Readers speak: CT doctors on the issue of hospital boarding in emergency departments

Hartford Courant – Sunday, May 31, 2026
By Christopher Moore

Opinion by Dr. Christopher Moore, for Connecticut College of Emergency Physicians Board of Directors.

We read with great empathy the opinion piece by Liam McCusker regarding his 97-year-old grandfather who spent 40 hours in an emergency department hallway waiting for an inpatient bed. We fully agree this should not be happening.

What Liam is describing is the human impact of a practice known as hospital boarding in the ED – often simply termed “boarding”. This is the well-known and now endemic practice of keeping admitted patients in the ED while awaiting an inpatient bed.

In 2024 the Connecticut College of Emergency Physicians, or CCEP, advocated for and helped pass the first state law in the country requiring hospitals to report boarding (data available on CCEP website). Statewide, in 2024, nearly 39% of all patients admitted through Connecticut EDs spent at least four hours after admission waiting in the ED.

This was essentially steady in 2025, though many individual hospitals made progress on the issue. While four hours is widely considered the benchmark for what should be unacceptable, many patients stay longer, often on gurneys in a hallway.

The harms of boarding are well-documented. It is deadly, particularly for older patients who are at higher risk for delirium. It compromises patient safety and privacy. It is one of the main causes of ED overcrowding – much more than the common perception that it is low acuity patients who crowd the ED. Boarding also burns out staff, which can lead to a cycle that decreases staffing availability and exacerbates capacity issues.

Despite all that we know about the prevalence and harms of boarding, it continues to rise nationally. Interestingly, while hospital capacity is an issue in some cases, Connecticut data suggests that boarding appears to occur as a hospital practice in many situations despite potential excess capacity. Remarkably, a patient (or their insurance) pays the same for an “admission” whether much of that time is spent on a gurney in an ED hallway or in a private inpatient bed with dedicated nursing care.

At this point it is incumbent on the state to look more closely at the data, the harms, and solutions for this public health issue.

Submitted by Dr. Christopher Moore, for Connecticut College of Emergency Physicians Board of Directors.

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