Emergency departments have long been designed to manage unpredictability. However, many today are operating in a constant state of strain. What were once intermittent surges in volume and acuity have become persistent conditions.
While the intensity varies across regions, the underlying challenge is shared: emergency care demand is rising faster than the system’s capacity to respond. In this environment, health systems are rethinking how emergency departments are staffed, structured, and sustained.
Rising Patient Volumes and Declining Capacity in Emergency Departments
According to the CDC’s National Center for Health Statistics, U.S. emergency departments manage nearly 140 million visits annually, with more than 18 million resulting in hospital admissions. At the same time, inpatient capacity in many health systems has not grown at the same pace as emergency demand.
Research published in JAMA Network Open, titled Healthcare Staffing Shortages and Potential National Hospital Bed Shortage, estimates that national hospital occupancy could reach 85% by 2032. Contributing factors include an aging population and a reported 16% decline in staffed inpatient beds following the COVID-19 pandemic. For context, the average hospital occupancy rates rose from approximately 64% (2009–2019) to roughly 75% between May 2023 and April 2024.
A 2022 study published in JAMA Network Open, Hospital Occupancy, and Emergency Department Boarding During the COVID-19 Pandemic illustrates the operational impact of elevated occupancy. When hospital occupancy exceeds 85%, hospitals are unable to meet The Joint Commission's 4-hour boarding benchmark. During these periods, the median emergency department boarding time was roughly 6.6 hours, compared to 2.4 hours in months when occupancy was lower.
Prolonged Wait Times and Boarding Challenges in Emergency Care
When hospitals operate near or above capacity, emergency department throughput often slows. Although patient volume plays a role, rising acuity levels and limited availability of inpatient beds contribute to delays in assessment, treatment, and transfer. In a survey conducted by the American College of Emergency Medicine Physicians (ACEP), 1 in 4 doctors reported that patients waited more than two weeks for hospital admission or transfer.
Data from the Centers for Medicare & Medicaid Services (CMS) offer an additional perspective. As of April 2025, the average time spent at an emergency department visit is 158 minutes, with five states averaging over 180 minutes and Washington, D.C., having an average time of 305 minutes.
Extended emergency delays affect more than patient flow. They disrupt timely treatment, reduce access to critical resources, and place additional strain on emergency medicine teams already operating under pressure.
Workforce Strain and Burnout Among Emergency Medicine Providers
The emergency medicine workforce is managing a sustained increase in patient volumes and longer wait times. These conditions are placing additional pressure on clinicians and contributing to elevated rates of burnout.
In 2025, 56% of emergency medicine physicians reported burnout, with an additional 25% indicating they also experienced depression, according to a survey led by Medscape. Notably, 63% of emergency medicine physicians surveyed stated they would accept less pay for improved work-life balance.
Prolonged burnout can contribute to reduced job satisfaction and increased provider turnover, directly impacting patient care, leading to longer wait times, decreased efficiency, and compromised access to emergency services.
Approaches to Supporting Emergency Department Access
Optimizing Clinical Workforce Efficiency and Patient Flow
To address the pressures on emergency departments, many health systems are shifting focus from short-term fixes to longer-term operational strategies. A central area of focus is workforce optimization: aligning staffing models with fluctuating demand and supporting emergency medicine physicians and advanced practice providers (APPs) more effectively.
Efforts to reduce overcrowding and streamline patient flow can help improve throughput. Enhancing workforce efficiency through targeted training and dynamic staffing models can also relieve pressure during peak periods.
Key Strategies for Workforce Optimization Include:
- Match staffing levels to patient volume surges.
- Use real-time analytics to forecast demand.
- Offer flexible scheduling to mitigate burnout.
- Integrate APPs and locum tenens to support core teams.
These approaches are often employed in combination, particularly in organizations experiencing high turnover, constrained hiring markets, or seasonal surges in demand.
Integrating Interim Healthcare Staffing in Long-Term Workforce Planning
Emergency medicine locum tenens physicians and advanced practice providers can offer an additional layer of support for emergency departments experiencing clinical staffing shortages. While previously viewed as a temporary solution, interim healthcare staffing is increasingly being integrated into long-term workforce strategies.
Benefits of Emergency Medicine Locum Tenens:
- Ensures continuous coverage.
- Enhances operational stability.
- Reduces provider burnout.
- Expands access to care, particularly in rural or underserved areas.
By incorporating locum tenens coverage into broader workforce planning, health systems can strengthen their ability to maintain consistent emergency care access.
For a deeper look at the data, trends, and strategies shaping emergency care today, download our white paper, A System Under Strain: Rising Demands in Emergency Medicine, by completing the short form below.
