Lessons from SARS: A retrospective study of outpatient care during an infectious disease outbreak

BMC Pediatrics

Research Article

Lesley Wylie¹  Nehad Nasef²  Karel O'Brien²  Sharon Unger² 

[1] Neonatal Neurodevelopmental Follow Up, SickKids, Toronto, Ontario, Canada;Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada;Neonatal Neurodevelopmental Follow Up, SickKids, Toronto, Ontario, Canada;

关键词: Cerebral Palsy;    Developmental Delay;    Severe Acute Respiratory Syndrome;    Severe Acute Respiratory Syndrome;    Mount Sinai Hospital;   

DOI  :  10.1186/1471-2431-10-51

 received in 2009-11-23, accepted in 2010-07-20,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundDuring severe acute respiratory syndrome (SARS) outbreak in Toronto, outpatient clinics at SickKids Hospital were closed to prevent further disease transmission. In response, a decision was made by the neonatal neuro-developmental follow up (NNFU) clinic staff to select patients with scheduled appointments to have a mail/telephone assessment using Ages and Stages Questionnaire (ASQ) or to postpone/skip their visit. The objective of this study was to compare the developmental assessment and its outcome in two groups of NNFU clinic patients, SARS versus non-SARS, over three standard clinic appointments.MethodsWe compared the diagnostic accuracy (identification of developmental delay), and patient management (referral for therapy or communication of a new diagnosis) of the strategies used during SARS, April/May 2003, to the standard assessment methods used for patients seen in April/May 2005 (non-SARS). In all cases data were obtained for 3 patient visits: before, during and after these 2 months and were compared using descriptive statistics.ResultsThere were 95 patients in the SARS group and 99 non-SARS patients. The gestational age, sex, entry diagnosis and age at the clinic visit was not different between the groups. The NNFU clinic staff mailed ASQ to 27 families during SARS, 17 (63%) were returned, and 8 of the 17 were then contacted by telephone. Criteria used to identify infants at risk selected for either mailed ASQ or phone interviews were not clearly defined in the patients' charts. There was a significant under identification of developmental delay during SARS (18% versus 45%). Of those who responded to the mailed questionnaire, referrals for therapy rates were similar to non-SARS group. The lost to follow up rate was 24% for the SARS group compared with 7% for non-SARS. There was no difference in the overall rate of developmental delay in the two groups as identified at the 'after' visit.ConclusionsPoor advanced planning led to a haphazard assessment of patients during this infectious disease outbreak. Future pandemic plans should consider planning for outpatient care as well as in hospital management of patients.

【 授权许可】

Unknown   
© Nasef et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.