Key takeaways:
- ED boarding times across hospitals are getting worse, hurting patient experience and outcomes.
- Health systems across the country have implemented a host of initiatives and staffing changes to meet the challenge of ED boarding.
- Effective strategies include robust outpatient resources, discharge lounges, faster discharges to SNFs and the use of hallway beds on the floors.
BOARDING PATIENTS in the ED while they wait for inpatient beds is bad for patient outcomes and for hospital bottom lines—and it’s getting worse. A June 2025 study in Health Affairs based on 2017-24 data found that while waiting for a bed for 24 hours or more used to be rare, nearly 5% of patients now being admitted board that long during peak winter months.
How can hospitals reduce ED boarding? A recent Society of Hospital Medicine Webinar featured three hospitalist leaders who shared the interventions their health systems use to alleviate ED boarding.
Successful interventions they described ranged from the use of hallways beds and discharge lounges to faster discharges to SNFs and more targeted identification of avoidable admissions.
Strategies to reduce ED boarding: Hallway beds and discharge lounges.
Cooper University HealthCare deploys two different interventions to relieve ED boarding. Read more here.
Strategies to reduce ED boarding: Faster discharges to post-acute facilities.
Trinity Health Michigan works closely with its post-acute care network to craft transition collaboration agreements. Read more here.
Strategies to reduce ED boarding: Surrounding patients with outpatient resources.
Lehigh Valley Health Network has put in place a triage process that clinicians use with all patients presenting to the ED. Read more here.
Phyllis Maguire has been Executive Editor of Today’s Hospitalist since 2006. Based in Bucks County, Pa., her health care interests are hospital medicine and long-term care options. She also likes zydeco, hiking, and reading memoirs and romances.
When hospital beds are scarce, patients “board” in the emergency department until an inpatient bed becomes available. Here is documentation from HealthAffairs of rising burdens of hospital boarding in the United States.
