As you have seen yourself and heard from your emergency physician colleagues around the country, our hospital emergency departments (EDs) have reached or are past the breaking point due to a long-standing problem known as “boarding,” where patients are held in the ED following stabilization and care awaiting an inpatient bed or space in a tertiary facility where they can be safely transferred.

To address this crisis, ACEP's advocacy began in 2022 with a letter to the White House that urged the President to convene a national, multi-stakeholder summit. We also amplified our request for a summit through advocacy to Congress during ACEP's last two Leadership and Advocacy Conferences (LAC), where hundreds of emergency physicians went to Capitol Hill to tell personal stories of boarding and to urge elected officials to prompt action from the Department of Health and Human Services (HHS) by signing on to a letter from Congress to HHS urging them to convene a summit of stakeholders to identify solutions. HHS responded to this bi-partisan letter led by Rep Debbie Dingell (D-MI) and Rep. Brian Fitzpatrick (R-PA), charging the Agency for Healthcare Research and Quality (AHRQ) with taking on this difficult and pressing issue.

In addition, ACEP collected more than 140 personal stories from emergency physicians across the country and nearly all respondents (97%) cited boarding times of more than 24 hours, with one-third stating they had patients stay more than one week, and 28% citing they had patients boarding more than two weeks.

As a direct result of over two years of advocacy by ACEP, in early October, the AHRQ held a Summit to Address Emergency Department Boarding which brought together patients, emergency physicians, emergency nurses, hospital leaders and other stakeholders. The results of this Summit are ongoing with ACEP taking the lead on many proposed solutions.

Although there is no one-size-fits-all solution to ED boarding, there are targeted approaches that we are pursuing to alleviate the strain on the emergency care team. 

Right now, you can urge your Senators and Representative to cosponsor the bipartisan “Improving Mental Health Access from the Emergency Department Act,” (S. 1346/H.R. 5414) introduced by Sens. Shelley Moore Capito (R-WV) and Maggie Hassan (D-NH) and Reps. Raul Ruiz, MD (D-CA) and Brian Fitzpatrick (R-PA). The bill would help address a significant component of psychiatric boarding by providing grants to EDs to increase access to follow-up psychiatric care for patients, such as expedited placement, increased tele-psychiatry support, expanded availability of inpatient psychiatric beds, increased coordination with regional service providers, and regional bed availability tracking and management programs, based on the individual needs of their EDs and communities.

Your voice and your stories are critical in bringing Congress’ attention to the crisis of boarding and making it a priority to find solutions for patients – their constituents.