Frequent attendances to a London emergency department: a service improvement project embedding mental health into the team

Abstract

Background A small number of patients who repeatedly attend emergency departments (EDs) utilise disproportionally large amounts of healthcare resources. It has been suggested in previous studies that ED attendances may be reduced and social and clinical outcomes improved by intervening with individual case management.Methods We identified a cohort of seven patients whom we selected for intensive case management. A team led by liaison psychiatry and emergency care clinicians reviewed these patients when they presented to the ED. A bio-psycho-social assessment provided diagnostic assessment and formulation, identifying the most appropriate care pathway and interventions for the patient, including social care input if necessary.Results Post intervention we saw a dramatic reduction in ED attendance for most of our patients. Our pilot study shows that in six of the seven cases the Frequent Attendances (FA) Programme has resulted in a significant decrease in the number of attendances to the ED (in the 12 months...