I think Sarasota, Florida ER has the right idea--an admission unit. A place to hold ER admits until the floors are "ready" to take the patient, and the direct admits go to that unit and the workup begins..supposedly cuts down on lenghth of stay (something administration might listen to). The ER may have to manage the unit but you can't cut ER staffing short to staff the admission unit. Staffing issue may kill the idea at the present time, in the midst of the nursing shortage.