Risk Factors, Costs, and Impacts of ED Boarding

April 9, 2026 updated by: Daniel Gingold, University of Maryland, Baltimore

Cost of Emergency Department Boarding for Hospitalized Patients in a Statewide Medical System

The goal of this observational study is to learn about the risk factors, costs, and operational impacts of emergency department boarding (patients admitted to the hospital but remaining in the emergency department awaiting placement on an inpatient floor)

The main questions it aims to answer is:

  1. What characteristics of patients make them more likely to experience ED boarding?
  2. What is the impact of ED boarding on costs of health care?
  3. How do high-boarding environments affect the clinical care of all patients in the emergency department, including those that do not board themselves.

Data will be secondary in nature, collected in the regular Participants already taking intervention A as part of their regular medical care for RA will answer online survey questions about their joint pain for 5 years.

Study Overview

Status

Completed

Conditions

Study Type

Observational

Enrollment (Actual)

30486

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Maryland
      • Baltimore, Maryland, United States, 21201
        • University of Maryland Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Adult patients admitted to the hospital under inpatient or observation status from the adult emergency department at an academic medical center, to floor/telemetry inpatient services that directly managed boarded patients in the ED (medicine, family medicine, neurology)

Description

Inclusion Criteria:

  • adults presenting to UMMS system hospitals and getting hospitalized by inpatient or observation over study period (2022-2025). At UMMC, should be admitted to an internal medicine team Med 1-4, Med 6, Med 5, med/surg/tele level (no IMC/ICU) and neuro floor level.

Exclusion Criteria:

  • Patients admitted to cardiology, cancer center, surgical services, IMC/ICU

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Patients Hospitalized from the ED to Boarding Services
Adult patients admitted to floor level services that directly manage patients in the ED (medicine, family medicine, neurology)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Boarding time
Time Frame: During hospitalization encounter
Time between admission order placement and ED departure. Only patients admitted to services that routinely take primary care responsibility for boarding patients in the ED will be classified as boarders
During hospitalization encounter

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Boarding Percentage
Time Frame: During hospital encounter
Proportion of hospitalization spent as ED boarder
During hospital encounter
Direct variable cost
Time Frame: During hospitalization
Cost. Includes direct nursing salary / fringe costs, medical supplies, drugs, ancillaries, etc. that are directly related to and highly variable with clinical volume
During hospitalization
Hospital length of stay
Time Frame: During hospitalization
Hospital length of stay
During hospitalization
Boarding Density Ratio
Time Frame: During patient's ED stay
Percentage of ED beds occupied by boarders during a patient's stay, calculated hourly and averaged across the patient's entire ED visit
During patient's ED stay

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Maryland, Baltimore

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2022

Primary Completion (Actual)

December 31, 2025

Study Completion (Actual)

December 31, 2025

Study Registration Dates

First Submitted

April 9, 2026

First Submitted That Met QC Criteria

April 9, 2026

First Posted (Actual)

April 16, 2026

Study Record Updates

Last Update Posted (Actual)

April 16, 2026

Last Update Submitted That Met QC Criteria

April 9, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • HP-00112665

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Risk of violating HIPAA and patient privacy without patient consent.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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