Fewer hospitals and shrinking budgets are making ERs more crowded and hectic than ever. Average wait times jumped from 38 minutes in 1997 to 56 minutes in 2006, while waits for heart-attack patients more than doubled in the same period. The good news is about 80 percent of ER visitors go home; the bad news is that sorting out the heart attacks from the gall-bladder attacks takes time. Here are a dozen smart strategies to ensure an ER visit that is short, easy, and productive.