Operational changes inside the emergency department, such as triage redesign or staffing adjustments, rarely resolve boarding on their own. Hospital-level strategies, such as smoothing surgical schedules across the week and improving discharge timing, have shown far greater impact.
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For frontline emergency physicians, boarding often feels inevitable. But experts say understanding the root causes of boarding is essential to addressing it.
Emergency physicians cannot solve the problem alone. Meaningful progress will require collaboration among hospital leaders, policymakers, payers, and clinicians.
For now, emergency departments remain the pressure valve of the U.S. health care system, absorbing the consequences of structural capacity constraints. But as policymakers increasingly recognize the patient-safety implications of boarding, experts say momentum for reform may finally be building.
Boarding is not an inevitable feature of emergency care. As Dr. Michael put it: “Boarding is not an immutable force of nature. It’s the result of system design, and systems can be redesigned.”
Leona Scott is a freelance writer based in Dallas.
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