JACEP Open Study Finds Waiting Room Treatment Does Not Have Higher Rate of 72-Hour Returns

This is not the research Cynthia Gaudet, DO, ever imagined conducting when she first got into medicine. Dr. Gaudet and colleagues evaluated the rate of return visits to the emergency department (ED) within 72 hours of discharge for patients evaluated in the waiting room. Because of ED crowding challenges, they hypothesized that some patients may be suitable for the completion of evaluation without rooming.

Dr. Gaudet

“It’s disheartening, but this is where we are right now,” said Dr. Gaudet, an emergency physician at Beth Israel Deaconess Medical Center. “I worry about the impact it has on patients. Our group is looking into that as well.”

Published in the June 2025 issue of JACEP Open, researchers found no significant increase in the rate of return for patients seen primarily in the waiting room or for those where the initial work-up started in the waiting room compared with those who were placed in a treatment space prior to a physician evaluation. The retrospective study evaluated more than 1,500 patients seen at a single academic ED, comparing those who began care in standard treatment rooms with those initially evaluated in alternative care spaces because of ED crowding.

Key metrics included lab utilization, imaging, time to admission, and return visits. The conclusion: patients managed outside private rooms received comparable care.

“We wanted to understand the downstream effects of what is happening because of these trying times and the pressure in the emergency department,” said Dr. Gaudet, who also serves as Director of Quality Assurance at UMass Memorial Health – Harrington. “I think the emergency department gives us a unique lens into all the places that the hospital system and the medical system are breaking down. We become the catch-all for everyone that comes in the door.”

The way waiting room medicine is practiced varies. Some hospitals carve out evaluation zones in hallways or create temporary exam spaces off to the side. Others designate teams to circulate through the waiting room itself.

“Some places have a few feet in the hallway or an extra room to pull people in momentarily for a history and exam,” Gaudet explained. “Other times, you’re just trying to find a sliver of space to assess patients quickly.”

Gaudet emphasized that this should not become standard. “We’re not trying to normalize hallway care,” she said. “Our goal is to gather evidence, understand what’s happening, and hopefully make a case for change.”