Objectives: Shoalhaven District Memorial Hospital is a rural (MM3) 150-bed hospital in Nowra, New South Wales, whose ED has evolved to a FACEM-led model of care (MOC). It has never had an emergency short stay area (ESSA). The objective of the present study was to pilot an ESSA and determine whether this MOC would increase the operational performance of the ED. Methods: An ESSA was designed and delivered by emergency medicine medical, nursing and allied health practitioners. The study period was July–December 2021, with a seasonally matched retrospective cohort of records extracted for comparison (July–December 2020). Both took place within the context of the ongoing COVID-19 pandemic. The primary outcome measured was percentage of admitted patients meeting Emergency Treatment Performance (ETP). Secondary outcomes included discharge ETP, overall ED and inpatient length of stay (LOS), mortality and representation rates. Results: The admission ETP for patients after the implementation