Objective: To determine whether faculty triage (FT) activities can shorten emergency department (ED) length of stay (LOS). Methods: This was a comparison study measuring the impact of faculty triage vs no faculty triage on ED LOS. It was set in an urban county teaching hospital. Subjects were patients presenting to the registration desk between 9 AM and 9 PM on 16 consecutive Mondays (August 2 to November 15, 1999). On eight Mondays, an additional faculty member was stationed at the triage desk. He or she was asked to expedite care by rapid evaluation orders for diagnostic studies and basic therapeutic interventions, and by moving serious patients to the patient care areas. He or she was not provided with detailed instructions or protocols. The ED LOS, time of registration (TIMEREG), inpatient admission status (ADMIT), x-ray utilization (XRAY), total patients registered each day between 9 AM and 9 PM (TOTREG), and patients who left without being seen (LWBS) were determined using an ED information system. The LOS was analyzed in relation to FT, ADMIT, and XRAY by the Mann-Whitney U test. The LOS was related to TIMEREG and TOTREG by simple linear regression. Stepwise multiple linear regression models to predict LOS were generated using all the variables. Results: Patients without FT (n = 814) had a mean LOS of 445 minutes. Patients with FT (n = 920) had a mean LOS of 363 minutes. Mean difference in LOS was 82 minutes (95% CI = 111 to 53), a reduction of 18%. The LOS was also related to: ADMIT 203 minutes (95% CI = 168 to 238), TOTREG 2.7 min/additional patient registered (95% CI = 1.15 to 4.3), and TIMEREG 0.14 min/min since 9 AM (95% CI = 0.07 to 0.21). The LWBS was reduced by 46% with FT. In multiple regression analysis , ADMIT, FT, TIMEREG, and XRAY were all related to LOS, but the model explained only a small part of variance (adjusted R 2 = 0.093). The faculty cost is estimated to be $11.98/patient. Conclusions: Faculty triage offers a moderate increase in efficiency at this ED, albeit with relatively high cost. A CCORDING to the American College of Emergency Physicians, between 1988 and 1999, emergency department (ED) patient visits escalated from 81.3 million to 100 million. 1 During the same period, the total number of the nation's EDs decreased 10%. These trends, coupled with other factors such as nursing shortages, lack of in-patient beds, and laboratory delays, to name a few, have precipitated overcrowding that has only worsened by the increasing numbers of uninsured individuals who use the ED for primary care. Concurrent with these stressors, managed care and government payers have demanded greater ED efficiency and lower costs. Institutions have proposed numerous solutions to improve ED efficiency and alleviate overcrowding such as creating triage protocols, fast tracks, From Texas Tech University Health Sciences Center, El Paso, TX (SNP, BKN, EDB, MJW).