• Sandra Richardson, Michael Ardagh, and Philip Hider.
• Emergency Department, Christchurch Hospital, Christchurch. sandra.richardson@cdhb.govt.nz
• N. Z. Med. J. 2006 Jan 1;119(1232):U1933.

AimsEmergency Departments (EDs) worldwide are facing a crisis from overcrowding--a common perception exists that inappropriate use of the ED is the major contributing factor. This study aims to examine the concept of 'inappropriate' ED attendances in relation to the Emergency Department at New Zealand's Christchurch Hospital. It specifically seeks to determine whether there is a consensus opinion among healthcare providers regarding a definition of 'inappropriate'.MethodsAn exploratory survey of health professionals involved with the referral, assessment, transport, and treatment of ED patients in Christchurch was carried out. A range of health professionals, including ambulance personnel, general practitioners, emergency department physicians, emergency nurses, and hospital managers were approached. A series of questions relating to definition and response to 'inappropriate' patients was asked, with an additional open-ended question relating to the definition of 'appropriateness'.ResultsThere are significant differences in the attitudes and perceptions of key health professionals involved in the referral, treatment, and admission of patients to the ED.ConclusionsWhile there are some areas of general agreement, there is no clear consensus between the professionals surveyed regarding the concept of 'appropriateness.' This has implications for any interventions aimed at addressing ED 'overcrowding' that assume the presence of a consensus understanding of this concept.

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