Emergency Department (ED) overcrowding has become an important problem in North American hospitals.1"3 A national survey identified the prolonged length of stay of admitted patients in the ED as the most frequent reason for overcrowding.4 This complex problem occurs when hospital inpatient census increases and prevents admitted patients from being assigned and transported to hospital beds in a timely manner.5 The practice of holding admitted patients in the ED, known as "boarding," is typically denned as the length of stay (LOS) in ED beginning 2 hours after the time of admission to the time of transfer to the wards.
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