Dr. Dark: I think it also goes to say: Do we have enough nurses? Where I work, do we have enough psych techs? Do we have enough ER techs? How can ACEP play a part in making sure that happens as well?

Dr. Terry: One of the key pieces is that ACEP cannot function in a bubble, so it’s really important that we continue to nurture relationships with other organizations. ACEP and the Emergency Nurses Association as well as the American Nurses Association intermingle and collaborate all the time. We talk extensively about how we can work together to improve issues such as workforce shortages relative to nursing and techs. The beautiful thing about ACEP is that we do have a pretty large sphere of influence. We’ve had conversations of late with the American Hospital Association and America’s Essential Hospitals to talk about how we can, together, ensure that the environment and the emergency department is adequate in terms of providing quality care based on staffing.

Dr. Dark: I want to talk a little bit about the boarding crisis that we’ve been experiencing for many years now, that seems to have only worsened recently. What’s your plan to address psychiatric boarding?

Dr. Terry: ACEP will continue to fight the boarding crisis. We had a summit around boarding a few months ago in Washington, DC where ACEP pulled together a large group of stakeholders. We sat down, we spent about seven hours or so talking about what is going on with boarding, why are we seeing an increase at an exponential rate? What’s different today than a decade ago relative to the boarding crisis, and what are the solutions? How can we address this epidemic that is resulting in, literally, people dying in waiting rooms across the country, resulting in people staying in the emergency department and languishing for months in the emergency department because there’s nowhere for them to be admitted to or transferred to? Psychiatric patients are particularly marginalized.

Much of the federal legislative efforts in terms of various bills actually focuses on mental health relative to boarding. And I think that that’s a strategic and also, obviously, ethically appropriate approach to really focus on these marginalized groups that need us to advocate on their behalf. There are a handful of bills currently, right now, being discussed, [such as] increasing resources for emergency departments to ensure that there are adequate warm handoffs, and community resources, and outpatient resources to direct our psychiatric patients to. There are grants focusing on making sure the infrastructure is strong relative to facilities for mental health and for psychiatric patients to go to from the emergency department. ACEP is supporting those bills and those efforts legislatively around ending boarding, particularly for patients with psychiatric illness.