In 2011, Academic Emergency Medicine convened a consensus conference entitled ''Interventions to Assure Quality in the Crowded Emergency Department.'' This article, a product of the breakout session on ''interventions to safeguard efficiency of care,'' explores various elements of the research agenda on efficiency and quality in crowded emergency departments (EDs). The authors discuss four areas identified as critical to achieving progress in the research agenda for improving ED efficiency: 1) What measures can be used to understand and improve the efficiency and quality of interventions in the ED? 2) Which factors outside of the ED's control affect ED efficiency? 3) How do workforce factors affect ED efficiency? 4) How do ED design, patient flow structures, and use of technology affect efficiency? Filling these knowledge gaps is vital to identifying interventions that improve the delivery of emergency care in all EDs.