Hospital Emergency Room Efficiency Audit Form
Please complete this form to assess and document the operational efficiency of the hospital emergency room.
Facility Name
*
Date of Audit
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Auditor Full Name
*
First Name
Last Name
Contact Email
*
example@example.com
Patient Flow Assessment
*
Rows
Excellent
Good
Fair
Poor
Patient registration process
1
2
3
4
Triage process efficiency
5
6
7
8
Patient transfer to treatment area
9
10
11
12
Discharge procedures
13
14
15
16
Average Patient Wait Time (minutes)
*
Staff Responsiveness
*
Very Slow
1
2
3
4
Very Fast
5
1 is Very Slow, 5 is Very Fast
Resource Availability Assessment
*
Rows
Adequate
Needs Improvement
Insufficient
Medical equipment
17
18
19
Medications
20
21
22
Clean linens
23
24
25
Sanitary supplies
26
27
28
Cleanliness and Safety Observations
Waiting areas are clean
Treatment rooms are sanitized
Hand hygiene stations available
Clear signage for emergency exits
Other (please specify)
Communication and Information Provided to Patients
*
1
2
3
4
5
Overall Emergency Room Efficiency
*
Excellent
Good
Fair
Poor
Additional Comments or Recommendations
Submit Audit
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