Emergency department workers are raising alarms about boarding levels remaining high in hospitals and systems even as COVID-19 cases decline, and on June 21, they categorized the situation as a crisis.
The American College of Emergency Physicians, Emergency Nurses Association and National Alliance on Mental Illness held a congressional briefing to educate and persuade lawmakers to adopt their solutions to ED overcrowding.
The Joint Commission's standard for boarding — or the time it takes to transition a patient from the ED to beds in hospital wings, psychiatric facilities or nursing homes — is four hours. In a survey of emergency room physicians, 97 percent said boarding times exceeded 24 hours, according to an ACEP study cited by USA Today.
A 2022 study published in JAMA found that hospitals with occupancies more than 85 percent saw boarding longer than four hours 88.9 percent of the time. When boarding exceeds this standard, there's a heightened safety risk including more medical errors, compromised patient privacy and increased mortality, according to the study.
Despite the COVID-19 pandemic waning, hospitals are still struggling to shorten boarding hours, ED workforce groups said during the congressional briefing.
Christopher Kang, MD, president of ACEP, had the final word at the meeting:
"There are three things you can take home from my remarks today: one, patient boarding is a clear and present public health danger affecting thousands of individual and collective patients daily; two, although EDs bear almost the entire burden of boarding, patient boarding is emblematic of the floundering of the current healthcare system; and three, initial important steps can be taken today."