Medical groups to Biden: ED boarding at a 'crisis point'

The American Medical Association and American Nurses Association were among dozens of medical groups who warned that staffing shortages have brought emergency department boarding to a "crisis point" in a Nov. 7 letter to President Joe Biden. 

While not a new issue, ED boarding — when admitted patients are held in the ED because no inpatient beds are available — is "further spiraling the stress and burnout driving the current exodus of excellent physicians, nurses and other healthcare professionals," the groups wrote, calling the problem "its own public health emergency." 

The groups also underscored the patient safety and quality risks associated with boarding, such as care delays and in some cases, death. They cited an anonymous emergency physician who said, "We have patients who unfortunately have died in our waiting room while awaiting treatment. These deaths were entirely due to boarding. Our boarding numbers have unfortunately skyrocketed in the wake of COVID-19 as a consequence of increasing surgical volumes and decreasing inpatient nursing staffing." 

In the wake of an "emergency care system already near collapse," and the exacerbated strain emergency rooms face amid a national surge in pediatric respiratory illnesses, the groups urged the Biden administration to convene a summit of stakeholders from across the healthcare system to identify long-term solutions to boarding. 

"If the system is already this strained during our 'new normal,' how will emergency departments be able to cope with a sudden surge of patients from a natural disaster, school shooting, mass casualty traffic event, or disease outbreak?" the letter said. 

The Joint Commission lists boarding as a patient safety risk that shouldn't exceed four hours. 

Read the letter in full here

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