Public hospitals in the United States receive nearly three times as many emergency department (ED) visits as private hospitals. One of the most serious problems facing these safety net hospitals is ED throughput--how efficiently patients can be seen, cared for, and discharged. A team from the National Public Health and Hospital Institute proposes to identify public hospitals that have made great strides in easing ED overcrowding and facilitating patient flow. After analyzing the strategies used by five high performers, project staff will develop an educational program for 15 hospitals that are struggling with ED throughput. Working collaboratively, these facilities will then develop initiatives to increase their efficiency and their ability to provide high-quality emergency care. The grantee will provide in-kind cofunding.