Addressing the Hospital Boarding Crisis in the US—Time to Act

Boarding, the practice of holding patients in the emergency department (ED) while awaiting an inpatient bed, is associated with myriad harms that are magnified in older adults, who are also at risk for delirium, functional decline, and death.1,2 Nonetheless, older adults are more likely to experience boarding.1 For these reasons, boarding metrics were included in the Centers for Medicare & Medicaid Services (CMS) Age-Friendly Hospital Measure requiring that hospitals report on adherence to age-friendly care, including transferring older patients out of the ED within 8 hours of arrival and/or 3 hours of the decision to admit.