On the medical drama “The Pitt,” patients often spend hours in the emergency department waiting for a bed in the hospital, a detail that makes the show feel realistic. That practice, what’s known as boarding, remains a serious problem for hospitals across the United States.
A paper this week in JAMA found that, across 17 US healthcare systems, which included 56 emergency departments, more than half of patients who need to be admitted to the hospital wait four hours or more for an in-patient bed—with some people standing by for 24 hours or longer.
“Risk concentrates at these moments where one clinical team hands a patient to another. Emergency and in-patient teams work on different clocks, and they’re doing this under resource constraints,” Alex Janke, MD, MHS, an assistant professor of emergency medicine at the University of Michigan Medical School and first author of the paper, said in a university press release.
“What our data show is that some hospitals consistently manage that transition in under four hours, and others take more than a day, which suggests it comes down to how a hospital organizes the work, not just how full it is.”
Boarding can last anywhere from 4 to 24+ hours
The researchers examined electronic health record data from more than 3 million adult emergency department visits from June 1, 2024, to May 31, 2025. Almost a half million people, 492,135 needed to be admitted for general medical care—which includes geriatrics, internal medicine, or family medicine—and of those patients, 263,666 (53.6%) waited at least four hours for a bed.