Audit of frequent attendees to an ENT emergency clinic

Objective: To audit the number of patients attending an ENT emergency clinic more than twice in the same clinical episode. Method: A completed audit cycle. The inclusion criterion for the retrospective arm was patients who had attended the ENT emergency clinic more than twice between I September to 30 November 2007. Data were analysed and interventions implemented. The re-audit, using the same inclusion criteria, was done between I March to 31 May 2008. Results: The initial audit found that 38 patients were seen more than twice in the ENT emergency clinic, giving rise to 81 excess clinic appointments. After intervention, the re-audit identified 19 patients who were seen more than twice in the ENT emergency clinic, giving rise to 24 'excess' clinic appointments. Conclusion: By insisting that patients seen more than twice in the ENT emergency clinic were reviewed by a senior clinician, and by introducing a management guideline for acute otitis externa, we reduced excess clinic appointments by 70 per cent.