In order to evaluate the quality of emergency room care, it is essential to understand and define the standards that define high-quality care. My standards for high-quality Emergency Room care include the following: 1) it maintains life. 2) It provides rapid attention to injuries in order to prevent impairment. 3) It is professional and focused on providing maximized attention to the patients’ needs. 4) It includes rapid response to crisis. 5) It includes alleviating pain. 6) It includes having well-trained personnel.7) It also includes efficiency. 8) It provides rapid assessment. 9) It provides cleanliness. 10) Finally, It utilizes excellent equipment. The American College of Emergency Physicians has established the following standards for high-quality Emergency Room care. 1) Emergency departments must possess the staff and resources necessary to evaluate all individuals presenting to the emergency department (ED.) 2) Emergency departments must also be able to provide or arrange treatment necessary to attempt to stabilize emergency patients who are found to have an emergency medical condition. 3) Because of the unscheduled and episodic nature of health emergencies and acute illnesses, experienced and quality physician, nursing, and ancillary personnel must be available 24 hours a day to serve those needs. 4) Evaluation, management, and treatment of patients must be appropriate and expedient. 5) Resources should exist in the ED to accommodate each patient from the time of arrival through evaluation, decision-making, treatment, and disposition. 6) Excellent facility design 7) State-of-the-art equipment 8) Access to required medications. (www.acep.org) The first standard is that a high-quality Emergency Room provides rapid attention. When I brought my 17-year-old son, who has asthma, to the Sutter Medical Center Emergency Department, he had difficulty breathing, was wheezing, had severe sweating, and heart palpitations. Unfortunately, the triage nurse did not prioritize my child’s medical needs. He had to wait a full 30 minutes to receive medical attention at the waiting area. When a person has an asthma attack, they need oxygen to live. If they do not receive rapid medical attention, his breathing problems increase and can even lead to shock. When my son had another asthma attack, I took him to the Kaiser Permanente Emergency Room. There the triage nurse determined that my son was in crisis. Thus, she immediately sent him to a treatment room where he received rapid attention. As a result, his crisis ended quickly. In conclusion, Kaiser was far superior to Sutter with regard to rapid attention. The second standard is that a high-quality Emergency Room provides well-trained personnel 24 hours a day. At Sutter, the triage nurse who evaluated my son did not seen to be well-trained about the effect of asthma. The doctors and nurses who provided care to my son were well-trained and were able to end his attack. At Kaiser, 100% of the personnel were well- trained. The triage nurse correctly evaluated my son and prioritized his care. The physicians and nurses who treated him were able to quickly stop his attack. The personnel at Kaiser were all well- trained where as a key staff member at Sutter was not well-trained. The third standard is that high-quality Emergency Room provides a clean, well-organized and well- designed facility. At Sutter, the Emergency Room was small and not well-ventilated. Patients were crowded together; thus their screams and pain made others anxious and germs could be easily spread. The vinyl floor was scuffed and dull, the window had a view of a brick wall, and the walls were painted drab green. In contrast, the Kaiser Permanente Emergency Room has been recently renovated inside and out. It is an attractive room with new furniture. The waiting room is spacious, and people are not crowded together. It is very clean. In conclusion, the Kaiser Emergency Room is superior with regard to high-quality facilities. The fourth standard is that a high-quality Emergency Room provides state-of- the- art equipment. At Sutter, there was a mix of modern and old equipment. The nebulizer was extremely old; however, the oxygen equipment was modern. At Kaiser, 100% of the equipment was modern. The Kaiser equipment was much more powerful, and helped to end my son’s attack more rapidly. In conclusion, Kaiser‘s Emergency Room equipment was superior to Sutter’s Emergency Room equipment because it was much more modern. The fifth standard is that there is immediate access to required medications. At both Sutter and Kaiser, my son received the necessary medication. Consequently, Kaiser and Sutter were equal with regard to the standard of access to medication. In conclusion, overall, the Emergency services at Kaiser Permanente were far superior to those provided by Sutter Medical Center. If I could it over again, I would have chosen to go to Kaiser Permanente both times. I only hope that the word gets out about Sutter Medical Center so that other patients do not make the same mistake I did and receive poor quality Emergency Room Care.