WASHINGTON – U.S. Senator Chris Coons (D-Del.) and David McCormick (R-Pa.) introduced the Addressing Boarding and Crowding in the Emergency Department (ABC-ED) Act, bipartisan legislation to help alleviate emergency department overcrowding by improving the efficiency of emergency care to deliver better health outcomes.
When inpatient hospital beds reach capacity, patients are often required to “board” in the emergency department (ED). Although this practice is meant to be temporary, a staggering 97% of emergency doctors report caring for patients who have been boarding in the ED for more than 24-hours, according to the American College of Emergency Physicians. This gridlock delays care for new patients and puts ED nurses – who are often responsible for 10 or more patients at once – under even higher pressure and stress.
The ABC-ED Act would alleviate these issues by allowing public health data modernization grants to be used for developing and maintaining real-time systems that track hospital bed availability to inform state and regional emergency care planning. Improving data systems for hospitals serving neighboring communities – like those on the border of Delaware and Pennsylvania – can reduce wait times, improve patient flow, and support emergency medical staff.
“If you’ve ever had to go to an emergency room in Delaware, you know that wait times are just too long,” said Senator Coons. “Too many patients end up having to wait hours, or even days, for a bed to open up in the hospital, no matter the emergency. I’ve heard from so many Delawareans about this problem, and I’m proud to lead the federal effort to find solutions. I urge our colleagues to take up this bipartisan bill that will help hospitals modernize their systems, take stress off emergency rooms, and ensure more Americans are getting the care they need as soon as possible.”
“Advanced technology and AI are re-shaping the way our country and economy work,” said Senator McCormick. “It’s critical to Americans’ long-term health and wellbeing that our nation’s hospitals can access technological resources to update their procedures and practices and ensure patients are receiving the care they need in a timely fashion. I’m grateful to work across the aisle with Senator Coons to help improve the quality and efficiency of our nation’s healthcare system.”
In addition to Senators Coons and McCormick, the legislation is co-sponsored by U.S. Senators Lisa Blunt Rochester (D-Del.), Thom Tillis (R-N.C.), Angus King (I-Maine), and Markwayne Mullin (R-Okla.). It is led in the House by Representatives Joyce (R-Pa.) and Dingell (D-Mich.).
“This bipartisan legislation is a practical step towards addressing overcrowding in emergency departments across the nation,” said Senator Tillis. “By giving states the tools to better track and manage hospital capacity in real-time, we can improve patient care, reduce delays, and help save lives.”
“Overcrowded emergency departments can mean longer wait times for patients and a lack of resources for staff,” said Senator Blunt Rochester. “We need to confront this part of our health care crisis by investing in technology that can identify shortages before they become a problem. I’m glad to be introducing this bill and hope to see it brought to the Floor for a vote.”
“Emergency departments in Oklahoma and across the country are overwhelmed. This bill is a critical step in the right direction to address this crisis." said Senator Mullin. "I'm proud to partner with my colleagues on this to get our hospitals and healthcare workers the resources they need to improve the patient experience in emergency departments.”
Specifically, the ABC-ED Act would:
The bill is endorsed by the American College of Emergency Physicians (ACEP) and the Delaware Healthcare Association.
“Boarding in the emergency department is a national public health crisis that puts patient lives at risk and strains emergency physicians and care teams every day,” said Alison Haddock, MD, FACEP, President of the American College of Emergency Physicians. “We are deeply grateful to Senators Coons, McCormick, Tillis, King, Mullin, and Blunt Rochester for their leadership on this critical issue for emergency medicine, and for joining our House champions, Representatives Joyce and Dingell, to ensure this legislation is a bipartisan, bicameral priority. The ABC-ED Act equips emergency physicians with resources and real-time data to inform medical decisions that can reduce dangerous delays and improve the flow of patients through the emergency care continuum."
“Crowded emergency departments and long wait times can put a strain on our healthcare workforce and lead to patients abandoning care. We thank Senator Coons for his leadership in introducing the ABC-ED Act and his bipartisan work on solutions to address this growing challenge. Many factors contribute to ED wait times like increased utilization during respiratory illness season and barriers that prevent individuals from being transferred to post-acute care facilities. Efforts like this legislation will reduce wait times and help enhance our system of care for both patients and our workforce,” said Brian Frazee, President & CEO of the Delaware Healthcare Association.
“Delaware ACEP would like to thank Senators Coons, Blunt Rochester, and their colleagues for their support of access to emergency care in Delaware and in the country. Delaware citizens have seen some of the longest wait-times in the country for ER visits, with hundreds of patients waiting for hours for care in the ERs state-wide at busy times. With his sponsorship of the ABC-ED Act, Sen. Coons has shown his understanding and support for the emergency healthcare team. Bottlenecks in the entire healthcare system lead to patients who are admitted to the hospital waiting for their hospital beds in the ER. This results in worse health outcomes for those patients as well as the patients who are waiting to be seen in the space that is occupied by admitted patients. It is with deep gratitude that the physicians of Delaware ACEP proudly support Senator Coons' sponsorship of the ABC-ED act to address these concerns and improve health outcomes for this state and for the country,” said the Delaware ACEP Board of Directors.
Delawareans have dealt with longer ED wait times than nearly every other state for more than a decade. The average ED visit time in Delaware was 141 minutes in 2023 – only a marginal improvement from the 156 minutes averaged in 2013. As a result of long wait times, Delawareans are also more likely to leave without treatment, putting their lives unnecessarily at risk. Long ED wait times are the result of intersecting challenges ranging from health workforce and primary care shortages to insufficient options for discharge due to a shortage of nursing home and behavioral health care options. Last year, the Delaware Healthcare Association reported that more than 300 long-stay patients were boarding in Delaware’s hospitals – using about 10% of the state’s hospital beds – despite being medically ready for discharge. Recent hospital closures in Pennsylvania will further strain hospital capacity issues in the region, making this federal initiative to complement state and local leadership more pressing than ever.
The text of the bill is available here.