Emergency department boarding called a statewide patient‑safety crisis; task force urges quality measures and discharge reforms

HARTFORD — Emergency physicians, a statewide working group and family members told the Public Health Committee that emergency department (ED) boarding — admitted patients held in ED spaces for many hours or days because no inpatient bed is available — is a patient safety and workforce crisis in Connecticut.

Dr. Chris Moore, emergency physician and lead of a December 2024 ED boarding working group, urged lawmakers to adopt stronger statewide measures. “I would like to suggest that you strengthen this bill by directing the Office of Health Strategy to incorporate boarding measures… as a quality measure for value‑based care,” Moore said. He told the committee that decades of local experience and a new reporting law (PA 24‑4) show the problem is widespread and linked to system‑wide capacity and discharge inefficiencies.

Nut graf: The task force recommended a multi‑pronged approach that includes statewide capacity planning, routine use of ED boarding metrics in quality programs, strengthened discharge and post‑acute care pathways and targeted incentives to ensure hospital resources move to safely reduce boarding. Witnesses said expedited conservatorship rules alone would be insufficient without investments in post‑acute capacity and hospital discharge systems.

Panel members said boarding increases infections, delays definitive care and contributes to staff burnout and violence toward clinicians. “Nearly 4 in 10 admitted patients to the emergency department… will experience boarding times of at least 4 hours,” Moore said, citing a public‑reporting baseline. Dr. Daniel Friess, an ED physician who co‑authored the task force report, told the committee the group recommended embedding boarding measures as quality signals for hospitals because incentivizing the problem’s reduction could be revenue‑neutral.

Families who have lost children and advocates also spoke. Toni Ann Trulello described her son Michael, a medically fragile child, and urged lawmakers to build a statewide pediatric hospice program to avoid tragedies where families must provide end‑of‑life care without in‑home hospice supports.

Lawmakers and clinicians agreed that boarding is a symptom of deeper problems: shortages of appropriate post‑acute spots, increasing length of stay driven by an older population with complex needs, and administrative barriers to discharge. Senator Cohen, who helped convene the working group, said the report contains dozens of recommendations and asked the committee to prioritize actionable items such as a discharge‑challenges task force and adding boarding to routine quality measurements.

A number of clinicians urged immediate steps: mandate and report standard boarding metrics; create incentives or penalties tied to boarding as part of value‑based payment; fund pilot projects to improve inpatient throughput and to expand post‑acute capacity; and coordinate better with state agencies on placement of patients who are medically ready for discharge but lack appropriate placement.

What’s next: Committee members said they will fold the report’s recommendations into follow‑on bill language and look for near‑term actions the legislature can take this session, while acknowledging broader funding and capacity measures may take longer.

Ending: Clinicians warned that without systemic change, boarding will continue to threaten patient safety and staff retention. The working group report gives lawmakers a roadmap of operational and payment levers — from statewide capacity planning to ED boarding as a hospital quality metric — that could reduce boarding and its harms.