| Reasonably Safe Emergency Department |
Dangerous Emergency Department |
| Average doctor-to-patient ratio of one to ten |
Average doctor-to-patient ratio of one to more than ten |
| Average nurse-to-patient ratio of one to five |
Average nurse-to-patient ratio of one to more than five |
| Keeps statistics on waiting time and has as goal to average one hour or less |
Does not follow waiting time and/or has no formal program to reduce it |
| Allows nursing supervisor to call for ambulance diversion when filled to capacity |
Has unwritten policy against going on diversion to avoid losing revenue |
| Maintains strict policy on assigning only nurses with proper credentials and orientation |
Uses temp-agency nurses without adequate orientation |
| Has a written protocol for stabilizing and transferring patients with problems requiring treatment at another hospital |
No such protocol in place or not reviewed and updated every three months |
| Keeps a list of on-call specialists and contacts each daily to confirm availability and response time |
No calls made to specialists each day to confirm availability |
| Has strict policy on keeping patients under close observation until medically cleared |
No such policy in place |
| Does not keep new admissions in emergency department for more than four hours; transfers admitted patients without beds to other hospitals |
Will keep admitted patients indefinitely in the emergency department until bed opens up; transfers admitted patients only upon demand |
by T.Sharon
