Using a Delphi study to define avoidable emergency department attendances in young adult patients


Some emergency department (ED) visits are for care that, although urgent, could be managed by a GP. We need clarity about what these ‘avoidable attendances’ (AAs) are and how to identify them in order to help tackle ED crowding. This project assessed the current approaches used to identify AAs and aimed to obtain agreement from Emergency Medicine (EM) consultants on what AAs are.

A literature search from 2010 to March 2023 was undertaken. In addition, EM consultants throughout England were enrolled into a modified ‘Delphi study’ (similar to a survey) to reach agreement on a definition of AAs. We found a number of definitions of AAs and a variety of approaches for identifying them in the ED. EM consultants agreed that identifying AAs using routinely available patient data recorded in EDs could best identify AAs. The next step is to develop systems for identifying AAs in real time during ED care.


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