Officials at Dallas-based Parkland Memorial Hospital have announced changes in emergency room procedures to improve care and reduce long waits. Included is a new process for evaluating patients entering the ER, allowing them to confer immediately with a nurse or paramedic. Those interactions will permit better observation of patients as they await care, the hospital said. Some of the changes were the result of an Oct. 21 evaluation of Parkland's emergency operations by the Joint Commission.