The Tánaiste and Minister for Health, Mary Harney, has said reform is essential in the way individual hospitals manage patients, in particular the operation of admission and discharge policies.
She said wards were closed in hospitals as a result of the winter vomiting bug and this had contributed to difficulties in Accident and Emergency departments.
The Health Service Executive has said it is setting up a dedicated task force to try to relieve overcrowding in A&E departments.
The announcement came after the Irish Nurses Organisation said there were 495 patients on trolleys in A&E departments today.
It is the highest number recorded since records began and which exceeds yesterday's figure of 455 patients.
This evening, the HSE said the number of patients on trolleys had been reduced to 337.
The HSE has blamed a temporary spike in activity outside Dublin, cases of the winter vomiting bug, and the recent cold snap on the increased pressure at A&E units.
The INO said the hospitals worst affected with patients on trolleys in Dublin A&E units today were St James's (39), Tallaght (39) and St Vincent's University Hospital (34).
For the rest of the country it said hospitals particularly affected were Cavan General (38), Wexford General (35), Cork University Hospital (33) and Letterkenny (30).
INO General Secretary Liam Doran has called for an emergency action plan to deal with what he claimed was unprecedented overcrowding.
Mr Doran said the plan should include the cancellation of all planned hospital admissions and the opening of all closed beds.
