{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:58:00Z","timestamp":1792511880142,"version":"4.5.0"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Emergency department (ED) boarding, or holding admitted patients in the ED due to a lack of available inpatient beds, presents a major challenge to healthcare systems. This study examines the impacts of ED boarding on clinician wellness, burnout, moral injury, and workplace violence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We distributed a survey to members of the American Academy of Emergency Medicine over 4 weeks in early 2025. It included 9 questions on experiences with boarding, demographics, and practice setting, plus an optional free-response question. Descriptive statistics were performed, and free-response questions were explored for insight and broader themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 195 respondents, 54.1% reported experiencing violence related to ED boarding, and 98.5% reported an impact on job satisfaction. Ninety-six respondents submitted free-text comments, which reflected 4 major themes: frustration and burnout; verbal and physical abuse; moral injury tied to profit-driven decision-making; and impacts on clinical care and patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These preliminary findings that highlight additional adverse outcomes of boarding can be used to inform future policy decisions and clinical operations interventions to reduce and mitigate effects of ED boarding.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/haschl\/qxaf134","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T08:01:44Z","timestamp":1751443304000},"source":"Crossref","is-referenced-by-count":6,"title":["Workforce impact of emergency department boarding"],"prefix":"10.1093","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1638-8893","authenticated-orcid":false,"given":"Vicki","family":"Norton","sequence":"first","affiliation":[{"name":"Florida Atlantic University Charles E. Schmidt College of Medicine , Department of Emergency Medicine, Boca Raton, FL 33431 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8955-2060","authenticated-orcid":false,"given":"Kraftin E","family":"Schreyer","sequence":"additional","affiliation":[{"name":"Lewis Katz School of Medicine at Temple University , Department of Emergency Medicine, Philadelphia, PA 19140 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6908-034X","authenticated-orcid":false,"given":"Diane","family":"Kuhn","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine , Department of Emergency Medicine, Indianapolis, IN 46202 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,4]]},"reference":[{"key":"2026060610183938000_qxaf134-B1","author":"The Joint Commission"},{"key":"2026060610183938000_qxaf134-B2","author":"Centers for Disease Control and Prevention"},{"issue":"3","key":"2026060610183938000_qxaf134-B3","first-page":"557","article-title":"Emergency department crowding: the canary in the healthcare system","volume":"38","author":"Mazer-Amirshahi","year":"2020","journal-title":"Emerg Med Clin North Am"},{"issue":"6","key":"2026060610183938000_qxaf134-B4","first-page":"1","article-title":"Financial incentives and their impact on hospital capacity","volume":"2","author":"NEJM Catalyst","year":"2021","journal-title":"NEJM Catal Innov Care Deliv"},{"key":"2026060610183938000_qxaf134-B5","author":"US Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation"},{"key":"2026060610183938000_qxaf134-B6","author":"Statista"},{"issue":"4","key":"2026060610183938000_qxaf134-B7","first-page":"291","article-title":"The association between boarding and mortality in critically ill patients","volume":"22","author":"Viccellio","year":"2015","journal-title":"Am J Emerg Med"},{"issue":"2","key":"2026060610183938000_qxaf134-B8","first-page":"172","article-title":"The impact of emergency department crowding measures on time to antibiotics for patients with community-acquired pneumonia","volume":"19","author":"Pines","year":"2013","journal-title":"Acad Emerg Med"},{"key":"2026060610183938000_qxaf134-B9","doi-asserted-by":"publisher","first-page":"S0196-0644(24)01251-4","DOI":"10.1016\/j.annemergmed.2024.11.020","article-title":"Use of hallway beds, radiology studies, and patients in pain on arrival to the emergency department are associated with patient experience","volume":"24","author":"Kuhn","year":"2025","journal-title":"Ann Emerg Med"},{"issue":"4","key":"2026060610183938000_qxaf134-B10","doi-asserted-by":"publisher","first-page":"32","DOI":"10.12927\/hcq.2007.19312","article-title":"Frequency, determinants, and impact of overcrowding in emergency departments in Canada","volume":"10","author":"Bond","year":"2007","journal-title":"Healthc Q"},{"issue":"8","key":"2026060610183938000_qxaf134-B11","doi-asserted-by":"publisher","first-page":"e0203316","DOI":"10.1371\/journal.pone.0203316","article-title":"Prevalence and consequences of emergency physician burnout: a systematic review","volume":"13","author":"Ospina","year":"2018","journal-title":"PLoS One"},{"issue":"2","key":"2026060610183938000_qxaf134-B12","first-page":"12","article-title":"Violence against healthcare workers: a growing epidemic","volume":"49","author":"The Joint Commission","year":"2023","journal-title":"Jt Comm J Qual Patient Saf"},{"issue":"3","key":"2026060610183938000_qxaf134-B13","first-page":"176","article-title":"Workplace violence: a survey of emergency physicians in the state of Michigan","volume":"18","author":"Kowalenko","year":"2011","journal-title":"Am J Emerg Med"},{"key":"2026060610183938000_qxaf134-B14","author":"Whitehouse"},{"issue":"11","key":"2026060610183938000_qxaf134-B15","doi-asserted-by":"publisher","first-page":"965","DOI":"10.1056\/NEJMp2306904","article-title":"A doctrine in name only\u2014strengthening prohibitions against the corporate practice of medicine","volume":"389","author":"Zhu","year":"2023","journal-title":"N Engl J Med"},{"key":"2026060610183938000_qxaf134-B16"},{"key":"2026060610183938000_qxaf134-B17","article-title":"State lawmakers seek to revive bans on corporate control of medical providers","author":"Cumming","year":"27, 2025","journal-title":"Wall Street J"}],"container-title":["Health Affairs 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