In 1994, the Department of Emergency Medicine at Loma Linda Univer sity Medical Center (LLUMC) set out to implement a comprehensive emergency department (ED) model: a model that headed in the opposite direction of popularized solutions of which the objective is to keep patients out of the ED. This model increases the number of services offered. It triages patients within its walls to an area cost effective for the patient?s acuity and allows patients to immediately move to a higher level of care if the provider sees the need.