This project primarily aims to investigate and improve rejection of specimens in the emergency room (ER) of a medical center. Statistical data for 2004/01 to 2004/06 revealed a rejection rate of 1.19% , ranking first in the hospital. During August to October, using the “recording list for the causes of ER specimen rejection” as a tool, the factors for the rejection of ER specimens was investigated. Analysis of the results showed problems such as wrong examination sheets, lack of examination sheets, repeat examination sheets, lack of patients’ basic information or wrong information, lack of specimens, incorrect specimens, specimens without labeling or signification, contamination of specimens, transportation delays of sending of specimens to the wrong destinations and so on. Following discussing with relevant departments, a panel was established to monitor nursing quality, designing the standard chart of ER specimen transportation and specimens containers, to ensure the computerized of medical order, announcing the correct regulation of works, improving health education and promotion, arranging staffs to attend further education training programs and so on. The project was practiced until 94/04 and the average rejection of ER specimens has dropped to 0.41%. The goal can be achieved through quality monitoring.