The draft report of the Emergency Department Task Force, seen by RTÉ News, has called for extra funding for the Fair Deal nursing home scheme, so that waiting times are no longer than four to six weeks.
The report says the number of delayed discharges in hospitals must not exceed 500 by the end of this year.
It calls for patients to be discharged before 11am, more weekend discharges and some delegation of discharge decision making to senior nursing staff.
It says patients should be seen by the emergency and admitting teams within one hour.
The report calls for access to senior decision making during the peak period of 8am to 8pm and access to diagnostics during these hours, on a seven-day basis.
It says extra capital and day-to-day funding will be needed to develop long-term care capacity, if these are to be public beds.
It recommends surgical rates be increased, overnight stays reduced and some minor surgery should move to GP settings.
It also calls for extra emergency medicine consultants to be appointed.
The report says during 2014 emergency department trolley waiting times deteriorated for the first time in three years.
This was due to several factors, including long waiting times for the Fair Deal scheme, the increase in delayed discharges and a growth in emergency department admissions.
It says prolonged waiting times in emergency departments leads to longer inpatient stays and persistent overcrowding leads to poorer outcomes and patient deaths increase.
The report is expected to be finalised soon and presented to Minister for Health Leo Varadkar, who is due to bring it to Cabinet.
The Irish Nurses and Midwives Organisation has said that 9,657 patients were on trolleys in February, following admission to a bed.
It says this is the highest ever figure recorded for February.
It represents a 33% increase compared to 2014 and a 75% increase compared to 2013.
Liam Doran, General Secretary of the INMO, said the overcrowding situation had deteriorated significantly and that urgent, radical and sustained action is needed.
He said the Government must provide extra funding.