A Plan To Reduce Emergency Room ‘Boarding’ Of Psychiatric Patients

Alakeson, Vidhya; Pande, Nalini; Ludwig, Michael

doi:10.1377/hlthaff.2009.0336

Cited by 112Emergency and Acute Care StudiesPsychiatric care and mental health servicesMental Health Treatment and Access

A Plan To Reduce Emergency Room ‘Boarding’ Of Psychiatric Patients

Alakeson, Vidhya, Pande, Nalini, Ludwig, Michael·2010·Health Affairs

DOI 10.1377/hlthaff.2009.0336

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Abstract

Overcrowded U.S. emergency rooms have become a place of last resort for psychiatric patients. Psychiatric boarding, defined as psychiatric patients' waiting in hallways or other emergency room areas for inpatient beds, is a serious problem nationwide. Boarding consumes scarce emergency room resources and prolongs the amount of time that all patients must spend waiting for services. It is often the result of an inability to gain timely access to community-based care. As policy makers implement the new health reform law, improving access and continuity of community mental health care through health homes must be a priority. We present a seven-point plan to address psychiatric boarding.

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Boarding patients often receive limited psychiatric intervention due to limited hospital resources.
“Boarding patients, defined as patients held in EDs and medical units for an extended period of time while awaiting psychiatric placements, often receive limited psychiatric intervention due to limited hospital resources (Alakeson et al., 2010; Campbell & Pierce, 2018; Leyenaar et al., 2021).”
From Experiences of Child and Adolescent Psychiatric Patients Boarding in the Emergency Department from Staff Perspectives: Patient Journey Mapping (2023) · cites this paper as Alakeson et al., 2010

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Authors: Alakeson, V., Pande, N., & Ludwig, M.
Affiliations: Nuffield Trust (GB)
National Quality Forum (US)
Columbia University (US)
Venue: Health Affairs
Publisher: Health Affairs Publishing, LLC
Published: 2010-09
Volume: 29
Issue: 9
Pages: 1637-1642
ISSN: 0278-2715 (ISSN-L)
1544-5208
DOI: 10.1377/hlthaff.2009.0336
OpenAlex: W2105663605
Cited by: 107
References: 3
Citations by year: 2026: 3 · 2025: 1 · 2024: 4 · 2023: 5 · 2022: 6 · 2021: 9 · 2020: 10 · 2019: 12 · 2018: 8 · 2017: 8 · 2016: 7 · 2015: 14 · 2014: 8 · 2013: 4 · 2012: 4
FWCI: 3.96
Type: journal article
Language: en
Open access: closed
Locations: Health Affairs (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Public Health Service (HHS-100-03-0027)
Topics: Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords: psychiatric boarding, emergency department overcrowding, psychiatric patients, hospital bed capacity, health homes, continuity of care, health care reform, emergency department resource allocation
MeSH terms: Community Mental Health Services, Crowding, Emergency Service, Hospital, Health Services Accessibility, Hospitalization, Humans, United States, Efficiency, Organizational, Health Care Reform, Patient-Centered Care, Time-to-Treatment

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A Plan To Reduce Emergency Room ‘Boarding’ Of Psychiatric Patients

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