The following is a summary of “Inpatient boarding definitions and mitigation strategies: A cross-sectional survey of academic emergency departments in the United States,” published in the May 2023 issue of Emergency Medicine by Heukelom, et al.

For a study, researchers sought to evaluate the definition of boarding across academic emergency departments (EDs) and identify mitigation strategies to manage overcrowding caused by inpatient boarding.

A cross-sectional survey was conducted using boarding-related questions embedded in the annual benchmarking survey administered by the Academy of Academic Administrators of Emergency Medicine and the Association of Academic Chairs of Emergency Medicine. The survey assessed boarding definitions and practices in participating institutions. 

Descriptive analysis was used to assess and tabulate the results. Out of 130 eligible institutions, 68 participated in the survey. Approximately 70% of institutions reported starting the boarding clock at the time of ED admission, while 19% indicated that the clock began upon completion of inpatient orders. Regarding the duration of boarding, around 35% of institutions considered patients boarded within 2 hours, while 34% considered patients boarded after more than 4 hours following the admission decision. In response to ED overcrowding caused by inpatient boarding, 35% of institutions reported using hallway beds for patient care. Surge capacity measures reported included having a high census/surge capacity plan (81%), implementing ambulance diversion (54%), and utilizing a discharge lounge within the institution (49%).

The study revealed wide variations in the definitions of boarding across academic EDs. Inpatient boarding has significant implications for patient care and well-being, emphasizing the need for standardized definitions to describe this phenomenon.

Source: sciencedirect.com/science/article/abs/pii/S0735675723000724