Emergency department (ED) boarding is a growing crisis that traps admitted patients in emergency rooms, delays lifesaving care, and demands urgent hospital action now.
Leah Binder
President and CEO, The Leapfrog Group
There is a growing crisis in America’s emergency rooms known as emergency department boarding, or ED boarding. Emergency physicians are sounding the alarm, while patient advocates and policymakers are taking notice.
Emergency departments are the front door to a hospital. However, for too many patients, they have become hallways and holding areas instead. Boarding occurs when patients who have already been admitted remain in the ED because no inpatient beds are available. According to the Association of Academic Chairs of Emergency Medicine, ED boarding rose nearly 130% from 2012 to 2019 and increased further after COVID-19. The issue has even been spotlighted on the Emmy-winning HBO drama “The Pitt.”
A problem that affects everyone
This is not just an inconvenience. It affects everyone. Crowded emergency departments mean longer wait times, delayed diagnoses, and clinicians and facilities stretched beyond safe capacity. Older adults and patients experiencing behavioral health crises often endure the longest boarding times.
It’s time for things to change. At The Leapfrog Group, an independent watchdog representing employers and patients, we believe that transparency galvanizes change. In 2025, Leapfrog added questions to our hospital survey about ED boarding times, and we intend to publicly report this data next year. The Centers for Medicare & Medicaid Services (CMS) also approved a new measure this year that requires hospitals to track and report ED boarding and transfer delays.
Measuring ED boarding alone does not solve the problem, but shining a light on it is a critical step. Ignoring it guarantees it will persist.
ED boarding is not inevitable; it reflects choices. Hospital leaders must measure it, own it, and set time-bound goals to reduce it so no patient who needs a hospital bed is left waiting in harm’s way.
