Table 1.

Guidelines for Anchors Used in the Manual of Operations for Individual Quality of Care Adjectival Scale

Score	Category of Care	Description of Care
7	Extremely Appropriate	Extremely appropriate medical care is the best you can imagine in the average U.S. hospital ED. Extremely appropriate care minimizes the risk of complications, maximizes the likelihood of a good outcome, and maximizes humane care and respect for patients/parent's wishes
6	Very Appropriate	Medical care that is slightly less in quality than “Extremely Appropriate”
5	Somewhat Appropriate	Medical care that is slightly better in quality than “Intermediate”
4	Intermediate	Intermediate care is acceptable but just minimally so
3	Somewhat Inappropriate	Medical care that is slightly less in quality than “Intermediate”
2	Very Inappropriate	Medical care that is slightly better in quality than “Extremely Inappropriate”
1	Extremely Inappropriate	Extremely inappropriate care is malpractice. This care has egregious errors and is likely to result in more harm than benefit or is likely to cause more harm or less benefit than alternative approaches available at the average U.S. hospital ED.