The emergency department serves as the community health care safety net—ensuring medical care is available to anyone who needs it, whenever they need it. But if you’ve been to a hospital emergency department lately, you’ll likely know that it is filled with people seeking care—sometimes beyond what it can handle.
Part of this is due to a lack of capacity. Hundreds of emergency departments have closed in the past decade. At the same time, more people are going.
There are two kinds of waiting: in the waiting room and for a hospital inpatient bed.
You may be in the emergency department for hours, especially if your health problem is complicated. Determining why you are sick may require many tests. The doctor may need to talk with another specialist to find out how to help you feel better. It also may take several hours for doctors to stabilize you so that your condition is not life-threatening.
Many patients who have been admitted to the hospital lie in gurneys along the halls, waiting hours or longer be moved to an inpatient bed. This practice, known as “boarding,” can strain an already overwhelmed emergency department and prevent emergency staff from caring for additional patients from the waiting room or who arrive from an ambulance—which can lead to the ambulance being diverted to another hospital.
Boarding is the primary cause of gridlock in our nation's emergency departments.
Boarding and emergency department crowding are dangerous because they can jeopardize a patient’s ability to receive high-quality, lifesaving medical care in a timely manner and interfere with the ability of emergency departments to respond to a potential pandemic illness or mass casualty.
Many hospitals have stopped “boarding” patients in emergency departments and instead, once they are admitted to the hospital, move them directly to the floors to which they are admitted. This spreads the burden of overcrowding throughout the hospital and often results in beds becoming more quickly available.
Emergency physicians have developed effective solutions to overcrowding and improving patient care. The American College of Emergency Physicians works at the state and national levels, in urging decision makers and policymakers to implement these solutions to help emergency patients and to improve our healthcare system as a whole.