Audit of frequent attendees to an ENT emergency clinic

To audit the number of patients attending an ENT emergency clinic more than twice in the same clinical episode.

A completed audit cycle. The inclusion criterion for the retrospective arm was patients who had attended the ENT emergency clinic more than twice between 1 September to 30 November 2007. Data were analysed and interventions implemented. The re-audit, using the same inclusion criteria, was done between 1 March to 31 May 2008.

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.

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.