On paper, triage is severity × wait. In a real ER at 3am, it's severity × wait × who-just-got-out-of-surgery × which-tech-is-on-CRI × the-thing-the-owner-said-on-the-phone-that-only-the-front-desk-heard. The board has to encode all of it without slowing anyone down.
Rule 1 · The board re-ranks itself
No one has time to drag and drop. Severity changes? The patient moves. A vet finishes surgery? Their bay surfaces. A tech logs a CRI started? The patient drops to the back of the queue, color-coded so we know they're in care, not waiting.
Rule 2 · The handoff card has to be readable in the time it takes to wash hands
Twenty seconds, max. We landed on: signalment, presenting complaint, current vitals delta from baseline, last drug given, next due. Everything else is one tap away. The handoff card is the document of record at shift change — if you can't read it in 20 seconds, it's the wrong document.
Rule 3 · The owner's first 90 seconds
They're scared, exhausted, and have repeated themselves three times by the time they reach you. The board now shows the front-desk note verbatim under the patient — what the owner actually said, not the triage tech's paraphrase. Every doctor in our shift report cited this as the change that mattered most.
Rule 4 · No-show on the board is a thing
Patient checked in, got bumped, owner left without telling anyone — it happens. The board now flags 30+ minute lobby times automatically and surfaces them with a soft peach pulse. We catch a few of these a week — and some of those calls find the owner still in the parking lot.
90 days in
The board is built to move the numbers that matter. Throughput climbs, Cat-1 waits fall, and Sev-1 to-treatment stays at zero because we don't wait for Sev-1s, ever. The goal we cared most about: per-visit charting time drops from minutes to well under two.
I'd been an ER director for eight years before this. The change felt smaller than I expected when we shipped each piece, and bigger than I expected when I looked at the numbers in aggregate. That's how good operational tooling tends to land.