Approximately 90% of emergency departments worldwide are overcrowded , leading to dangerous delays, reduced quality of care, and strain on medical staff. But if you’ve ever been to the emergency room, you know this already.
When I visited rural North Carolina, I went to the ER after a splinter lodged in my finger and could not be removed with tweezers. The front desk was unable to provide an estimated wait time, and I remained in the waiting room for four hours. During that time, I observed several troubling instances of inadequate care: a man who had to wheel himself to the bathroom after requesting assistance, a visibly feverish child, and a patient who began to seize. I was only seen after my athletic trainer mentioned my curfew, at which point I received treatment almost immediately.
My other experience of ER care was even more disturbing. This time in suburban New Jersey, I had passed out after feeling light-headed. I had to wait six hours to see a doctor at the ER. The doctor downplayed my condition, but my gynecologist later recommended immediate surgery, highlighting the lack of urgency and the potential for misdiagnosis in the crowded ER.
Overcrowding in hospital emergency rooms is a global crisis that leaves patients vulnerable to delayed care and medical complications. Whether in rural areas, where low- and middle-income families face affordability and access barriers, or in bustling urban centers where demand exceeds capacity, overcrowding is becoming inescapable.
A Yale study found that once hospital occupancy surpasses 85%, boarding times – the time it takes to be admitted to a hospital bed – soar past the standard four-hour window, hitting a median of 6.58 hours during the COVID-19 pandemic. These statistics highlight the urgent need for system reform.
Both of my experiences shared one key similarity: patients arriving by ambulance received prompt treatment, regardless of the severity of their condition. This disparity underscores the necessity for clear, effective protocols, something a bill currently before Connecticut’s legislature seeks to establish. House Bill 6976 would regulate when and how hospitals in the state can divert ambulances, aiming to enhance patient safety and ensure responsible use of resources.
Ambulance diversion occurs when an emergency room directs arriving ambulances to other facilities as a way to temporarily relieve overcrowding. For obvious reasons, it’s a controversial practice.
This bill is a careful initiative aimed at tackling complicated issues. The legislation aims to enhance efficient and coordinated responses by setting criteria for when ERs can initiate ambulance diversions and ensuring hospitals comply with EMS protocol. It calls for greater transparency, requiring hospitals to inform the Department of Public Health about diversion incidents, which is also crucial. These reports can help to illuminate the root causes of ER overcrowding, whether due to staff shortages, lack of beds, or systemic inefficiencies. Most importantly, the bill mandates that hospitals create contingency plans for handling diverted patients, minimizing the risk that anyone might be overlooked during critical situations.
Still, the bill is not without its drawbacks. Many stakeholders, including the Connecticut Hospital Association and Yale New Haven Health, warn that the bill’s mandates could overwhelm hospitals already stretched thin. Requiring prior notice to DPH before initiating a diversion might delay critical decisions. Emergency room teams work in unpredictable, fast-paced environments, so seconds matter. Additionally, the bill adopts a uniform approach that might not account for the varying circumstances of hospitals throughout the state of Connecticut. Bed availability, staffing levels, patient acuity shifts hourly, and fixed rules cannot always account for those variables.
Another issue is that the bill focuses narrowly on diversion policy while overlooking the larger, structural causes of ER overcrowding. Without expanding access to primary care, increasing inpatient capacity, or resolving insurance-related delays, HB 6976 risks failing to provide timely treatment to patients who could otherwise be helped.
To honestly confront the crisis of ER overcrowding, Connecticut lawmakers must weigh the promise of HB 6976 against its limitations. The bill is well-intentioned and, in some areas, necessary. However, it will only succeed if legislators actively collaborate with healthcare providers, remain open to flexible implementation, and – crucially – pursue broader reforms.
Emergency department overcrowding is not just a matter of logistics; rather, it is a human issue. It is about the mother waiting anxiously with her feverish child or the elderly man in a wheelchair left to manage alone. It is about ensuring every patient is met with urgency, dignity, and care.
Sydney Hess is a senior at Sacred Heart University, majoring in Healthcare Administration.