With heads nodding in agreement, the stakeholders acknowledged the need for increased investment in public health, more emphasis on evidence-based policy, and a re-alignment of the financial incentives that could better encourage coordination across hospitals and other care settings, from specialty referrals to enhanced mental health care support.

Still, there are concerns that systemic factors degrade the quality of the care that emergency physicians and others know they can deliver.

“This crisis is causing moral injury,” said Christopher Kang, MD, FACEP, Immediate Past President of ACEP. “It hurts me to my core if I can’t do what I’m trained to do, especially in those instances where I might be the only one available to help. We have to do better.”

As recognition of ubiquitous challenges shifted toward the talk of solutions, progress on several fronts was noted.

Multiple initiatives were recognized for their ability to stabilize mental health crises, including EmPATH units and the coordinated crisis response model used by Northwell Health, which involves schools working closely with the hospital to make sure students get the medical attention they need.

At the local level, the participants acknowledged the largely untapped potential for patient advocacy groups to raise awareness and work toward tailored solutions that resonate where they are needed most.

“Boarding is a disease causing widespread dysfunction and we feel it every day. Until we make everyone aware of what’s going on, we are doing a disservice to our patients,” said ACEP President Aisha Terry, MD, MPH, FACEP.

Everyone recognized the detrimental impact of emergency department violence on staffing constraints and burnout, with stakeholders voicing enthusiasm for legislative solutions such as the SAVE Act, which ACEP directly informed and strongly supports.

The Summit is one important piece of ACEP’s comprehensive campaign to address boarding in the emergency department.

Beyond writing to the White House, ACEP gathered more than 140 troubling stories from members on the frontlines and is actively involved in developing federal legislation to close gaps in mental health care, as well as tackle the broader boarding issue more systemically.

There are hopes for another summit in the months ahead as these discussions continue.

ACEP leadership on difficult issues like this is invigorating emergency physicians across the country. As a result, there are new chances to address longstanding issues head-on with emergency physicians driving meaningful change.

Steve Arnoff is a senior communications manager at ACEP.