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From the Director

Photograph of AHRQ's Director: Carolyn M. Clancy, M.D.

Hospital emergency departments (EDs) are where life-and-death decisions are made every day. Communities and patients rely on them to save lives. But the crisis of hospital ED crowding threatens patient safety and community trust. AHRQ's guide to reducing ED crowding can help hospitals identify and implement strategies to improve ED patient flow and reduce crowding.

AHRQ's updated Emergency Severity Index (ESI) handbook also helps improve ED patient care by providing a standardized way to triage patients accurately and quickly. Deciding which patients get treated first is the critical task of the triage nurse. Within a few minutes, the nurse must size up how severely ill or injured a patient is and get him to the right place for care, whether it is a fast-track area for less ill patients or an ED bed for immediate lifesaving interventions.

The ESI helps nurses make accurate assessments of the right level of care a patient needs. Overall, the 5-level ESI triage system helps get the patient to the right resources in the right place at the right time. The updated ESI handbook includes a new chapter on triaging children. This section will be particularly helpful for triage nurses at general hospitals, who do not see children as often as those in children's hospitals.

AHRQ has invested in research on emergency department care for many years and is committed to advancing the evidence base to improve ED safety, quality, and efficiency of care. These two important new tools will help hospitals improve the care they provide to patients in communities across America every day.

Carolyn M. Clancy, M.D.

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