Prolonged boarding times (increased wait times for admitted patients) in the emergency department result in an increase in morbidity and mortality in critically ill adult patients admitted to the ICU. Overcrowding in the emergency department (ED), medication errors, and a delay in transfer to the ICU are the leading reasons for an increase in morbidity and mortality. This project focuses on a comprehensive assessment of a Las Vegas emergency department. The assessment will determine if the issues cited in the literature of: 1) overcrowding, 2) medication errors, and 3) delay in transfer are a current problem in the Las Vegas emergency department and based on the assessment data and evidence-based plan will be developed.