• Maame Y A B Yiadom, Anthony Napoli, Michael Granovsky, Rebecca B Parker, Randy Pilgrim, Jesse M Pines, Jeremiah Schuur, James Augustine, Nicholas Jouriles, and Shari Welch.
• From the, Department of Emergency Medicine, Emergency Care Health Services Research Data Coordinating Center, Vanderbilt University, Nashville, TN, USA.
• Acad Emerg Med. 2020 Jul 1; 27 (7): 600-611.

BackgroundA shared language and vocabulary are essential for managing emergency department (ED) operations. This Fourth Emergency Department Benchmarking Alliance (EDBA) Summit brought together experts in the field to review, update, and add to key definitions and metrics of ED operations.ObjectiveSummit objectives were to review and revise existing definitions, define and characterize new practices related to ED operations, and introduce financial and regulatory definitions affecting ED reimbursement.MethodsForty-six ED operations, data management, and benchmarking experts were invited to participate in the EDBA summit. Before arrival, experts were provided with documents from the three prior summits and assigned to update the terminology. Materials and publications related to standards of ED operations were considered and discussed. Each group submitted a revised set of definitions prior to the summit. Significantly revised, topical, or controversial recommendations were discussed among all summit participants. The goal of the in-person discussion was to reach consensus on definitions. Work group leaders made changes to reflect the discussion, which was revised with public and stakeholder feedback.ResultsThe entire EDBA dictionary was updated and expanded. This article focuses on an update and discussion of definitions related to specific topics that changed since the last summit, specifically ED intake, boarding, diversion, and observation care. In addition, an extensive new glossary of financial and regulatory terminology germane to the practice of emergency medicine is included.ConclusionsA complete and precise set of operational definitions, time intervals, and utilization measures is necessary for timely and effective ED care. A common language of financial and regulatory definitions that affect ED operations is included for the first time. This article and its companion dictionary should serve as a resource to ED leadership, researchers, informatics and health policy leaders, and regulatory bodies.© 2020 by the Society for Academic Emergency Medicine.

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