Ensuring Staffing Keeps Pace with Growth in Attendances! Historic Attendance Trend Analysis with Implications for Future Staffing.

Introduction: Emergency Department (ED) attendances have been growing worldwide for decades, the rationale for this is societal, cultural, and geographically dependent, but has not been described in detail. Increased access to primary care has been postulated as a solution; however, as the number of General Practitioners (GPs) and GP training posts has increased over the last decade in Ireland, so too has the rise in ED attendances. Detailed analysis is required on an ongoing basis to predict the Staff, staff, and space required to appropriately manage the growing cohort of attendances. Methods: Trend analysis of system-generated attendance reports to evaluate 10 years of attendance patterns (2014-2024) and predict potential future pinch points. Data examined in Excel. Results: Monthly attendances ranged from a low of 540 to a high of 5028. Average monthly attendance increased from 2657 in 2014 to 4744 in 2024. First month > 3,000 was June 2015, first month > 4,000 June 2021, and first > 5,000 attendances was May 2024. Conclusion: COVID lockdowns in 2020 and 2021 negatively affected attendance, as did a fire resulting in a hospital evacuation in March 2023. Determining trends in presentations and future predictions is important to ensure that staffing levels match predicted attendances and thus avoid “black escalation” and offload delay. The first time attendances exceeded 3000/month was June 2015, th years later in 2018, every month exceeded 3,000 attendances, and have done so almost every month since, apart from COVID lockdowns, and during fire restricted attendance months in 2023. First month > 4,000 attendances June 2021, and since August 2023, 2 years later, every month has exceeded 4,000 attendances. In May 2024, the first month,> 5,000 attendances occurred. IF predictive models hold in 22 months, every month will be > 5,000 attendances with implications for admissions, bed capacity, ambulance turnover, and more importantly, ED staffing.