Re-attendance to the emergency department

Abstract

The re-attendance of patients to emergency departments is becoming an increasingly common problem and yet there is not much research available on this subject. This report describes an audit carried out in the emergency department of this hospital, specifically looking at the issue of re-attendance and if there is anything that can be done to prevent it. Traditionally, emergency departments in the United Kingdom have been staffed at junior doctor level by senior house officers (SHO); however, with the advent of modernising medical careers in the United Kingdom, departments are being staffed at this level by foundation year 2 doctors (FY2). Whereas SHO range in experience from a year post-qualification to a possible 5-6 years post-qualification, all FY2 doctors have only one year post-qualification clinical experience. In this audit, FY2 doctors, despite seeing fewer patients per head than the middle-grade tier, had a higher level of re-attendance and it is hypothesised whether this is due to the impact of modernising medical careers on their training.

Seniority of the first-treating doctor does not influence the outcome of acute whiplash injury: a prospective cohort study

“…Nowadays, JD are implemented as responsible health professionals in emergency care because of an increasing number of patients and a limited availability of experienced medical staff [11,18,19]. This phenomenon was also present in our study as the number of WP treated by one physician was higher in the JD group when compared with the MED group (factor 1.20).…”

“…This phenomenon was also present in our study as the number of WP treated by one physician was higher in the JD group when compared with the MED group (factor 1.20). There are investigations showing the dilemma that saving specialization in the early stage of health care can cause elevated effort at a later stage of disease and consequently can increase health care costs [17,19]. Fortunately, we did not observe this effect in the first therapy of acute whiplash injury as there was no difference between both groups concerning the seekingbehavior for additional medical help.…”

“…In detail, the vast majority of WP classified the interaction as ''normal'', but two-thirds of these rated the educational characteristics of the emergency-physician as ''not sufficient''. This might be explained by the fact that based on the elevated workload in emergency departments, there is only a low level of medical time investment available for the treatment of minor injuries like whiplash injury [17][18][19]. Anyhow, we detected a non-significant superior educational attitude of JD, which is likely to be explained by the well-known fact that JD spend more time talking to patients in emergency care [22].…”

“…Second, numerous investigations showed that a junior doctor is not only a responsible health professional but also a learner and concluded that early trauma management should be performed by more experienced physicians in order to optimize victim's recovery [11,19,20].…”

Predictors of frequent attenders of emergency department at an acute general hospital in Singapore

“…Population ageing has been cited as one of the reasons for the disproportionate ED attendances by elderly subjects,15 contributing a substantial and increasing proportion of ED workload in developed countries 16 17. In Singapore, 7% of the population is currently aged ≥65 years and by 2030 this will increase to 19% 18.…”