Crowding of emergency departments has been a recognized problem nationwide since the 1980s. With reduced numbers of hospital beds and increasing visits to the emergency department, this difficulty likely will become worse.

Struggles to find new and innovative strategies for dealing with crowding have led to many changes in clinical operations. In an effort to encourage the free exchange of emergency department process-improvement projects among ACEP members, the ACEP Practice Management Committee has established a forum where this exchange can take place at www.acep.org/membersurvey.aspx?formid=45474.

Emergency department leaders throughout the United States have tried multiple procedures to improve the function of our emergency departments. These efforts have included the implementation of fast tracks, physician triage, the management of hallway patients and lobby patients, ambulance diversions, caring for boarded patients in the emergency department, improvement in door-to-doctor times, maintenance of excellent patient satisfaction scores during times of emergency department crowding, and attempts to improve the movement of patients to the inpatient units.

Many positive improvements are reported in journals. Many more never make it to publication, and those with negative results are almost never reported in peer-reviewed journals.

The ACEP Web site forum will allow members to share the results of their process-improvement projects regardless of whether the project was a success or a failure, to disclose obstacles and roadblocks, and to reveal processes that enabled improvement and sustainability.

The forum will establish an area in which to tap into the vast quantity of experiences and data on clinical operations that ACEP members can provide. With the knowledge and experience obtained from this site, members’ future improvement projects will likely result in more successes, with less time spent repeating the failures of others.

In addition to data from the process initiative implemented, ACEP members will be requested to provide information about their institution (including emergency department size, average in-hospital census, and availability of specialists), their project, the rationale for a specific intervention, replicable details including implementation plan, evaluation methods, results, and lessons learned.

Members can submit this information anonymously or provide their contact information to enable individual discussions of their crowding solutions. Case studies will be available exclusively to ACEP members.

Dr. Halfpenny is a member of ACEP’s Practice Management Committee.