ED Boarding Time Varies Considerably Across Hospitals

THURSDAY, Aug. 20, 2026 (HealthDay News) — The timeliness of the transition from emergency department (ED) to inpatient management varies considerably by hospital, according to a research letter published online in the Journal of the American Medical Association.

Alexander T. Janke, M.D., from the University of Michigan in Ann Arbor, and colleagues characterized variation in time to initiation of inpatient management while boarding among patients admitted to general medical services in a retrospective cross-sectional analysis of electronic health record data from 17 health systems.

Overall, 492,135 patients were admitted to general medical services among 3,271,585 ED visits; 53.6 percent of these patients experienced boarding of at least four hours in the ED while awaiting an inpatient bed. The researchers found that 17.3, 4.7, and 0.9 percent of all patients requested for admission to a general medical service experienced at least four, 12, and 24 hours, respectively, without inpatient management in the ED; 55.0, 54.6, and 53.6 percent of these patients, respectively, were older adults (65 years or older). A median of 0.4 and 0.1 percent of admitted patients were exposed to at least 12 and at least 24 hours without inpatient management across hospitals; in three hospitals, more than 1 in 20 patients experienced 24 hours or more without inpatient management. Prolonged delays occurred more often for admissions at academic hospitals, hospitals with more beds, and those with greater Medicaid share.

“Some hospitals consistently manage that transition in under four hours, and others take more than a day, which suggests it comes down to how a hospital organizes the work, not just how full it is,” Janke said in a statement.

Several authors disclosed ties to the health technology industry.

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