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BoardingBoarding is a practice of holding patients in the ER until a hospital bed opens up. When emergency patients are boarded, they lie on gurneys or sit in chairs in the emergency department, often filling every available space, including the hallways. And, shockingly, boarded patients sometimes have to wait for days for a hospital bed to become available. It has a significant negative effect on patient safety, comfort, and satisfaction – these patients are often gravely ill and in great pain, and boarding does not allow them the dignity of privacy.

The practice of boarding endangers all patients’ care because it greatly contributes to crowding and ambulance diversion. The emergency staff is unable to care for the additional patients in the waiting room or from an ambulance because they are tending to the boarded patients. When ambulances are diverted, critically ill patients must travel farther for care, which delays their treatment, when precious seconds count.

In fact, in a 2007 ACEP survey of nearly 1,500 emergency doctors, 13 percent said they personally experienced a patient dying as a result of boarding in the emergency department.

Factors contributing to boarding include:

  • Increased number of emergency visits 
  • Patient population is much sicker
  • Hospitals continue to operate as 9 to 5, Monday through Friday institutions with skeleton crews on evenings, nights, and weekends, despite the fact the majority of patients entering the hospital through the emergency room do so in the afternoons and evenings 
  • Hospital beds accounted for by patients undergoing elective surgery

If passed by Congress, the Access to Emergency Medical Services Act can help address the practice of boarding. Take action now by contacting your legislators today to urge their co-sponsorship of this important legislation and to hold hearings on the critical state of emergency care.

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