ED Waiting Room Safety Reassessment Round

Hourly emergency department waiting room round to reassess patients, capture vital sign changes, identify clinical deterioration, and document escalation actions.

Round Identification

• Round start time recorded
• Round completed within hourly interval
  Confirm the reassessment round was completed within the expected hourly cadence.
• Inspector name or role recorded
• Waiting room census documented
  Number of patients present in the waiting room at the time of the round.

Patient Reassessment

• Each waiting patient visually reassessed
  Confirm every patient in the waiting room was observed during the round.
• New or worsening symptoms identified
  Document whether any patient reported or displayed worsening pain, dyspnea, chest pain, syncope, bleeding, altered mental status, or other concerning change.
• Level of distress observed
  Overall observed distress level for the most concerning patient encountered during the round.
• Ambulatory status unchanged or safe
  Confirm patients who were ambulatory remained safe to ambulate and did not demonstrate new instability.
• Mental status change noted
  Identify any new confusion, lethargy, agitation, or decreased responsiveness.

Vital Signs and Clinical Triggers

• Vital signs obtained for patients requiring reassessment
  Confirm updated vital signs were obtained for patients due for reassessment or with concerning symptoms.
• Heart rate
• Respiratory rate
• SpO2
• Blood pressure
  Record blood pressure in systolic/diastolic format, for example 128/76.
• Temperature

Escalation and Safety Actions

• Provider or triage nurse notified for abnormal findings
  Confirm escalation occurred for any abnormal vital signs, worsening symptoms, or observed deterioration.
• Patient moved to treatment area or higher-acuity location
  Document whether the patient was transferred out of the waiting room when clinically indicated.
• Additional interventions initiated
  Select any interventions initiated during the round.
• Escalation details documented
  Record who was notified, when they were notified, and the response or disposition.

Waiting Room Environment and Safety

• Waiting room is observable by staff
  Confirm patients remain within line of sight or active monitoring coverage appropriate to the setting.
• Seating, floor, and walkways free of immediate hazards
  Check for spills, trip hazards, blocked pathways, or unsafe seating conditions.
• Privacy, dignity, and infection control concerns noted
  Document any issues affecting patient privacy, masking, isolation needs, or infection control precautions.
• Immediate environmental issue escalated
  Confirm any environmental hazard was reported to the appropriate team for correction.