Emergency Room Wait Times Climb as Hospitals Struggle With Patient Boarding

Emergency room wait times at several Pennsylvania hospitals have climbed over the past year, a trend administrators attribute largely to patient boarding, the practice of holding admitted patients in emergency department beds for hours or sometimes days because no inpatient bed is available elsewhere in the hospital.

"The emergency department is designed to move patients through quickly," one hospital's emergency medicine chief said. "When admitted patients are stuck there because there's nowhere else to put them, that capacity just isn't available for the next person walking in with chest pain."

Hospital officials point to a combination of factors driving the bed shortage, including staffing constraints that have forced some hospitals to keep licensed beds closed due to lack of nursing staff to safely operate them, along with a shortage of available nursing home and rehabilitation placements that delays discharging patients who no longer need acute hospital care but aren't ready to go home.

Some hospitals have implemented boarding mitigation protocols, including moving stable admitted patients to hallway beds in non-emergency units during peak crowding, a stopgap measure hospital leaders acknowledge is imperfect but preferable to further backing up emergency department capacity.