Somehow I missed this before now, but a group from Cincinnati actually started testing patients who reported penicillin allergies... in the ED!
Our results are supportive of the feasibility of conducting penicillin skin testing in the ED and demonstrate the potential influence of conducting skin testing in the ED. The rate of false-positive reports of penicillin allergy in our patient population was high: more than 90% of patients reporting a penicillin allergy did not have a positive skin test result. These findings are consistent with previous reports from other non-ED patient populations...
...The introduction of penicillin skin testing to the ED environment could help decrease the overuse of broad-spectrum antibiotics in the ED...
It took little time to train the ED docs to administer this common skin test used in clinics, and results were available withing 30 minutes. No special background or skills were required to perform this trial -- it's a great example of tackling frustrating problems with straightforward research design.