Sync template from atomicqms-style deployment

.gitea/workflows/atomicai.yml

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+name: AtomicAI Urgent Care Assistant
+
+on:
+  issue_comment:
+    types: [created]
+  issues:
+    types: [opened, assigned]
+  pull_request:
+    types: [opened, synchronize, assigned]
+  pull_request_review_comment:
+    types: [created]
+
+jobs:
+  claude-assistant:
+    runs-on: ubuntu-latest
+    if: |
+      github.actor != 'atomicqms-service' &&
+      (
+      (github.event_name == 'issue_comment' && contains(github.event.comment.body, '@atomicai')) ||
+      (github.event_name == 'issues' && github.event.action == 'opened' && contains(github.event.issue.body, '@atomicai')) ||
+      (github.event_name == 'pull_request' && github.event.action == 'opened' && contains(github.event.pull_request.body, '@atomicai')) ||
+      (github.event_name == 'pull_request_review_comment' && contains(github.event.comment.body, '@atomicai')) ||
+      (github.event.action == 'assigned' && github.event.assignee.login == 'atomicai')
+      )
+
+    permissions:
+      contents: write
+      issues: write
+      pull-requests: write
+
+    steps:
+      - uses: actions/checkout@v4
+        with:
+          fetch-depth: 0
+
+      - name: Run AtomicAI Urgent Care Assistant
+        uses: https://beta.atomicqms.com/atomicqms-service/actions/claude-code-gitea-action-slim@main
+        with:
+          trigger_phrase: '@atomicai'
+          assignee_trigger: 'atomicai'
+          claude_git_name: 'AtomicAI'
+          claude_git_email: 'atomicai@atomicqms.local'
+          custom_instructions: |
+            You are AtomicAI, an AI assistant specialized in Urgent Care Quality Management.
+
+            ## Your Expertise
+            - Urgent Care Association (UCA) accreditation standards
+            - Triage protocols and acuity assessment
+            - Point-of-care testing (CLIA waived)
+            - Minor procedure protocols (laceration repair, splinting)
+            - Occupational medicine and workers comp
+            - Infection control and isolation procedures
+            - Transfer protocols for higher acuity patients
+            - Medication dispensing and prescribing
+            - Radiology and diagnostic imaging protocols
+            - Patient flow and wait time optimization
+
+            ## Document Creation Guidelines
+            - Place Clinical SOPs in SOPs/Clinical/
+            - Place Triage Protocols in Protocols/Triage/
+            - Place Procedure SOPs in SOPs/Procedures/
+            - Place Lab SOPs in SOPs/Laboratory/
+            - Place Patient Forms in Forms/Patient/
+            - Place Policies in Policies/
+
+            ## Numbering Convention
+            - SOP-UC-XXX for Urgent Care SOPs
+            - SOP-TRI-XXX for Triage SOPs
+            - SOP-PRO-XXX for Procedure SOPs
+            - SOP-LAB-XXX for Laboratory SOPs
+            - POL-XXX for Policies
+            - FRM-XXX for Forms
+
+            Always create branches and submit changes as Pull Requests for review.
+            Focus on efficient, high-quality episodic care.
+          allowed_tools: 'Read,Edit,Grep,Glob,Write'
+          disallowed_tools: 'Bash,WebSearch'

Forms/FRM-001-Document-Change-Request.md

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+# Document Change Request Form
+
+| Form ID | FRM-001 | Revision | 1.0 |
+|---------|---------|----------|-----|
+
+---
+
+## Section 1: Request Information
+
+| Field | Entry |
+|-------|-------|
+| Request Date | |
+| Requested By | |
+| Department | |
+
+## Section 2: Document Information
+
+| Field | Entry |
+|-------|-------|
+| Document Number | |
+| Document Title | |
+| Current Revision | |
+
+## Section 3: Change Description
+
+### Type of Change
+- [ ] New Document
+- [ ] Revision to Existing Document
+- [ ] Document Obsolescence
+
+### Description of Change
+*(Describe the proposed change in detail)*
+
+
+
+
+### Reason for Change
+*(Explain why this change is needed)*
+
+
+
+
+## Section 4: Impact Assessment
+
+### Affected Areas
+- [ ] Training Required
+- [ ] Other Documents Affected
+- [ ] Process Changes Required
+- [ ] Validation Impact
+
+### List Affected Documents
+
+
+## Section 5: Approvals
+
+| Role | Name | Signature | Date |
+|------|------|-----------|------|
+| Requester | | | |
+| Document Owner | | | |
+| Quality Assurance | | | |
+
+---
+
+*Form FRM-001 Rev 1.0*

Forms/FRM-003-CAPA-Form.md

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+# Corrective and Preventive Action (CAPA) Form
+
+| Form ID | FRM-003 | Revision | 1.0 |
+|---------|---------|----------|-----|
+
+---
+
+## Section 1: CAPA Identification
+
+| Field | Entry |
+|-------|-------|
+| CAPA Number | |
+| Date Initiated | |
+| Initiated By | |
+| CAPA Owner | |
+| Target Closure Date | |
+
+## Section 2: Classification
+
+### Type
+- [ ] Corrective Action
+- [ ] Preventive Action
+
+### Source
+- [ ] Customer Complaint
+- [ ] Internal Audit
+- [ ] External Audit
+- [ ] Process Deviation
+- [ ] Nonconforming Product
+- [ ] Management Review
+- [ ] Other: ____________
+
+### Priority
+- [ ] Critical (5 business days)
+- [ ] Major (15 business days)
+- [ ] Minor (30 business days)
+
+## Section 3: Problem Description
+
+*(Describe the nonconformity or potential nonconformity)*
+
+
+
+
+## Section 4: Immediate Containment
+
+*(Actions taken to contain the immediate impact)*
+
+
+
+
+## Section 5: Root Cause Investigation
+
+### Investigation Method Used
+- [ ] 5 Whys
+- [ ] Fishbone Diagram
+- [ ] Fault Tree Analysis
+- [ ] Other: ____________
+
+### Root Cause Determination
+
+
+
+
+## Section 6: Corrective/Preventive Actions
+
+| Action | Responsible | Due Date | Status |
+|--------|-------------|----------|--------|
+| | | | |
+| | | | |
+| | | | |
+
+## Section 7: Effectiveness Verification
+
+| Criteria | Method | Result |
+|----------|--------|--------|
+| | | |
+
+Verification Date: ____________
+Verified By: ____________
+
+## Section 8: Closure
+
+| Role | Name | Signature | Date |
+|------|------|-----------|------|
+| CAPA Owner | | | |
+| Quality Approval | | | |
+
+---
+
+*Form FRM-003 Rev 1.0*

Forms/FRM-006-Audit-Checklist.md

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+# Internal Audit Checklist
+
+| Form ID | FRM-006 | Revision | 1.0 |
+|---------|---------|----------|-----|
+
+---
+
+## Audit Information
+
+| Field | Entry |
+|-------|-------|
+| Audit Number | |
+| Audit Date | |
+| Area/Process Audited | |
+| Lead Auditor | |
+| Auditee(s) | |
+
+---
+
+## Checklist Items
+
+| # | Requirement/Question | Reference | C/NC/NA | Evidence/Notes |
+|---|---------------------|-----------|---------|----------------|
+| 1 | Are current versions of applicable procedures available? | SOP-001 | | |
+| 2 | Are personnel trained on applicable procedures? | SOP-003 | | |
+| 3 | Are training records current and complete? | SOP-003 | | |
+| 4 | Are records properly maintained and retrievable? | SOP-001 | | |
+| 5 | Are nonconformities being documented and addressed? | SOP-002 | | |
+| 6 | Are CAPAs being completed on time? | SOP-002 | | |
+| 7 | Is equipment calibrated and maintained? | | | |
+| 8 | Are process controls being followed? | | | |
+| 9 | Are quality objectives being monitored? | | | |
+| 10 | | | | |
+
+**Legend:** C = Conforming, NC = Nonconforming, NA = Not Applicable
+
+---
+
+## Findings Summary
+
+| Finding # | Type | Description | Clause Reference |
+|-----------|------|-------------|------------------|
+| | | | |
+| | | | |
+
+---
+
+## Auditor Signature
+
+| Auditor | Signature | Date |
+|---------|-----------|------|
+| | | |
+
+---
+
+*Form FRM-006 Rev 1.0*

Forms/Intake-Forms/FRM-UC-001-Triage-Assessment.md

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+# Urgent Care Triage Assessment
+
+| Form ID | FRM-UC-001 | Revision | 1.0 |
+|---------|-------------|----------|-----|
+
+---
+
+## Patient Information
+
+| Field | Entry |
+|-------|-------|
+| Patient Name | |
+| MRN | |
+| Date of Birth | |
+| Age | |
+| Sex | ☐ Male ☐ Female |
+| Date | |
+| Time of Arrival | |
+| Time of Triage | |
+
+---
+
+## Chief Complaint
+
+*In patient's own words:*
+
+**Duration of Symptoms:**
+
+---
+
+## Vital Signs
+
+| Parameter | Value | Normal? |
+|-----------|-------|---------|
+| Temperature | °F / °C | ☐ Yes ☐ No |
+| Heart Rate | bpm | ☐ Yes ☐ No |
+| Respiratory Rate | /min | ☐ Yes ☐ No |
+| Blood Pressure | / mmHg | ☐ Yes ☐ No |
+| SpO2 | % on ☐ RA ☐ O2 ___L | ☐ Yes ☐ No |
+| Pain Score | /10 | |
+| Weight | kg / lbs | |
+| Blood Glucose (if indicated) | mg/dL | ☐ N/A |
+
+---
+
+## Allergies
+
+☐ No Known Drug Allergies (NKDA)
+☐ No Known Allergies (NKA)
+
+| Allergen | Type | Reaction |
+|----------|------|----------|
+| | ☐ Drug ☐ Food ☐ Environmental | |
+| | ☐ Drug ☐ Food ☐ Environmental | |
+| | ☐ Drug ☐ Food ☐ Environmental | |
+
+---
+
+## Current Medications
+
+| Medication | Dose | Frequency |
+|------------|------|-----------|
+| | | |
+| | | |
+| | | |
+| | | |
+
+---
+
+## Brief Medical History
+
+☐ None significant
+
+| Condition | Yes | Condition | Yes |
+|-----------|-----|-----------|-----|
+| Diabetes | ☐ | Heart Disease | ☐ |
+| Hypertension | ☐ | Lung Disease/Asthma | ☐ |
+| Kidney Disease | ☐ | Liver Disease | ☐ |
+| Blood Clots/DVT | ☐ | Cancer | ☐ |
+| Seizures | ☐ | Immunocompromised | ☐ |
+| Pregnancy | ☐ (LMP: _______) | Other: | ☐ |
+
+---
+
+## History of Present Illness
+
+### OPQRST
+
+| Element | Response |
+|---------|----------|
+| **O**nset: When did this start? | |
+| **P**rovocation: What makes it better/worse? | |
+| **Q**uality: Describe the symptom | |
+| **R**adiation: Does it travel anywhere? | |
+| **S**everity: How bad is it (0-10)? | |
+| **T**iming: Constant or comes and goes? | |
+
+### Associated Symptoms
+
+| Symptom | Present | Symptom | Present |
+|---------|---------|---------|---------|
+| Fever/Chills | ☐ | Nausea/Vomiting | ☐ |
+| Headache | ☐ | Diarrhea | ☐ |
+| Shortness of Breath | ☐ | Urinary Symptoms | ☐ |
+| Chest Pain | ☐ | Rash | ☐ |
+| Dizziness | ☐ | Weakness | ☐ |
+| Cough | ☐ | Vision Changes | ☐ |
+| Sore Throat | ☐ | Numbness/Tingling | ☐ |
+
+---
+
+## Quick Look Assessment
+
+### General Appearance
+
+| Observation | Finding |
+|-------------|---------|
+| Alert and oriented | ☐ Yes ☐ No |
+| In acute distress | ☐ Yes ☐ No |
+| Skin color | ☐ Normal ☐ Pale ☐ Flushed ☐ Cyanotic |
+| Respiratory effort | ☐ Normal ☐ Labored |
+| Ambulation | ☐ Independent ☐ Assisted ☐ Wheelchair ☐ Stretcher |
+| Obvious injuries | ☐ None ☐ Present: _______ |
+
+---
+
+## Screening Questions
+
+### Safety Screens
+
+| Question | Response |
+|----------|----------|
+| Fall in past 24 hours? | ☐ Yes ☐ No |
+| Head injury? | ☐ Yes ☐ No |
+| Loss of consciousness? | ☐ Yes ☐ No |
+| Recent surgery? | ☐ Yes (When: _______) ☐ No |
+| Recent travel? | ☐ Yes (Where: _______) ☐ No |
+| Exposure to COVID-19/illness? | ☐ Yes ☐ No |
+
+### For Women of Childbearing Age
+
+| Question | Response |
+|----------|----------|
+| Could you be pregnant? | ☐ Yes ☐ No ☐ N/A |
+| Last menstrual period | |
+| Currently breastfeeding? | ☐ Yes ☐ No ☐ N/A |
+
+---
+
+## Red Flag Assessment
+
+**Check if ANY present (requires immediate provider notification):**
+
+| Red Flag | Present |
+|----------|---------|
+| Chest pain/pressure | ☐ |
+| Difficulty breathing at rest | ☐ |
+| SpO2 <92% | ☐ |
+| Severe headache (worst of life) | ☐ |
+| Sudden vision loss | ☐ |
+| Sudden weakness/numbness | ☐ |
+| Speech difficulty | ☐ |
+| Facial droop | ☐ |
+| Uncontrolled bleeding | ☐ |
+| Altered mental status | ☐ |
+| Syncope | ☐ |
+| Anaphylaxis symptoms | ☐ |
+| Suicidal/homicidal ideation | ☐ |
+
+**If ANY checked → Immediate provider evaluation and consider ED transfer**
+
+---
+
+## Acuity Level Assigned
+
+☐ **Level 1 - Emergent** (ED Transfer Required)
+   → Provider/911 notified: Time _______ Name _______
+
+☐ **Level 2 - Urgent** (Provider within 15 min)
+   → Provider notified: Time _______
+
+☐ **Level 3 - Semi-Urgent** (Provider within 30 min)
+
+☐ **Level 4 - Non-Urgent** (Provider within 60 min)
+
+☐ **Level 5 - Redirect** (Outside UC scope)
+   → Redirected to: _______
+
+---
+
+## Interventions Initiated
+
+| Intervention | Ordered | Completed |
+|--------------|---------|-----------|
+| Ice pack | ☐ | ☐ |
+| Elevation | ☐ | ☐ |
+| Wound care | ☐ | ☐ |
+| POC glucose | ☐ | ☐ |
+| POC UA | ☐ | ☐ |
+| POC strep | ☐ | ☐ |
+| POC flu/COVID | ☐ | ☐ |
+| ECG | ☐ | ☐ |
+| Other: | ☐ | ☐ |
+
+---
+
+## Pain Assessment
+
+| Field | Entry |
+|-------|-------|
+| Location | |
+| Quality | ☐ Sharp ☐ Dull ☐ Aching ☐ Burning ☐ Throbbing |
+| Intensity (0-10) | /10 |
+| Onset | ☐ Sudden ☐ Gradual |
+| Duration | |
+| What relieves it? | |
+| What worsens it? | |
+| Previous episodes? | ☐ Yes ☐ No |
+
+---
+
+## Injury Details (if applicable)
+
+| Field | Entry |
+|-------|-------|
+| Mechanism of Injury | |
+| Time of Injury | |
+| Location of Injury | |
+| Tetanus status | ☐ Up to date ☐ Needs update ☐ Unknown |
+| Work-related? | ☐ Yes ☐ No |
+
+---
+
+## Additional Notes
+
+---
+
+## Re-Triage (if waiting time extended)
+
+| Time | Vital Signs | Condition Changed? | New Acuity | Initials |
+|------|-------------|-------------------|------------|----------|
+| | | ☐ Yes ☐ No | | |
+| | | ☐ Yes ☐ No | | |
+| | | ☐ Yes ☐ No | | |
+
+---
+
+## Triage Nurse/MA Signature
+
+| Field | Entry |
+|-------|-------|
+| Name | |
+| Credentials | |
+| Signature | |
+| Date | |
+| Time | |
+
+---
+
+## Provider Acknowledgment
+
+| Field | Entry |
+|-------|-------|
+| Provider notified at | (time) |
+| Provider seen at | (time) |
+| Provider Signature | |
+
+---
+
+*Form FRM-UC-001 Rev 1.0 - Urgent Care Triage Assessment*

Forms/Training/FRM-004-Training-Record.md

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+# Training Record Form
+
+| Form ID | FRM-004 | Revision | 1.0 |
+|---------|---------|----------|-----|
+
+---
+
+## Section 1: Employee Information
+
+| Field | Entry |
+|-------|-------|
+| Employee Name | |
+| Employee ID | |
+| Department | |
+| Job Title | |
+
+## Section 2: Training Information
+
+| Field | Entry |
+|-------|-------|
+| Training Title | |
+| Training Date | |
+| Training Duration | |
+| Trainer Name | |
+| Trainer Qualification | |
+
+### Training Type
+- [ ] Initial Training
+- [ ] Retraining
+- [ ] Refresher
+- [ ] Procedure Update
+
+### Delivery Method
+- [ ] Classroom
+- [ ] On-the-Job
+- [ ] Self-Study
+- [ ] Computer-Based
+- [ ] Other: ____________
+
+## Section 3: Training Content
+
+*(List topics covered or attach training materials)*
+
+
+
+
+## Section 4: Assessment
+
+### Assessment Method
+- [ ] Written Test
+- [ ] Practical Demonstration
+- [ ] Verbal Assessment
+- [ ] Observation
+
+### Assessment Results
+
+| Metric | Result |
+|--------|--------|
+| Score (if applicable) | |
+| Pass/Fail | |
+
+## Section 5: Signatures
+
+| Role | Name | Signature | Date |
+|------|------|-----------|------|
+| Trainee | | | |
+| Trainer | | | |
+| Supervisor | | | |
+
+---
+
+*Form FRM-004 Rev 1.0*

Policies/POL-001-Quality-Policy.md

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+# Quality Policy
+
+| Document ID | POL-001 |
+|-------------|---------|
+| Title | Quality Policy |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+
+---
+
+## 1. Policy Statement
+
+[ORGANIZATION NAME] is committed to providing products and services that consistently meet customer requirements and applicable regulatory requirements. We strive for continual improvement of our Quality Management System to enhance customer satisfaction.
+
+## 2. Quality Objectives
+
+Our organization commits to:
+
+1. **Customer Focus**: Understanding and meeting customer needs and expectations
+2. **Regulatory Compliance**: Maintaining compliance with all applicable regulations and standards
+3. **Continuous Improvement**: Continually improving the effectiveness of our QMS
+4. **Employee Engagement**: Ensuring all employees understand their role in quality
+5. **Risk-Based Thinking**: Identifying and addressing risks and opportunities
+
+## 3. Management Commitment
+
+Top management demonstrates commitment to the QMS by:
+
+- Ensuring the quality policy is appropriate to the organization's purpose
+- Ensuring quality objectives are established and compatible with strategic direction
+- Ensuring integration of QMS requirements into business processes
+- Promoting the use of the process approach and risk-based thinking
+- Ensuring resources needed for the QMS are available
+- Communicating the importance of effective quality management
+- Ensuring the QMS achieves its intended results
+- Engaging, directing, and supporting persons to contribute to QMS effectiveness
+
+## 4. Scope
+
+This policy applies to all employees, contractors, and processes within the scope of our Quality Management System.
+
+## 5. Communication
+
+This policy shall be:
+- Communicated and understood within the organization
+- Available to relevant interested parties as appropriate
+- Reviewed for continuing suitability
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

README.md

@@ -1,3 +1,133 @@
-# urgent-care
+# Urgent Care & Walk-In Clinic Quality Management System
 
 A comprehensive QMS template designed for urgent care centers, walk-in clinics, and immediate care facilities.
+
+## 🏥 Designed For
+
+- **Urgent Care Centers** - Walk-in acute care facilities
+- **Retail Health Clinics** - Pharmacy-based clinics
+- **Occupational Health Clinics** - Workers' comp and employer health
+- **After-Hours Clinics** - Extended hour primary care
+- **Pediatric Urgent Care** - Children's walk-in services
+- **Sports Medicine Clinics** - Athletic injury care
+- **Freestanding Emergency Departments** - Stand-alone emergency services
+
+## 📋 Regulatory Framework
+
+This template supports compliance with:
+
+- **The Joint Commission** - Ambulatory Care accreditation
+- **UCAOA** - Urgent Care Association standards and benchmarks
+- **CMS** - Medicare/Medicaid requirements
+- **State Medical Board** - Physician practice and supervision
+- **OSHA** - Bloodborne pathogens, workplace safety
+- **HIPAA** - Patient privacy requirements
+- **CLIA** - Point-of-care testing requirements
+- **State Facility Licensing** - Urgent care facility regulations
+- **EMTALA** - Emergency screening requirements (if applicable)
+- **CDC** - Infection control guidelines
+
+## Repository Structure
+
+```
+├── SOPs/
+│   ├── Patient-Flow/          # Triage, registration, rooming, discharge
+│   ├── Clinical-Protocols/    # Chief complaint-based treatment pathways
+│   ├── Procedures/            # Suturing, splinting, I&D, injections
+│   ├── Diagnostics/           # X-ray, lab, POCT procedures
+│   ├── Safety/                # Infection control, emergencies, transfers
+│   └── General/               # Document control, training, CAPA
+├── Forms/
+│   ├── Triage-Forms/          # ESI triage, vital signs, acuity
+│   ├── Visit-Documentation/   # History, exam, assessment, plan templates
+│   ├── Procedure-Consent/     # Procedure-specific consent forms
+│   ├── Discharge-Instructions/# Condition-specific aftercare
+│   ├── POCT-Records/          # Point-of-care testing logs
+│   └── Training/              # Competency assessments
+├── Policies/                  # Facility policies
+├── Work-Instructions/         # Step-by-step procedures
+└── Templates/                 # Document templates
+```
+
+## Document Numbering Convention
+
+- **POL-XXX**: Policies
+- **SOP-PF-XXX**: Patient Flow SOPs
+- **SOP-CP-XXX**: Clinical Protocol SOPs
+- **SOP-PRC-XXX**: Procedure SOPs
+- **SOP-DX-XXX**: Diagnostic SOPs
+- **SOP-SAF-XXX**: Safety SOPs
+- **WI-XXX**: Work Instructions
+- **FRM-XXX**: Forms and Records
+
+## 🤖 AI-Powered Assistance
+
+This repository includes **AtomicAI**, your urgent care QMS assistant. Mention `@atomicai` in any issue or pull request to:
+
+- Draft triage and patient flow procedures
+- Create clinical treatment protocols
+- Generate procedure SOPs for common urgent care procedures
+- Develop discharge instruction templates
+- Create emergency transfer protocols
+- Review documents for accreditation compliance
+
+### Example Prompts
+
+- "@atomicai create an SOP for ESI triage in urgent care"
+- "@atomicai draft a laceration repair protocol with suturing technique"
+- "@atomicai write a chest pain evaluation and transfer protocol"
+- "@atomicai create discharge instructions for ankle sprain"
+- "@atomicai develop a point-of-care strep testing procedure"
+- "@atomicai create an occupational injury documentation form"
+
+## Getting Started
+
+1. **Establish Triage Protocols** - Implement acuity-based patient flow
+2. **Define Clinical Pathways** - Create chief complaint-based protocols
+3. **Set Up Procedure Standards** - Document common urgent care procedures
+4. **Implement POCT Program** - Configure point-of-care testing QC
+5. **Train Staff** - Use competency assessment forms
+
+## Key Documents to Create First
+
+1. **Triage Protocol** - Acuity assessment and flow decisions
+2. **Chest Pain/ACS Protocol** - High-risk complaint management
+3. **Laceration Repair SOP** - Wound care and suturing procedure
+4. **Fracture/Splinting Protocol** - Immobilization and referral
+5. **Transfer to ED Protocol** - Emergency transfer criteria and process
+6. **POCT Quality Control SOP** - Point-of-care testing requirements
+7. **Discharge Instruction Library** - Condition-specific aftercare
+
+## Special Considerations for Urgent Care
+
+### Patient Flow
+- Walk-in vs. scheduled appointments
+- Triage and acuity assessment
+- Wait time management
+- Left without being seen (LWBS) tracking
+- Throughput optimization
+
+### Clinical Scope
+- Chief complaint-based protocols
+- Scope of practice limitations
+- Transfer and referral criteria
+- High-risk complaint management
+- Pediatric-specific considerations
+
+### Procedures
+- Wound care and suturing
+- Fracture management and splinting
+- Abscess I&D
+- Foreign body removal
+- Injection techniques
+
+### Safety and Compliance
+- Emergency equipment and medications
+- Infection control (isolation, PPE)
+- Controlled substance management
+- Medical record documentation
+- Quality metrics (door-to-provider, LWBS)
+
+---
+
+*This template is maintained by AtomicQMS. For questions, open an issue in this repository.*

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

@@ -0,0 +1,112 @@
+# 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

@@ -0,0 +1,265 @@
+# 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

@@ -0,0 +1 @@
+# Placeholder

Templates/SOP-Template.md

@@ -0,0 +1,62 @@
+# Standard Operating Procedure: [Title]
+
+| Document ID | SOP-XXX |
+|-------------|---------|
+| Title | [Title] |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | [DEPARTMENT] |
+
+---
+
+## 1. Purpose
+
+[State the purpose of this procedure]
+
+## 2. Scope
+
+[Define the scope and applicability]
+
+## 3. Responsibilities
+
+### 3.1 [Role 1]
+- [Responsibility]
+- [Responsibility]
+
+### 3.2 [Role 2]
+- [Responsibility]
+- [Responsibility]
+
+## 4. Definitions
+
+| Term | Definition |
+|------|------------|
+| | |
+
+## 5. Procedure
+
+### 5.1 [Section Title]
+
+[Procedure steps]
+
+### 5.2 [Section Title]
+
+[Procedure steps]
+
+## 6. Related Documents
+
+- [List related procedures, forms, etc.]
+
+## 7. References
+
+- [External standards, regulations, etc.]
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |

Work Instructions/WI-001-Template.md

@@ -0,0 +1,68 @@
+# Work Instruction: [Title]
+
+| Document ID | WI-001 |
+|-------------|--------|
+| Title | [Title] |
+| Revision | 1.0 |
+| Effective Date | [DATE] |
+| Author | [AUTHOR] |
+| Approved By | [APPROVER] |
+| Department | [DEPARTMENT] |
+
+---
+
+## 1. Purpose
+
+[Describe the purpose of this work instruction]
+
+## 2. Scope
+
+[Define what activities this instruction covers]
+
+## 3. Safety Precautions
+
+- [List any safety requirements]
+- [Personal protective equipment needed]
+- [Hazards to be aware of]
+
+## 4. Equipment/Materials Required
+
+| Item | Specification |
+|------|---------------|
+| | |
+| | |
+
+## 5. Procedure
+
+### Step 1: [Title]
+[Detailed instructions]
+
+### Step 2: [Title]
+[Detailed instructions]
+
+### Step 3: [Title]
+[Detailed instructions]
+
+## 6. Acceptance Criteria
+
+[Define what constitutes successful completion]
+
+## 7. Records
+
+| Record | Location | Retention |
+|--------|----------|-----------|
+| | | |
+
+## 8. References
+
+- [Related SOPs]
+- [Specifications]
+- [Standards]
+
+---
+
+## Revision History
+
+| Rev | Date | Description | Author |
+|-----|------|-------------|--------|
+| 1.0 | [DATE] | Initial release | [AUTHOR] |