There are many ways, according to the old proverb, to skin a cat, but probably not as many ways as there are to address the problems of patient flow and overcrowding in emergency departments (ED); the UK 4-hour target of recent years is just one idea of many.

An organisation known as The Advisory Board Company also has the issue of patient flow and ED overcrowding on its agenda;1 it is a US-based group that “serves a membership of more than 2700 leading hospitals, health systems, universities and other mission-driven enterprises in the USA and, increasingly, worldwide”. One component of their work is owned by a subgroup known as the Council of International Hospitals and is “dedicated to unlocking the value of the Advisory Board’s large body of US research for leading institutions worldwide”. Their philosophy is that “the power of good ideas is universal in its application” and they aim “to provide hospital executives across the globe with the most salient best practices and analyses to help them navigate the emerging trends and policies impacting their institutions”.2

In …