Boarding in the ED while awaiting an inpatient bed is associated with myriad harms that are magnified in older adults, who are also at risk for delirium, functional decline, and death. Nonetheless, older adults are more likely to experience boarding, and this boarding has reached -- and exceeded -- crisis levels. Thanks to Adrian Haimovich, Sarah D. Berry, and Bruce E. Landon for highlighting this in their recent research letter in JAMA Internal Medicine.
Maura Kennedy, Kevin Biese, MD and I wrote an editorial accompanying that article that we hope serves as a call to action. We believe that solving the capacity and boarding crises involves: (1) insisting it is not acceptable or inevitable, (2) committing to transformative change, and (3) prioritizing this change. Clinicians, policymakers, health care executives, payers, quality and safety leaders, and patient advocates all have a role to play in making this change happen. Without action, vulnerable older adults will continue to board on stretchers in loud and bright ED hallways, experience immobility and sleep deprivation, and develop delirium and other serious complications.
LinkedIn post here.