Clinician Consensus on “Inappropriate” Presentations to the Emergency Department in the Better Data, Better Planning (BDBP) Census: A Cross-sectional Multi-center Study of Emergency Department Utilization in Ireland

Introduction: Utilization of the Emergency Department (ED) for non-urgent care increases demand services, therefore reducing avoidable attendance is an important area intervention in prevention ED crowding. This study aims to develop a consensus among clinicians across settings about “appropriateness” at Ireland. Method: The Better Data, Planning was multi-center, cross-sectional investigating factors influencing utilization Following ethical approval, data compiled patient summary files which were assessed measures appropriateness by academic General Practitioner (GP) and Medicine Consultant (EMC) National Panel. In cases where not reached charts Independent Review Panel (IRP). At each site all autonomously local GP-EMC panels. Results: determined that 11% 38% n=306 lower acuity presentations could be treated GP within 24-48h (k=0.259; p<0.001) 18% 35% attendances considered “inappropriate” (k=0.341; p<0.001). For deemed “appropriate” admission rate 47% compared 0% attendees. There no on 45% (n=136). Subset analysis IRP appropriate ranged from 0-59% inappropriate 0-29%. Local review (n=306) 40-76% sites. Conclusion: Multidisciplinary agree use Irish EDs issue. However, obtaining challenging there significant cohort complex heterogeneous agreement this study. research again demonstrates complexity crowding, introduction evidence-based pathways targeting may serve alleviate problem our EDs.