A new study concludes that the ED alone cannot be blamed for the fact that chest pain patients in crowded EDs are at greater risk for post-admission complications. However, the lead author argues there are steps ED managers can take to improve outcomes for these high-risk patients. Patients have to be seen quickly and diagnosed appropriately. Medication reconciliation and transfer of information to the hospital electronic medical record is even more important for these patients. Processes for handover to the inpatient team must be made more seamless.