Boarding: Health Care’s Dangerous Bottleneck

The National Academy of Medicine declared emergency department (ED) crowding a national epidemic nearly 20 years ago, a crisis that has since evolved into a boarding epidemic.1 Boarding refers to the practice of holding patients in the ED after the decision to admit has been made, and it is ubiquitous across US EDs and has negative consequences for patients, family members, clinicians, and the health care system.2-8 Boarding has been identified as the single biggest challenge facing EDs and is thought to constitute a major driver of burnout.