Building a public-private partnership to confront the emergency department boarding crisis

Abstract

The nation's critically crowded emergency departments have aptly been called “the sentinel canaries in the health care system,” given their nexus point between inpatient, ambulatory, perioperative, and long-term care systems. Emergency department boarding—holding or physically keeping a patient in an emergency department after the clinical decision to admit the individual to the hospital—is a critical symptom of overload and breakdown of the more extensive health care delivery system. Despite more than 25 years of incontrovertible scientific evidence that the practice is associated with significant harm, little progress has been made in confronting its structural and economic drivers at a national scale. This article, authored by federal health care leaders, opens the Health Affairs Scholar Featured Series by highlighting the importance of a public-private partnership approach and lays the foundation for a series that will further present a holistic evaluation of the topic, encouraging a multi-faceted approach toward resolving this critical health system issue.