Audit of unexpected return visits to an accident and emergency department

Unscheduled re-attendances of patients to the A&E Department were examined over 50 days. A re-attendance rate of 1.9 per 100 new patients was found. Of 102 return visits, only 35 resulted in no change in the diagnosis or treatment. Common faults in the initial consultation were failure to explain the condition and prognosis adequately and failure to provide adequate analgesia. Review of patients reattending unexpectedly by a more senior member of staff is a means of identifying faults in management and advising and educating junior staff.