Boarding in the Emergency Department: Specific Harms to Older Adults and Strategies for Risk Mitigation

Emergency department (ED) boarding, which refers to holding patients in the ED for prolonged periods while awaiting an inpatient bed, is linked to patient harm and is associated with worsening ED crowding. Evidence suggests that older patients are at increased risk of complications from boarding, including the development of delirium. By prioritizing the admission of at-risk older patients to inpatient beds, ED may improve the both the quality of care for these patients and reduce inpatient lengths of stay. Older patients who must board in the ED may benefit from targeted interventions to help mitigate risks from ED boarding.