House Letter of Support for Addressing Boarding and Crowding in the Emergency Department Act

Dear Representatives Joyce and Dingell,

On behalf of the Emergency Nurses Association and its nearly 45,000 members, I am writing to express our support for H.R. 2936, the Addressing Boarding and Crowding in the Emergency Department (ABC-ED) Act. This important legislation comes at a time when overcrowding in our hospitals and boarding in our emergency departments have reached crisis levels, negatively impacting
patients and emergency nurses charged with their care.

A lack of available inpatient beds at our nation’s hospitals forces those facilities to “board” patients in the emergency department. Other systemic issues, such as a lack of available and appropriate behavioral health services, staffing shortages and operational inefficiencies contribute to the problem of boarding in emergency departments.

This results not only in overcrowding in emergency departments but also leads to documented increases in patient morbidity and mortality. Further, the boarding of patients, which often occurs in hallways and waiting areas, contributes to increased workplace violence and harassment directed at emergency nurses and other health care providers. This increases burnout and causes many to leave the profession, further straining the system. Utilizing emergency department resources in this manner also results in higher system costs for these patients, straining the system’s ability to provide high-quality, appropriate care.

The ABC-ED Act would provide new opportunities for improving patient flow and hospital capacity by modernizing the infrastructure around hospital bed tracking systems, as well as implementing Medicare pilot programs to improve care transitions for those with acute psychiatric needs and the elderly. We also applaud the inclusion of a Government Accountability Office report to identify and evaluate best practices for tracking hospital capacity to more rapidly implement successful strategies to minimize boarding.

We thank you for your leadership on this critical issue that impacts the lives of all Americans who visit emergency departments. If you have any questions or would like to contact ENA about how we can help enact this important program, please contact ENA Director of Government Relations Rob Kramer at 202-465-4756.

Sincerely,
Ryan Oglesby, PhD, MHA, RN, CEN, CFRN, NEA-BC
2025 ENA President