title: An audit of the ophthalmic division of the accident and emergency department of the Royal Victoria Eye and Ear Hospital, Dublin.
abstract: The objective was to study the patterns of emergency department visits and to make recommendations on ways of improving the service. Patients' demographic data, diagnoses, source of referral and follow-up were entered onto a database. Three thousand seven hundred consecutive patients' visits over a six-week period were entered. The average daily attendance ranged between 80-100 people. 54% of patients were self-referrals. 20% had a previous visit to the hospital. 17% were referred from a GP, 5% from another hospital and 3% from opticians. Superficial injury to the eye and ocular adnexae was the most common diagnostic category. 56% of patients were discharged at the first visit. 23% returned for review to casualty. 14% were referred to OPD, 3% directly to a consultant for review and 1% were admitted to hospital. Waiting times for consultation for patients was highly variable ranging from thirty minutes to five hours, mean two hours. The department provides a service far in excess of its defined function. Non urgent problems accounted for as much as 60-70% of all emergency department visits. Improvement of ophthalmic training of GPs, introduction of an ophthalmic triage system and expansion of outpatient services is recommended so that casualty remains a genuine emergency service and not a primary care service with uncontrollable numbers and unacceptable waiting times for patients.
authors.affiliation: The Royal Victoria Eye and Ear Hospital, Dublin. sineadfenton@fenton22.fsnet.co.uk
authors.forename: S
authors.initials: S
authors.lastname: Fenton
authors.forename: E
authors.initials: E
authors.lastname: Jackson
authors.forename: M
authors.initials: M
authors.lastname: Fenton
mesh_terms: D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005128:Eye Diseases / Q000628:therapy*; D005131:Eye Injuries / Q000628:therapy*; D006801:Humans; D007494:Ireland; D008485:Medical Audit; D009885:Ophthalmology / Q000193:education; D010821:Physicians, Family / Q000193:education; D012017:Referral and Consultation / Q000706:statistics & numerical data; D014218:Triage