I don't think that comparison is valid. * On a carrier 100% of the people are well trained professionals. Not so in a hospital, were patients have never been t

I don't think that comparison is valid. * On a carrier 100% of the people are well trained professionals. Not so in a hospital, were patients have never been trained to be good patients. * Not only are people not trained to be patients, they are, especially in situations of distress, usually not helpful at all. As a rule, you do not trust a diagnosis provided by a patient (even if a doctor!) because the person might exhibit an acute stress reaction (https://en.wikipedia.org/wiki/Acute_stress_reaction https://en.wikipedia.org/wiki/Acute_stress_reaction) - avoiding this state by prior exposition is one of the reasons why pilots train emergency situations in flight simulators. * Managing "hospital ED patient flow" is something that has improved a lot (see your example of direct transfer to trauma units), but it still is the attempt to manage the inherently unmanageable: On a carrier you know how many jets you have in the air and how long their fuel lasts and thus you can coordinate, in an ED you can only, if such a system exists in your region, have incoming ambulances diverted to other hospitals. But you still have no idea who will stumble through your door the next moment, brought by friends or taxis. I am all for collecting data and applying metrics to make a process better, but there are some areas where the collection and evaluation should be done by professionals who understand what they are grading, not by amateurs who either entered that area involuntarily (actual emergencies) or who just try play the system for their own advantage (getting prescriptions).