Strategies to Improve Emergency Department Boarding

Authors

• Chelsea Dwyer Byrne, University of LynchburgFollow

Specialty

Emergency Medicine

Abstract

ABSTRACT

Boarding is a common and critical issue in Emergency Departments (ED) that contributes to overcrowding, worsening length of stay (LOS) and left without being seen (LWBS) rates. It also leads to worse patient care with increased mortality and morbidity, higher undesired events, and decreased patient and staff satisfaction. ED boarding is associated with higher healthcare costs, as well as potential revenue loss when hospital constraints result in the cancellation of elective surgeries. Three databases were searched, including PubMed, ProQuest Nursing and Allied Health, and CINAHL Complete. The search phrase used was: ("solutions" OR "strategies") AND ("ED boarding" OR "emergency department boarding"). Results were limited to studies published within the last 5 years. The evidence shows that strategies that focus on decreasing inpatient LOS are most effective in decreasing ED boarding times. These strategies include early discharge planning, multidisciplinary rounding teams, and involving case management in patient care. Policy changes that focus on creating alternatives to in hospital admission and decreasing inpatient LOS would also likely be helpful, and should be explored.  Future multi-institutional studies are needed to further investigate the cost implications of ED boarding, as well as to clarify which interventions are most effective across different healthcare settings.

Keywords: Emergency department boarding, boarding, length of stay, boarding strategies

Recommended Citation

Dwyer Byrne C. Strategies to Improve Emergency Department Boarding. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).