Emergency departments at hospitals in Connecticut and across the country are likely bursting at the seams as a result of what’s called ED boarding.
The problem is not that too many patients are showing up at the ED. It’s that patients who have been discharged from the ED are needing longer-term care, but they’re stuck on hallway stretchers for hours or even days.
The reason? Increased demand for in-patient beds, according to Connecticut College of Emergency Physicians (CCEP). Boarding patients are not well enough to return home – they might need a bed at a psychiatric hospital, connect with a behavioral health facility in the community, or require a bed at a rehabilitation center or nursing home. They also face delays in insurance companies authorizing longer-term care.
Experts say a new public-facing dashboard that shows boarding trends across hospitals across Connecticut will help raise awareness and encourage solutions to address the ongoing issue.
The Connecticut legislature in 2023 passed the first law in the country requiring hospitals to report boarding data annually through 2029.
New public-facing dashboard
CCEP launched the dashboard Jan. 21.
Data shows that of the 14% of patients in a Connecticut ED in 2024 who required in-patient care – more than 200,000 people – nearly 40% remained in the ED for more than four hours after admission.
“This threshold is widely agreed to be unacceptable and negatively impacts patient care,” CCEP said in a statement. “Boarding leads to poorer outcomes for patients, increased crowding, and significant staff burnout.”
Lengthy boarding can result in “real, bad impacts on patient care outcomes,” said Dr. Jeff Gordon, a state senator and member of the state Public Health Committee.
“This is not the fault of emergency department physicians or staff,” he said. “It is a wider health care system problem.”
Overcrowded emergency departments can negatively affect patient health and “challenge physicians’ capacity to assist the public,” said Dr. Saud Anwar, a state senator and co-chair of the Public Health Committee.
“Having this information in front of us lays out how stark our state’s needs are,” he said.
Rough flu season and ED boarding
Meanwhile, ED physicians statewide are currently grappling with a flu surge.
“This winter is shaping up to be the worst flu season in nearly a quarter century,” said Dr. Christopher Moore, a CCEP board member and an ED doctor. “As a state we are already boarding so much that when a surge comes we are not well prepared to absorb excess capacity, and patients suffer.”
Moore said doctors are seeing some of the worst boarding and crowding since the peak of the COVID-19 years in 2020 and 2021.
Nearly half of all Connecticut residents will seek care in an ED this year, according to CCEP. That’s an increase from 2024, when there were more than 1.6 million ED visits statewide.
