Headache: clinical governance in health care management in the Emergency Department.

Headache is a common Emergency Department (ED) problem accounting for 1.7%-4.5% of patients every year. The main aim in the ED is to differentiate between primary and secondary headache. Although secondary headache represents the lowest percentage (20%) of ED patients presenting with headache, it can be life threatening. Patients with primary headache require a follow-up programme on discharge from the ED with a specialist headache clinic taking responsibility for these patients. This procedure was applied at Ravenna Hospital ED for 2 years and recorded (unpublished data) a reduction in the number of repeat visits to the ED for headache and the number of inappropriate admissions for headache (DRG 25).