Sync template from atomicqms-style deployment

SOPs/General/SOP-001-Document-Control.md

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+# Standard Operating Procedure: Document Control
+
+| Document ID | SOP-001 |
+|-------------|---------|
+| Title | Document Control |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | Quality Assurance |
+
+---
+
+## 1. Purpose
+
+To establish a procedure for the creation, review, approval, distribution, and control of documents within the Quality Management System.
+
+## 2. Scope
+
+This procedure applies to all controlled documents including:
+- Policies
+- Standard Operating Procedures (SOPs)
+- Work Instructions
+- Forms and Templates
+- Specifications
+- External documents of external origin
+
+## 3. Responsibilities
+
+### 3.1 Document Owner
+- Responsible for document content and accuracy
+- Initiates document creation and revision
+- Ensures periodic review is performed
+
+### 3.2 Quality Assurance
+- Maintains the document control system
+- Assigns document numbers
+- Manages document distribution
+- Archives obsolete documents
+
+### 3.3 Approvers
+- Review and approve documents before release
+- Ensure documents are adequate for intended purpose
+
+## 4. Procedure
+
+### 4.1 Document Creation
+
+1. Identify the need for a new document
+2. Request document number from Quality Assurance
+3. Draft document using appropriate template
+4. Include all required header information
+5. Submit for review and approval
+
+### 4.2 Document Review and Approval
+
+1. Route document to appropriate reviewers
+2. Reviewers provide comments within 5 business days
+3. Author addresses all comments
+4. Final approval by designated approver
+5. Quality Assurance releases document
+
+### 4.3 Document Numbering
+
+Documents shall be numbered according to the following convention:
+
+| Type | Prefix | Example |
+|------|--------|---------|
+| Policy | POL | POL-001 |
+| SOP | SOP | SOP-001 |
+| Work Instruction | WI | WI-001 |
+| Form | FRM | FRM-001 |
+
+### 4.4 Revision Control
+
+1. All changes require documented justification
+2. Changes follow same review/approval process as new documents
+3. Revision number increments with each approved change
+4. Revision history maintained in document footer
+
+### 4.5 Document Distribution
+
+1. Current versions available in document control system
+2. Obsolete versions marked and archived
+3. Training on new/revised documents as needed
+
+### 4.6 Periodic Review
+
+1. Documents reviewed at least every 2 years
+2. Review documented even if no changes made
+3. Reviews may result in revision or reaffirmation
+
+## 5. Related Documents
+
+- FRM-001 Document Change Request Form
+- FRM-002 Document Review Record
+
+## 6. Definitions
+
+| Term | Definition |
+|------|------------|
+| Controlled Document | Document managed under document control system |
+| Obsolete | Document no longer valid for use |
+| Revision | Updated version of a document |
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

SOPs/General/SOP-002-CAPA.md

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+# Standard Operating Procedure: Corrective and Preventive Action (CAPA)
+
+| Document ID | SOP-002 |
+|-------------|---------|
+| Title | Corrective and Preventive Action |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | Quality Assurance |
+
+---
+
+## 1. Purpose
+
+To establish a systematic process for identifying, investigating, correcting, and preventing nonconformities and potential nonconformities.
+
+## 2. Scope
+
+This procedure applies to:
+- Product and process nonconformities
+- Customer complaints
+- Audit findings
+- Process deviations
+- Potential nonconformities identified through risk analysis
+
+## 3. Definitions
+
+| Term | Definition |
+|------|------------|
+| Corrective Action | Action to eliminate the cause of a detected nonconformity |
+| Preventive Action | Action to eliminate the cause of a potential nonconformity |
+| Root Cause | Fundamental reason for a nonconformity |
+| Effectiveness Check | Verification that implemented actions achieved desired results |
+
+## 4. Responsibilities
+
+### 4.1 CAPA Owner
+- Investigates the issue
+- Identifies root cause
+- Develops and implements corrective/preventive actions
+- Verifies effectiveness
+
+### 4.2 Quality Assurance
+- Manages CAPA system
+- Assigns CAPA numbers
+- Tracks CAPA status
+- Reviews and approves CAPAs
+- Reports CAPA metrics to management
+
+### 4.3 Management
+- Provides resources for CAPA implementation
+- Reviews CAPA trends
+- Ensures timely closure
+
+## 5. Procedure
+
+### 5.1 CAPA Initiation
+
+1. Identify nonconformity or potential nonconformity
+2. Document issue on CAPA Form (FRM-003)
+3. Classify severity and priority
+4. Assign CAPA owner
+
+### 5.2 Investigation
+
+1. Gather relevant data and evidence
+2. Interview personnel involved
+3. Review related documents and records
+4. Use appropriate investigation tools:
+   - 5 Whys
+   - Fishbone Diagram
+   - Failure Mode Analysis
+
+### 5.3 Root Cause Analysis
+
+1. Identify potential root causes
+2. Verify root cause through evidence
+3. Document root cause determination
+4. Consider systemic implications
+
+### 5.4 Action Development
+
+1. Develop corrective/preventive actions
+2. Assign responsibilities and due dates
+3. Assess actions for:
+   - Appropriateness to problem severity
+   - Impact on other processes
+   - Resource requirements
+
+### 5.5 Implementation
+
+1. Execute approved actions
+2. Document implementation evidence
+3. Update affected documents/processes
+4. Provide training as needed
+
+### 5.6 Effectiveness Verification
+
+1. Define effectiveness criteria
+2. Allow sufficient time for actions to take effect
+3. Collect and analyze data
+4. Document verification results
+5. If ineffective, reopen CAPA for further action
+
+### 5.7 Closure
+
+1. Review all CAPA documentation
+2. Verify all actions completed
+3. Confirm effectiveness verified
+4. Obtain approval for closure
+
+## 6. CAPA Metrics
+
+Quality Assurance shall track and report:
+- Number of open CAPAs
+- CAPA aging
+- On-time closure rate
+- Effectiveness rate
+- CAPAs by category/source
+
+## 7. Related Documents
+
+- FRM-003 CAPA Form
+- SOP-003 Nonconforming Product Control
+- SOP-004 Customer Complaints
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

SOPs/General/SOP-003-Training.md

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+# Standard Operating Procedure: Training and Competence
+
+| Document ID | SOP-003 |
+|-------------|---------|
+| Title | Training and Competence |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | Human Resources / Quality |
+
+---
+
+## 1. Purpose
+
+To ensure personnel performing work affecting product quality are competent based on appropriate education, training, skills, and experience.
+
+## 2. Scope
+
+This procedure applies to:
+- All employees performing quality-affecting activities
+- Contractors and temporary personnel
+- Personnel requiring GxP training
+
+## 3. Responsibilities
+
+### 3.1 Supervisors/Managers
+- Identify training needs for their personnel
+- Ensure training is completed before performing tasks
+- Evaluate competence of personnel
+- Maintain department training records
+
+### 3.2 Human Resources
+- Coordinate training programs
+- Maintain central training database
+- Track training compliance
+- Archive training records
+
+### 3.3 Quality Assurance
+- Develop QMS-related training
+- Approve training curricula for GxP activities
+- Audit training compliance
+
+### 3.4 Employees
+- Complete assigned training on time
+- Maintain current qualifications
+- Report training needs to supervisor
+
+## 4. Procedure
+
+### 4.1 Training Needs Assessment
+
+1. Identify competence requirements for each role
+2. Document requirements in job descriptions
+3. Assess current competence of personnel
+4. Identify training gaps
+
+### 4.2 Training Curriculum Development
+
+1. Define learning objectives
+2. Develop training materials
+3. Identify delivery method:
+   - Classroom
+   - On-the-job
+   - Self-study
+   - Computer-based
+4. Define assessment criteria
+5. Obtain approval from Quality (for GxP training)
+
+### 4.3 Training Delivery
+
+1. Schedule training session
+2. Document attendance
+3. Deliver training per curriculum
+4. Assess comprehension through:
+   - Written test (minimum 80% passing)
+   - Practical demonstration
+   - Supervisor observation
+
+### 4.4 Training Documentation
+
+Training records shall include:
+- Employee name and ID
+- Training title and date
+- Trainer name and qualifications
+- Assessment results
+- Signatures
+
+### 4.5 Retraining Requirements
+
+Retraining is required when:
+- Significant document revisions occur
+- Performance deficiencies identified
+- Extended absence from job function
+- Periodic requalification due
+
+### 4.6 New Employee Orientation
+
+All new employees shall complete:
+1. Company orientation
+2. Quality system overview
+3. Job-specific training
+4. SOP read and understand for applicable procedures
+
+## 5. Training Records Retention
+
+- Training records maintained for duration of employment
+- Records retained 3 years after employee departure
+- Records available for regulatory inspection
+
+## 6. Related Documents
+
+- FRM-004 Training Record Form
+- FRM-005 Training Assessment Form
+- Job Descriptions
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

SOPs/General/SOP-004-Internal-Audit.md

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+# Standard Operating Procedure: Internal Audit
+
+| Document ID | SOP-004 |
+|-------------|---------|
+| Title | Internal Audit |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | Quality Assurance |
+
+---
+
+## 1. Purpose
+
+To establish a systematic approach for conducting internal audits to verify the effectiveness of the Quality Management System.
+
+## 2. Scope
+
+This procedure covers:
+- QMS process audits
+- Compliance audits
+- Product audits
+- System audits
+
+## 3. Definitions
+
+| Term | Definition |
+|------|------------|
+| Audit | Systematic, independent examination to determine conformance |
+| Auditor | Person qualified to perform audits |
+| Finding | Observation of conformance or nonconformance |
+| Observation | Noted item not rising to level of finding |
+
+## 4. Responsibilities
+
+### 4.1 Lead Auditor
+- Plans and schedules audits
+- Prepares audit checklists
+- Conducts audit activities
+- Reports audit findings
+
+### 4.2 Quality Manager
+- Maintains audit program
+- Qualifies auditors
+- Reviews audit reports
+- Reports to management
+
+### 4.3 Auditee
+- Provides access to areas/records
+- Responds to findings
+- Implements corrective actions
+
+## 5. Procedure
+
+### 5.1 Annual Audit Schedule
+
+1. Develop annual audit schedule considering:
+   - Previous audit results
+   - Process criticality
+   - Regulatory requirements
+   - Changes to processes
+2. Ensure all QMS processes audited at least annually
+3. Obtain management approval
+4. Communicate schedule to affected areas
+
+### 5.2 Auditor Qualification
+
+Auditors shall:
+- Complete auditor training course
+- Conduct at least 2 audits under supervision
+- Be independent of area being audited
+- Maintain competence through ongoing audits
+
+### 5.3 Audit Preparation
+
+1. Review applicable procedures and standards
+2. Review previous audit reports
+3. Prepare audit checklist
+4. Notify auditee of audit scope and schedule
+5. Confirm auditor availability
+
+### 5.4 Conducting the Audit
+
+1. Hold opening meeting with auditee
+2. Execute audit checklist
+3. Gather objective evidence:
+   - Document review
+   - Personnel interviews
+   - Process observation
+4. Document findings with evidence
+5. Classify findings:
+   - Major Nonconformance
+   - Minor Nonconformance
+   - Observation
+6. Hold closing meeting
+
+### 5.5 Audit Reporting
+
+1. Complete audit report within 5 business days
+2. Report shall include:
+   - Audit scope and criteria
+   - Personnel interviewed
+   - Findings with evidence
+   - Recommendations
+3. Distribute report to auditee and management
+
+### 5.6 Finding Resolution
+
+1. Auditee responds with corrective action plan within 10 business days
+2. Quality reviews and approves plan
+3. Auditee implements corrective actions
+4. Auditor verifies effectiveness
+5. Close finding upon verification
+
+## 6. Audit Records
+
+Maintain for 5 years:
+- Audit schedules
+- Checklists
+- Reports
+- Corrective action records
+
+## 7. Related Documents
+
+- FRM-006 Audit Checklist Template
+- FRM-007 Audit Report Template
+- SOP-002 CAPA
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

SOPs/General/SOP-005-Management-Review.md

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+# Standard Operating Procedure: Management Review
+
+| Document ID | SOP-005 |
+|-------------|---------|
+| Title | Management Review |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | Quality Assurance |
+
+---
+
+## 1. Purpose
+
+To ensure top management reviews the Quality Management System at planned intervals to ensure its continuing suitability, adequacy, and effectiveness.
+
+## 2. Scope
+
+This procedure applies to the periodic management review of the QMS, including all processes and quality objectives.
+
+## 3. Frequency
+
+Management reviews shall be conducted:
+- At least annually
+- More frequently if significant changes occur
+- As needed based on quality performance
+
+## 4. Responsibilities
+
+### 4.1 Quality Manager
+- Prepares management review agenda and materials
+- Facilitates the meeting
+- Documents meeting minutes and action items
+- Tracks completion of action items
+
+### 4.2 Top Management
+- Attends management review meetings
+- Reviews QMS performance data
+- Makes decisions on QMS improvements
+- Allocates resources as needed
+
+### 4.3 Department Managers
+- Provides input data for their areas
+- Attends management review
+- Implements assigned action items
+
+## 5. Management Review Inputs
+
+The following shall be considered:
+
+### 5.1 Actions from Previous Reviews
+- Status of action items
+- Effectiveness of implemented actions
+
+### 5.2 Changes in Context
+- Internal changes (organization, resources)
+- External changes (regulations, market)
+
+### 5.3 QMS Performance
+- Customer satisfaction and feedback
+- Quality objectives achievement
+- Process performance metrics
+- Nonconformities and corrective actions
+- Audit results
+- Supplier performance
+
+### 5.4 Resource Adequacy
+- Personnel
+- Infrastructure
+- Work environment
+
+### 5.5 Risk and Opportunities
+- Risk assessment results
+- Effectiveness of risk controls
+- New opportunities identified
+
+### 5.6 Improvement Opportunities
+- Process improvements
+- Product improvements
+- QMS enhancements
+
+## 6. Management Review Outputs
+
+Decisions and actions related to:
+- Improvement of QMS and processes
+- Product improvement
+- Resource needs
+- Changes to quality policy or objectives
+
+## 7. Documentation
+
+### 7.1 Meeting Minutes
+- Date and attendees
+- Items discussed
+- Decisions made
+- Action items with owners and due dates
+
+### 7.2 Record Retention
+- Management review records retained for 5 years
+- Available for regulatory inspection
+
+## 8. Related Documents
+
+- FRM-008 Management Review Agenda Template
+- FRM-009 Management Review Minutes Template
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

SOPs/Patient-Care/SOP-UC-001-Triage-Protocol.md

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+# Standard Operating Procedure: Urgent Care Triage Protocol
+
+| Document ID | SOP-UC-001 |
+|-------------|-------------|
+| Title | Urgent Care Patient Triage and Acuity Assessment |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | Urgent Care |
+
+---
+
+## 1. Purpose
+
+To establish standardized procedures for triaging patients presenting to urgent care to ensure appropriate prioritization, timely care, and identification of emergent conditions requiring ED transfer.
+
+## 2. Scope
+
+This procedure applies to all patients presenting to urgent care including:
+- Walk-in patients
+- Scheduled same-day appointments
+- Patients referred from other providers
+- Pediatric and adult patients
+
+## 3. Responsibilities
+
+### 3.1 Triage Nurse/Medical Assistant
+- Conduct initial patient assessment
+- Assign acuity level
+- Obtain vital signs
+- Identify emergent conditions
+- Initiate appropriate protocols
+
+### 3.2 Urgent Care Provider
+- Review triage findings
+- Evaluate patients per acuity
+- Make disposition decisions
+- Authorize ED transfers
+
+### 3.3 Front Desk Staff
+- Check in patients
+- Alert clinical staff to arrivals
+- Facilitate registration
+
+## 4. Definitions
+
+| Term | Definition |
+|------|------------|
+| Triage | Process of prioritizing patients based on clinical urgency |
+| Acuity | Severity of patient's condition |
+| ESI | Emergency Severity Index (reference scale) |
+| ED Transfer | Patient requiring emergency department level care |
+| Chief Complaint | Primary reason for visit |
+
+## 5. Triage Levels
+
+### 5.1 Urgent Care Acuity Scale
+
+| Level | Description | Examples | Target Time |
+|-------|-------------|----------|-------------|
+| 1 - Emergent | Life/limb threatening, requires ED | Chest pain, stroke symptoms, severe dyspnea | IMMEDIATE ED transfer |
+| 2 - Urgent | Significant symptoms, needs prompt attention | High fever, moderate dyspnea, severe pain | <15 minutes |
+| 3 - Semi-Urgent | Moderate symptoms, stable | Lacerations, minor fractures, UTI symptoms | <30 minutes |
+| 4 - Non-Urgent | Minor symptoms, stable | Minor cold symptoms, prescription refills | <60 minutes |
+| 5 - Not Appropriate | Outside scope, needs referral | Chronic disease management, specialist care | Redirect to PCP |
+
+## 6. Procedure
+
+### 6.1 Initial Contact
+
+1. **Patient Arrival**
+   - Acknowledge patient within 5 minutes of arrival
+   - Brief visual assessment
+   - Determine if immediate attention needed
+
+2. **Quick Look Assessment**
+   Rapidly evaluate:
+   - Level of consciousness
+   - Respiratory effort
+   - Skin color
+   - Obvious distress
+   - Visible injuries
+
+### 6.2 Triage Assessment
+
+#### 6.2.1 Chief Complaint
+
+Document in patient's own words:
+- Primary symptom
+- Duration
+- Severity (0-10 scale for pain)
+
+#### 6.2.2 Vital Signs
+
+| Parameter | Normal Adult Range | Action if Abnormal |
+|-----------|-------------------|-------------------|
+| Temperature | 97.0-99.0°F | Assess for fever source |
+| Heart Rate | 60-100 bpm | Assess for underlying cause |
+| Respiratory Rate | 12-20/min | Oxygen, escalate if distressed |
+| Blood Pressure | <140/90 mmHg | Repeat, assess symptoms |
+| SpO2 | ≥95% on RA | Oxygen, consider ED transfer |
+| Pain Score | 0/10 | Pain management protocol |
+
+#### 6.2.3 Brief History
+
+| Element | Document |
+|---------|----------|
+| Onset | When did symptoms start? |
+| Provocation | What makes it better/worse? |
+| Quality | Describe the symptom |
+| Radiation | Does pain travel? |
+| Severity | Rate 0-10 |
+| Time | Constant or intermittent? |
+| Medications | Current medications |
+| Allergies | Drug and other allergies |
+| Last meal | Time of last food/drink |
+| Medical history | Relevant conditions |
+
+### 6.3 Level 1 - Emergent (ED Transfer Required)
+
+**Immediate recognition and action for:**
+
+| Condition | Signs/Symptoms | Action |
+|-----------|---------------|--------|
+| Cardiac emergency | Chest pain, diaphoresis, SOB, arm/jaw pain | Call 911, ECG if available |
+| Stroke | Facial droop, arm weakness, speech difficulty | Call 911, note time of onset |
+| Respiratory failure | SpO2 <90%, severe distress, cyanosis | Oxygen, call 911 |
+| Anaphylaxis | Airway swelling, hypotension, urticaria | Epinephrine, call 911 |
+| Severe trauma | Major bleeding, altered consciousness | Stabilize, call 911 |
+| Sepsis | Fever, tachycardia, hypotension, AMS | IV access, fluids, call 911 |
+| Active seizure | Convulsions, unresponsive | Protect, time seizure, call 911 |
+
+**ED Transfer Protocol:**
+1. Call 911 immediately
+2. Notify provider
+3. Initiate stabilizing measures
+4. Document time and interventions
+5. Provide EMS with clinical information
+6. Send documentation with patient
+
+### 6.4 Level 2 - Urgent
+
+**Requires provider evaluation within 15 minutes:**
+
+| Condition | Characteristics |
+|-----------|----------------|
+| High fever | >103°F adult, >102°F child <3 months |
+| Moderate respiratory distress | SpO2 92-95%, increased work of breathing |
+| Severe pain | 8-10/10 |
+| Significant bleeding | Controlled but significant |
+| Dehydration with vomiting | Unable to keep fluids down |
+| Acute abdominal pain | Severe, localized |
+| Altered mental status | Confusion, not baseline |
+| Syncope | Recent loss of consciousness |
+| Diabetic emergency | Hypoglycemia, ketoacidosis symptoms |
+
+### 6.5 Level 3 - Semi-Urgent
+
+**Provider evaluation within 30 minutes:**
+
+| Condition | Characteristics |
+|-----------|----------------|
+| Lacerations | Requiring sutures, bleeding controlled |
+| Possible fractures | Deformity, point tenderness, stable |
+| Moderate pain | 5-7/10 |
+| UTI symptoms | Dysuria, frequency, no fever |
+| Ear pain | Moderate, no fever |
+| Minor burns | <5% BSA, superficial |
+| Sprains/strains | Ambulating, stable |
+| Rash with mild symptoms | No systemic symptoms |
+
+### 6.6 Level 4 - Non-Urgent
+
+**Provider evaluation within 60 minutes:**
+
+- Upper respiratory symptoms (mild)
+- Minor sore throat
+- Minor skin conditions
+- Medication refills
+- Minor eye complaints (non-trauma)
+- Minor injuries not requiring sutures
+
+### 6.7 Level 5 - Redirect
+
+**Outside urgent care scope:**
+
+- Chronic disease management
+- Routine physical exams
+- Mental health crisis (redirect to crisis line/ED)
+- Dental emergencies (redirect to dentist/ED)
+- Specialty care needs
+- Workers' compensation (per facility policy)
+
+### 6.8 Pediatric Considerations
+
+#### Age-Specific Concerns
+
+| Age | Automatic Elevation Criteria |
+|-----|------------------------------|
+| <3 months | Any fever ≥100.4°F → ED |
+| <2 years | Fever >103°F, lethargy, poor feeding → Urgent |
+| All pediatric | Respiratory distress, dehydration, altered behavior → Urgent |
+
+#### Pediatric Vital Sign Norms
+
+| Age | HR | RR | Systolic BP |
+|-----|----|----|-------------|
+| Infant | 100-160 | 30-60 | 70-90 |
+| 1-3 years | 90-150 | 24-40 | 80-100 |
+| 4-6 years | 80-140 | 22-34 | 90-110 |
+| 7-12 years | 70-120 | 18-30 | 90-120 |
+| >12 years | 60-100 | 12-20 | 100-120 |
+
+### 6.9 Geriatric Considerations
+
+- Lower threshold for escalation
+- Atypical presentations common
+- Consider polypharmacy
+- Falls assessment
+- Cognitive baseline consideration
+
+## 7. Documentation
+
+Complete FRM-UC-001 Triage Assessment including:
+- Time of arrival and triage
+- Chief complaint
+- Vital signs
+- Allergies and medications
+- Brief history
+- Assigned acuity level
+- Interventions initiated
+- Provider notification time
+
+## 8. Re-Triage
+
+Re-assess waiting patients:
+- Every 30 minutes for Level 2
+- Every 60 minutes for Level 3-4
+- Immediately if condition changes
+- Document all re-assessments
+
+## 9. Quality Metrics
+
+| Metric | Target |
+|--------|--------|
+| Time to triage | <10 minutes |
+| Appropriate acuity assignment | >95% (audit) |
+| ED transfers identified at triage | >99% |
+| Patient complaints re: wait time | <5% |
+
+## 10. References
+
+- Emergency Severity Index (ESI) guidelines
+- Emergency Nurses Association guidelines
+- Pediatric Assessment Triangle
+- State nursing practice acts
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

SOPs/Safety/.gitkeep

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+# Placeholder