• Nicholas Faulkner, Paul Buntine, Breanna Wright, Deborah Leach, and Peter Bragge.
• BehaviourWorks Australia, Monash University, Melbourne, Victoria, Australia.
• Emerg Med Australas. 2023 Aug 1; 35 (4): 664671664-671.

ObjectivesProviding accurate and timely diagnoses is challenging in ED settings. We evaluated the feasibility and effectiveness of a short, structured rapid diagnosis discussion (RaDD) between a patient's initial doctor and a second doctor for patients presenting to ED with abdominal pain.MethodsControlled pre-post, mixed-methods pilot study in a metropolitan hospital network in Melbourne, Australia. Comparisons were made between an ED using RaDD for a 1-month period (n = 155) and two control EDs within the same hospital network (n = 2227) using standard practices. A short survey of 27 clinicians was also undertaken.ResultsProvisional diagnoses changed in 24.7% (95% confidence interval 19.0, 30.4) of all cases for which a RaDD case report sheet was completed, and clinicians' confidence in their decision-making was significantly higher when using RaDD (r = 0.27). RaDD significantly increased the likelihood that patients would be sent to the short stay unit and have a blood test ordered, and significantly reduced the likelihood that patients would be discharged home from the ED or leave at their own risk. Usage of the RaDD tool was low (25.2% of eligible cases), and qualitative feedback indicated that time limitations inhibited uptake.ConclusionsRaDD encouraged clinicians to take a more cautious, risk-averse approach to care and improved confidence in their diagnostic decisions. However, cost effectiveness of these outcomes and possible implementation barriers need to be further considered in subsequent studies.© 2023 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine.

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