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Reframing ED Boarding Through a Human Factors Sociotechnical Systems Lens
Letter/Communication   Peer reviewed

Reframing ED Boarding Through a Human Factors Sociotechnical Systems Lens

Woosuk Seo, Raj M. Ratwani, Jesse M. Pines and Edward R. Melnick
Journal of patient safety
10 Apr 2026
PMID: 41960648
Featured in Collection :   Drexel's Newest Publications

Abstract

Emergency department (ED) boarding, defined as holding admitted patients in the ED while awaiting an inpatient bed or transfer, is a persistent problem associated with longer lengths of stay, treatment delays, reduced care quality, and increased in-hospital mortality. Although interventions such as fast-track protocols, EHR tools, and policy mandates seek to reduce boarding, they often target isolated issues and yield inconsistent results due to limited integration and cross- departmental coordination. Thus, ED boarding must be viewed not merely as an operational ED issue but as a hospital-wide throughput challenge shaped by multiple sociotechnical factors affecting patient safety. [1st paragraph]

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