Influenza‐associated delays in patient throughput and premature patient departure in emergency departments in New South Wales, Australia: A time series analysis

Muscatello, DJ; Bein, Kendall J; Dinh, Michael

doi:10.1111/1742-6723.12808

Cited by 7 publications

(4 citation statements)

References 14 publications

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“…One study found that 25% of ED visits during peak periods are for fever and respiratory infection symptoms [9]. Peak influenza circulation is associated with reduced ED throughput efficiency, increased ED length of stay (LOS), and a greater proportion of patients who depart before seeing a physician [10]. Additionally, influenza patients' median LOS is five times greater than other ambulatory ED patients [11].…”

Section: Introductionmentioning

confidence: 99%

Using a novel rapid viral test to improve triage of emergency department patients with acute respiratory illness during flu season

Pedersen

Rogan

Yang

et al. 2018

Journal of Clinical Virology

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Section: Introductionmentioning

confidence: 99%

Using a novel rapid viral test to improve triage of emergency department patients with acute respiratory illness during flu season

Pedersen

Rogan

Yang

et al. 2018

Journal of Clinical Virology

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“…Many studies have shown increased emergency department stay lengths, bed use and premature patient departures during influenza epidemics. [3–5]…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of a rapid RT-PCR assay for point-of-care detection of influenza A/B virus at emergency department admission: A prospective evaluation during the 2017/2018 influenza season

et al. 2019

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Study objective To investigate the performance of a rapid RT-PCR assay to detect influenza A/B at emergency department admission. Methods This single-center prospective study recruited adult patients attending the emergency department for influenza-like illness. Triage nurses performed nasopharyngeal swab samples and ran rapid RT-PCR assays using a dedicated device (cobas Liat, Roche Diagnostics, Meylan, France) located at triage. The same swab sample was also analyzed in the department of virology using conventional RT-PCR techniques. Patients were included 24 hours-a-day, 7 days-a-week. The primary outcome was the diagnostic accuracy of the rapid RT-PCR assay performed at triage. Results A total of 187 patients were included over 11 days in January 2018. Median age was 70 years (interquartile range 44 to 84) and 95 (51%) were male. Nine (5%) assays had to be repeated due to failure of the first assay. The sensitivity of the rapid RT-PCR assay performed at triage was 0.98 (95% confidence interval (CI): 0.91–1.00) and the specificity was 0.99 (95% CI: 0.94–1.00). A total of 92 (49%) assays were performed at night-time or during the weekend. The median time from patient entry to rapid RT-PCR assay results was 46 [interquartile range 36–55] minutes. Conclusion Rapid RT-PCR assay performed by nurses at triage to detect influenza A/B is feasible and highly accurate.

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“…They are not generally used to forecast the severity of an emerging season and may not provide early warning for facilitating preparedness and surge capacity planning. Increased hospital and health system demand during the influenza season [8-10] is a high priority for health managers because influenza epidemics result in a surge of emergency department and hospital admissions [11-13].…”

Section: Introductionmentioning

confidence: 99%

Flucast: A Real-Time Tool to Predict Severity of an Influenza Season

Moa

Muscatello

Chughtai

et al. 2019

JMIR Public Health Surveill

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Background Influenza causes serious illness requiring annual health system surge capacity, yet annual seasonal variation makes it difficult to forecast and plan for the severity of an upcoming season. Research shows that hospital and health system stakeholders indicate a preference for forecasting tools that are easy to use and understand to assist with surge capacity planning for influenza. Objective This study aimed to develop a simple risk prediction tool, Flucast, to predict the severity of an emerging influenza season. Methods Study data were obtained from the National Notifiable Diseases Surveillance System and Australian Influenza Surveillance Reports from the Department of Health, Australia. We tested Flucast using retrospective seasonal data for 11 Australian influenza seasons. We compared five different models using parameters known early in the season that may be associated with the severity of the season. To calibrate the tool, the resulting estimates of seasonal severity were validated against independent reports of influenza-attributable morbidity and mortality. The model with the highest predictive accuracy against retrospective seasonal activity was chosen as a best-fit model to develop the Flucast tool. The tool was prospectively tested against the 2018 and the emerging 2019 influenza season. Results The Flucast tool predicted the severity of all retrospectively studied years correctly for influenza seasonal activity in Australia. With the use of real-time data, the tool provided a reasonable early prediction of a low to moderate season for the 2018 and severe seasonal activity for the upcoming 2019 season. The tool meets stakeholder preferences for simplicity and ease of use to assist with surge capacity planning. Conclusions The Flucast tool may be useful to inform future health system influenza preparedness planning, surge capacity, and intervention programs in real time, and can be adapted for different settings and geographic locations.

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Influenza‐associated delays in patient throughput and premature patient departure in emergency departments in New South Wales, Australia: A time series analysis

Abstract: Circulating influenza was associated with sustained increases and peaks in delayed patient throughput and premature patient departures. Influenza surveillance information may assist with development of health system and hospital workforce planning and bed management activities.

Cited by 7 publications

References 14 publications

Using a novel rapid viral test to improve triage of emergency department patients with acute respiratory illness during flu season

Using a novel rapid viral test to improve triage of emergency department patients with acute respiratory illness during flu season

Diagnostic accuracy of a rapid RT-PCR assay for point-of-care detection of influenza A/B virus at emergency department admission: A prospective evaluation during the 2017/2018 influenza season

Flucast: A Real-Time Tool to Predict Severity of an Influenza Season

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