This is an update on the situation of Piney Hospital’s Operational Inefficiencies. In this update I would like to open the mind and give ideas as well as solutions to the problems of a Level II trauma center. I will make suggestions on improving the satisfaction scores by implementing a survey that would be mailed to the patients upon the services of the ED after services are rendered. We also should take advantage of having the staff to do evaluations once a month of what could be done to improve the quality of ED and I believe that this will open up ideas and opinions so the staff will feel appreciated. This will also improve the overall point scale scores of the ED staff hospital wide. In giving surveys this will be able to keep a record on the improvements that need to take place in order for the ED to operate efficiently. I would also suggest that because this is a 575 bed hospital that is non-profit in a blue collar neighborhood that we implement an interpreter class for the staff for them to understand what to do when someone comes in to the ED and speaks another language besides English. I believe that putting in phones of a certain color that can interpreter the language of the patients for triage nurses to understand the patient. This will please the patient as well as the staff so that they will not feel lost or have to pay interpreter per hour to come in and interpret to cut any cost. Last but not least, to cut down excess wait times in the ED you should the rearrange the space flow in the ED and accessible so that the patients come in they can under that there is process as to how they are to be seen. I believe that that inputting a fast track program within your ED will help to improve the wait times for patients that have minor illness versus patients who may injures that would require care at that moment. With the fast track put in color