Healthcare · Emergency department · Instrument
Start at your own policy. Then walk to the door it exempts.
The first item you can do at your desk in two minutes, and it will land harder than anything we wrote. The rest is a twenty-minute walk. It stages nothing and asks you to evaluate no one’s clinical judgment.
Nothing is stored. Nothing is sent. No email, no login — this sheet is yours.
Emergency department · walk-the-bay
Nine things to read, see, and ask
Note the answer, not a score. Nothing here asks you to question the clinical carve-out — it is correct. It asks what the correct exception leaves open.
1. Pull your own written ED screening policy. Does it name the bypass — life-threatening arrivals and ambulances — in writing?
Two minutes at your desk. It almost certainly does, and it is correct. That sentence is the whole page.
2. Stand at the ambulance-bay entrance. Who is standing there right now?
Not who is assigned. Who is there.
3. Walk from the ambulance bay to a treatment bay. How many controlled transitions did you pass through?
Count the doors that actually stopped you.
4. Count the ED’s entrances. How many are screened? How many are staff, service, or internal routes?
The ratio is the point.
5. Stand at a bedside — not the nurses’ station. Where is the nearest duress activation, and could you reach it with a patient between you and the wall?
This is where assaults happen. Check it from there, not the desk.
6. If duress fires from that bedside, which screen does it reach — and who is watching that screen right now?
A screen nobody watches is not a response.
7. Look for unsecured objects in the waiting area and treatment bays — extinguishers, phones, lamps, loose chairs.
OSHA’s own ED guidance recommends securing these.
8. Pull last month’s reported assault count. Then ask a charge nurse what she’d estimate actually happened.
The gap between the two is the point — and both numbers are obtainable without clinical knowledge.
9. Ask when the ambulance-bay camera view was last verified against what it’s supposed to show.
A date, or “don’t know.” Both are findings.
Nothing on this sheet asks you to evaluate a clinical decision, question the carve-out, or assess a colleague’s judgment. The exception is correct. This is about what it leaves standing open, observed on an ordinary day.