Emergency department visits increased from 102.8 million to 136.1 million in 2009, resulting in crowding and increased wait times, affecting U.S. hospitals' ability to provide safe, timely patient care resulting in dangerous delays and serious health problems shown by research. The purpose of this project was to determine if competencies developed for the purpose of nurse practitioner practice, would access to practitioners increase, would there be a decrease in wait times to see the health care provider, and would the length of stay and the number of patients leaving without being seen from the emergency department decrease? Analysis of data was based on wait times from triage to health care provider and from health care provider to admission and discharge. The intervention included development, implementation, and evaluation of the effectiveness of identified competencies. The development of the competencies were based on the 2008 Emergency Nurses Association "Competencies for Nurse Practitioners in Emergency Care," a model for professional nurse practitioners upon entry into the emergency department. The findings of the study resulted in strengthening access to health care providers. The health care providers who attended the competency training can decrease wait times in the pediatric urgent care/emergency setting. Recommended is full implementation of the identified competencies into the pediatric emergency setting, increasing access to health care providers and ultimately reducing wait times. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]