Despite the advance of Emergency Medicine in Chile, there has not been any significant positive change in the quality of care or patient satisfaction, probably due to the luck of use of an effective and proved method for the operation of emergency departments. Even though, it is well known the fact that administrative strategies need to be tailored for each different department, there are some general key performance indicators that should be considered when beginning to lead an emergency room, to be interpreted as the “vital signs” for the first approach and will allow initial improvement of processes, towards continuous flow and against overcrowding, until more complex and local interventions are developed.