of the programme. We have also reduced ED bed-usage by providing an alternate setting for follow-up malaria screening. In addition, we have offloaded the responsibility for treatment of infectious diseases that can be managed in an outpatient setting, but require specific therapy, such as acute urinary tract infections, from the ED. Our programme underscores the range of febrile illnesses that are imported to Canada by travellers on a daily basis, and reinforces the need to combine history, physical examination and a minimum set of laboratory investigations to exclude potentially lifethreatening imported illnesses such as malaria and bacteraemia. Contributors FJ, TL and JM contributed to the study design, data collection and analysis, and to the critical appraisal of the manuscript. DJ, MK and SK contributed to data collection and analysis, and to the critical appraisal of the manuscript. HO and SS contributed to programme implementation, data collection and to the critical appraisal of the manuscript. AKB conceived the programme and study, contributed to the study design, data collection, analysis and interpretation, and was primarily responsible for writing the manuscript.