Hospital occupancy, ED boarding during COVID-19

Editor's Note

This study from Yale University School of Medicine, New Haven, Connecticut, finds that hospital occupancy greater than 85% was linked to increased emergency department (ED) boarding beyond the 4-hour standard, during the COVID-19 pandemic (January 2020 through December 2021), and ED boarding increased even when hospital occupancy did not.

When occupancy exceeded 85%, boarding exceeded The Joint Commission 4-hour standard for 88.9% of hospital-months. In those hospital-months, median ED boarding time was 6.58 hours vs 2.42 hours in other hospital-months.

Across all hospitals, the median ED boarding time was 2.00 hours in January 2020, 1.58 hours in April 2020, and 3.42 hours in December 2021. Median hospital occupancy was highest in January 2020 (69.6%), 48.7% in April 2020, and 65.8% in December 2021.

The harms associated wit ED boarding and crowding, which were long-standing before COVID-19, may have become further entrenched during the pandemic, the researchers say.