Should Hospitalists Manage Admitted Patients Boarding in the Emergency Department?

As hospital censuses increase, more admitted patients receive inpatient care while residing in the emergency department (ED). Investigators at a large urban academic medical center (Massachusetts General Hospital) performed a cross-sectional study of patients cared for by an ED-boarder service — including hospitalist physicians, advanced practice providers, and floor nursing staff. Patients were eligible for care by the ED-boarder service if they remained in the ED for 2 hours after an ED-physician submitted an admission order to a general medical inpatient service.

Among nearly 17,000 admitted general medical patients, half were cared for by the ED-boarder service, one third remained noncovered in the ED, and one sixth moved from the ED to …