Emergency Department Boarding Is Harmful for Critically Ill Patients

Clearly, emergency department (ED) crowding and boarding harms patients. These authors examined the particular harms when ED requests for intensive care unit (ICU) admission were denied or critically ill patients were boarded for prolonged periods in the ED.

The investigators reviewed records for adult patients for whom the ED requested ICU admission at a single academic hospital in New York where the 14-bed medical ICU averaged 91% capacity. Care for boarding patients remained the responsibility of the ED team. The authors determined predictors of ICU admission decisions and the effect of ED boarding time on the combined outcome of in-hospital mortality or persistent organ dysfunction (vasopressors, mechanical ventilation, or dialysis) or d…