Unscheduled Returns of Older Patients to the Emergency Department of an Irish Teaching Hospital in the Final Quarter of 2023

Background Rapid unscheduled returns to emergency departments (ED) are considered to be an indication of a potential lack of quality of care of an ED as outlined in the academic literature. Our ED multidisciplinary team (MDT) dedicated to the assessment and treatment of older persons is a relatively new one. In order to evaluate our efficacy, we sought to compare our rate of unscheduled returns with international norms. Methods Retrospective audit of 883 patients from October 2023 to January 2024. Our ED software programme which holds the patient histories was reviewed to establish whether the patients came back to the ED, if so, how quickly, and for what reason. The results were collated and reviewed. Results Average age: 81. Average Clinical Frailty Scale Score (CFS): 5. 69% of older patients assessed by the MDT did not return to our ED. 3% returned within 72hrs. 2% returned within one week. 9% returned within one month. 13% returned within 3 months. 2% returned within 6 months. Conclusion In numerous academic articles, the 72hr unscheduled return should not exceed 3-5%. While we would always seek to reduce the rate of unscheduled returns to our ED, the results show that our 72hr return percentage is within international norms. This is despite the age profile and frailty of the patients assessed, treated and reviewed.