Objectives and Background The eight new clinical quality indicators of performance for Emergency Departments (EDs) focus on patient satisfaction, patient safety and effectiveness of care. This audit aims to identify the extent to which frequent attenders to the three Heart of England hospitals contributed to two of these new indicators during the 3 months following their implementation. Frequent attenders are the small minority of patients who present to EDs regularly and, for the purpose of this audit, are defined as any patient who presents to the department five or more times in 1 month. A previously unpublished service evaluation within the three departments indicated the extent to which frequent attenders contribute to the workload of the Heart of England Emergency service. This work led to more detailed case review and analysis.

Method Patients who attended more than five times in a calendar month were identified and their notes analysed to identify their “unplanned re-attendance” and “left without being seen” rates. Further analysis shows at which stage during their ED attendance they decided to leave.

Results and Conclusions Within a 3-month period between April and June, 137 patients attended the departments five times or more per month. Initial analysis suggests that the small number of frequent attenders make a significant contribution to the two new clinical quality indicators, as well as the total work of the department. The full analysis will be presented along with our initial approach to addressing these issues and suggestions for further work.