A new study published in JAMA found wide variation in hospitals in how many hours patients wait before they start receiving quality inpatient-care in emergency departments.

Patients can sometimes wait hours or days in clogged emergency departments waiting for a bed to open up. This is known as boarding. The study shows 23% of emergency department boarding patients wait at least 4 hours before transitioning from emergency care to inpatient management. Some wait 12 or even 24 hours.

The four-hour mark was chosen based on the Joint Commission standard, which identified emergency department boarding for more than four hours prior to an inpatient bed transfer as a critical patient safety issue. Hospitals have increasingly mobilized inpatient teams for care while patients are still boarding.

Attention from experienced physicians and hospital pharmacists can make a major difference in patients' outcomes, especially those with more complex cases. 

Starting in January 2027, EHR systems at hospitals across the country will start to feed anonymous data about ED patients' travels through the system directly to the federal government's reporting system, which should hopefully shed more light on the boarding process and how inpatient teams are helping.