Since 1970, advocates for the Emergency Medicine specialty.
Workplace
The emergency department workplace faces myriad issues that can impact access, quality, and safety for both providers and patients. Workplace violence, boarding, and mental health are three concerns requiring immediate action.
Workplace violence
Violence in the ED is unacceptable. A September 2022 poll from the American College of Emergency Physicians reported 8 in 10 emergency physicians believe the rate of violence experienced in EDs has increased, with 45% saying it has greatly increased over the past five years — exacerbated by the COVID-19 pandemic. VACEP is working to strengthen protections for physicians, care teams and patients by increasing public awareness, advocating for policy changes and developing resources to help professionals mitigate and respond to these incidents. Both providers and patients need greater peace of mind that they are safe.
We also created a standalone document that dives deeper into the workplace violence issue. Get it here.
MENTAL HEALTH
Many patients in need of mental health care turn to EDs. We are working with Virginia Governor Glenn Youngkin’s office to improve access to mental health resources both out of and within an emergency department. This includes ensuring more inpatient beds are available to get them to care quickly and intervening earlier so those patients never have to come to the ER, such as more mobile crisis teams.
Once the patient leaves our care, we want to ensure they easily access the resources they need to manage their care at home or in outpatient settings. Should the individual require inpatient care, we also want to streamline and simplify the admissions process to mental health hospitals. Doing so can prevent boarding in the ER — a place where a person in mental health crisis only gets worse, which strains medical resources.
When mental health patients are boarding, neither patient nor providers win.
Boarding
Keeping admitted patients in either the emergency department while awaiting an inpatient bed is referred to as “boarding.” Boarding begins when an emergency physician makes the decision to admit and ends when the patient is placed in an appropriate inpatient unit bed or is delivered to surgical or procedural services. The top cause of ED boarding is a lack of available inpatient beds. Emergency patient care is adversely affected by nurses attending to the acute and episodic needs of the emergency patients and not having adequate time to spend with the admitted patients. This increases the chances of errors such as missing timed medications, and subjecting their patients to noisy and chaotic surroundings.