Close the Waiting Room to Patients – visitors only! Yes, bring the patients straight back. Nationally, only forty percent of ERs see patients in less than one hour[2]. In a low volume, Critical Access Hospitals (CAH) ERs, there should be little-to-no wait. Coupled with Triage protocols these adjuncts facilitate overall throughput[3]. Limit triage to what is crucial and bypass triage altogether when beds are available, with bedside registration. Additionally, initiate protocols at triage – this has been shown to facilitate timely post-triage care. Patients will drive 30 minutes, just to come to your Critical Access Hospital, when they know they can come straight back without any wait. The goal is to be known as the ER where you are always seen immediately. This is an excellent way to improve patient care outcomes, and increasing ER volume.