Many of the physician speakers confronted misconceptions about the causes of boarding during the Summit and clarified that boarding does not occur because of non-urgent visits. “I’m sorry, I don’t want to hear it. Low-acuity patients have nothing to do with boarding,” Dr. Kelen said. “Build a bigger ED?” he scoffed. “You can’t cure constipation by building more colon.”

Dr. Viccellio discussed how hospitals can adjust the way they work. “These solutions do not require that people work harder. They require that people work differently,” he said.

One way ACEP is creating a path for progress is by working with agencies to strengthen regulatory requirements for hospitals related to boarding.

“Twenty years of data associates boarding with worse outcomes,” said Dr. Pines. “Boarding is a fixable problem, but the incentives aren’t there to fix it. It takes leadership, time, energy, and sustainability.”

You Spoke, The Government Listened

A comprehensive, multi-year advocacy campaign to address the public health crisis of boarding escalated in 2022 with an ACEP letter to the White House that outlined significant concerns about the crisis and urging the President to convene a national summit.

ACEP collected hundreds of your troubling stories to highlight the urgent need for solutions, and we continued to sound the alarm with regulators, policymakers, and media.

In September 2023, ACEP organized and hosted the first National Stakeholder Summit on Boarding to analyze the causes of boarding, discuss barriers to overcome these causes, and identify priority areas to pursue in creating system-wide solutions. Representatives from 15 health care organizations, including the AHRQ, attended.