Participants who engage in this educational intervention will be able to:

• Describe current national trends in emergency department utilization, including rising patient volumes, acuity levels, and boarding times.
• Define emergency department crowding and explain its relationship to hospital-wide capacity and operational inefficiencies.
• Identify key input, throughput, and output factors that contribute to crowding and prolonged boarding.
• Analyze the impact of Emergency Department (ED) crowding on patient outcomes, staff well-being, and institutional financial performance.
• Evaluate strategies to reduce input pressures on the ED, including improved primary care access, telehealth integration, appointment scheduling models, and triage to non-ED care sites.
• Discuss the benefits and challenges of posting real-time ED wait times and implementing scheduled ED visits.
• Assess throughput optimization approaches such as rapid triage models, point-of-care testing, advanced practice provider utilization, medical scribes, and observation units.
• Summarize output strategies that improve hospital flow, including reverse triage, inpatient hallway boarding, active bed management, and early discharge protocols.
• Examine administrative interventions such as elective surgery coordination, discharge lounges, and discharge timing strategies that increase bed availability.
• Interpret international models such as the Four-Hour Rule and apply lessons learned to U.S. hospital operations.
• Develop an institutional framework that integrates executive leadership, operational management, and clinical teams to respond effectively to full-capacity events.
• Formulate a multidisciplinary plan to balance patient safety, operational efficiency, and resource stewardship during periods of high hospital census.