This fall, ACEP will participate in the Agency for Healthcare Research and Quality (AHRQ) Director’s summit on emergency department boarding.

ACEP’s participation in such a pivotal meeting was not just luck or convenience. ACEP helped make the summit possible by mobilizing Congress to request action from the Department of Health and Human Services (HHS) during the Leadership and Advocacy Conference in 2023. At that time, emergency physicians helped secure 44 signatories on a congressional “Dear Colleague” letter to the Administration, sounding the alarm onto the boarding crisis and asking them to establish such a task force. And they listened.

ACEP has been using our wide-ranging influence like this for years to work tirelessly with any stakeholder who has a role in boarding solutions to protect you and your patients. As the boarding crisis has escalated in the past few years, a variety of public and often less-than-public efforts have been made by ACEP leaders to solve the problems you face every day in the ED. These meetings, conversations, emails, and exchanges that are constantly happening with federal and state decision-makers to improve the specialty.

Collaborating with Other Stakeholders

Recently, ACEP’s Emergency Medicine Section Council to the American Medical Association (AMA) introduced a resolution, “Improvements to Patient Flow in the U.S. Healthcare System,” for consideration at the AMA House of Delegates 2024 Annual Meeting, June 8 – 12 in Chicago.

This resolution, if passed by the House of Delegates, directs the AMA to work with relevant stakeholders and propose recommendations to appropriate entities to improve patient flow and access to care throughout multiple environments in the U.S. health care system.

In September 2023, ACEP organized and hosted the first National Stakeholder Summit on Boarding to analyze the causes of boarding, discuss barriers to overcoming these causes, and identify priority areas to pursue in creating system-wide solutions.

ACEP prioritized attendance of hospital groups at this boarding summit so they could hear firsthand the impact that boarding is having on patients, physicians, and other health care workers, and also answer to this growing crisis. Certain possible solutions could have unintended consequences, and it’s important that all stakeholders talk through the challenges.

More nurses in inpatient units, for example, can help alleviate ED boarding; however, experience has shown that mandated ratios, especially with current nursing shortages, could exacerbate the problem: if there are too many patients and not enough nurses for the inpatient unit, patients are left boarding in the ED so the inpatient area stays in legal compliance.