Stroke (CVA) or TIANCT07532564
Risk Factors, Costs, and Impacts of ED Boarding
An observational study of Stroke (CVA) or TIA and Diabetes, run by University of Maryland, Baltimore at 1 site in United States.
Trial summary
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. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Stroke (CVA) or TIA, Diabetes, Asthma (Diagnosis)
- How many people
- 30,486 participants
- Where
- 1 siteUnited States
- Study dates
- 1 Jan 2022to 31 Dec 2025
- Phase
- Observational
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
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)
Who may be able to join
- adults (> 18 years old) presenting to UMMS system hospitals ED
- Patients hospitalized by inpatient or observation status over study period (2022-2025)
- Admitted to a service that directly manages boarding patient in the ED. At UMMC, patient should be admitted to an internal medicine team Med 1-4, Med 6, Med 5, med/surg/tele level (no IMC/ICU) and neurology floor level.
Who cannot join
- Patients admitted to cardiology, cancer center, surgical services
- Patients admitted to not floor level status (IMC/ICU)
Trial locations and contacts
1 site in 1 country.
United States1 site
University of Maryland Medical Center
Baltimore, Maryland, 21201
About this study
Official title: 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:
Read more
- What characteristics of patients make them more likely to experience ED boarding?
- What is the impact of ED boarding on costs of health care?
- 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.
- Conditions
- Stroke (CVA) or TIA, Diabetes, Asthma (Diagnosis), COPD (Chronic Obstructive Pulmonary Disease), Sepsis, Hypertension
- Keywords
- emergency department boarding, health care costs, emergency department operations, health services research
- Medical subject headings
- Stroke, Diabetes Mellitus, Asthma, Disease, Pulmonary Disease, Chronic Obstructive, Sepsis, Hypertension, Heart Failure
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| 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 being measured
The primary outcome is the main question the study is designed to answer.
Boarding Time
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
Measured: During enrollment hospital encounter, up to 300 days
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted16 Apr 2026
- Study start1 Jan 2022
- Primary completion31 Dec 2025
- Study completion31 Dec 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (18)Papers the sponsor has linked to this study.
- Other trials for Stroke (CVA) or TIAStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Cross-sectional
- Enrolment
- 30,486 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Maryland, Baltimore
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Daniel Gingold, University of Maryland, Baltimore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07532564
- Sponsor's protocol ID
- HP-00112665
- Status last verified
- May 2026
- First submitted
- 9 Apr 2026
- Last updated
- 17 Jun 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Risk of violating HIPAA and patient privacy without patient consent.
Publications
Ren A, Golden B, Alt F, Wasil E, Bjarnadottir M, Hirshon JM, Pimentel L. Impact of Global Budget Revenue Policy on Emergency Department Efficiency in the State of Maryland. West J Emerg Med. 2019 Oct 14;20(6):885-892. doi: 10.5811/westjem.2019.8.43201.
PubMed 31738715Morley C, Unwin M, Peterson GM, Stankovich J, Kinsman L. Emergency department crowding: A systematic review of causes, consequences and solutions. PLoS One. 2018 Aug 30;13(8):e0203316. doi: 10.1371/journal.pone.0203316. eCollection 2018.
PubMed 30161242Bernstein SL, Verghese V, Leung W, Lunney AT, Perez I. Development and validation of a new index to measure emergency department crowding. Acad Emerg Med. 2003 Sep;10(9):938-42. doi: 10.1111/j.1553-2712.2003.tb00647.x.
PubMed 12957975Weiss SJ, Derlet R, Arndahl J, Ernst AA, Richards J, Fernandez-Frackelton M, Schwab R, Stair TO, Vicellio P, Levy D, Brautigan M, Johnson A, Nick TG. Estimating the degree of emergency department overcrowding in academic medical centers: results of the National ED Overcrowding Study (NEDOCS). Acad Emerg Med. 2004 Jan;11(1):38-50. doi: 10.1197/j.aem.2003.07.017.
PubMed 14709427Roberts RR, Frutos PW, Ciavarella GG, Gussow LM, Mensah EK, Kampe LM, Straus HE, Joseph G, Rydman RJ. Distribution of variable vs fixed costs of hospital care. JAMA. 1999 Feb 17;281(7):644-9. doi: 10.1001/jama.281.7.644.
PubMed 10029127Schreyer KE, Martin R. The Economics of an Admissions Holding Unit. West J Emerg Med. 2017 Jun;18(4):553-558. doi: 10.5811/westjem.2017.4.32740. Epub 2017 May 1.
PubMed 28611873Canellas MM, Jewell M, Edwards JL, Olivier D, Jun-O'Connell AH, Reznek MA. Measurement of Cost of Boarding in the Emergency Department Using Time-Driven Activity-Based Costing. Ann Emerg Med. 2024 Oct;84(4):376-385. doi: 10.1016/j.annemergmed.2024.04.012. Epub 2024 May 24.
PubMed 38795079Canellas MM, Kotkowski KA, Michael SS, Reznek MA. Financial Implications of Boarding: A Call for Research. West J Emerg Med. 2021 Apr 9;22(3):736-738. doi: 10.5811/westjem.2021.1.49527. No abstract available.
PubMed 34125054Mitka M. Economics may play role in crowding, boarding in emergency departments. JAMA. 2008 Dec 17;300(23):2714-5. doi: 10.1001/jama.2008.753. No abstract available.
PubMed 19088342Stryckman B, Kuhn D, Gingold DB, Fischer KR, Gatz JD, Schenkel SM, Browne BJ. Balancing Efficiency and Access: Discouraging Emergency Department Boarding in a Global Budget System. West J Emerg Med. 2021 Sep 2;22(5):1196-1201. doi: 10.5811/westjem.2021.5.51889.
PubMed 34546898Sun BC, Hsia RY, Weiss RE, Zingmond D, Liang LJ, Han W, McCreath H, Asch SM. Effect of emergency department crowding on outcomes of admitted patients. Ann Emerg Med. 2013 Jun;61(6):605-611.e6. doi: 10.1016/j.annemergmed.2012.10.026. Epub 2012 Dec 6.
PubMed 23218508Gaieski DF, Agarwal AK, Mikkelsen ME, Drumheller B, Cham Sante S, Shofer FS, Goyal M, Pines JM. The impact of ED crowding on early interventions and mortality in patients with severe sepsis. Am J Emerg Med. 2017 Jul;35(7):953-960. doi: 10.1016/j.ajem.2017.01.061. Epub 2017 Jan 31.
PubMed 28233644Lauque D, Khalemsky A, Boudi Z, Ostlundh L, Xu C, Alsabri M, Onyeji C, Cellini J, Intas G, Soni KD, Junhasavasdikul D, Cabello JJT, Rathlev NK, Liu SW, Camargo CA Jr, Slagman A, Christ M, Singer AJ, Houze-Cerfon CH, Aburawi EH, Tazarourte K, Kurland L, Levy PD, Paxton JH, Tsilimingras D, Kumar VA, Schwartz DG, Lang E, Bates DW, Savioli G, Grossman SA, Bellou A. Length-of-Stay in the Emergency Department and In-Hospital Mortality: A Systematic Review and Meta-Analysis. J Clin Med. 2022 Dec 21;12(1):32. doi: 10.3390/jcm12010032.
PubMed 36614835Singer AJ, Thode HC Jr, Viccellio P, Pines JM. The association between length of emergency department boarding and mortality. Acad Emerg Med. 2011 Dec;18(12):1324-9. doi: 10.1111/j.1553-2712.2011.01236.x.
PubMed 22168198Boudi Z, Lauque D, Alsabri M, Ostlundh L, Oneyji C, Khalemsky A, Lojo Rial C, W Liu S, A Camargo C Jr, Aburawi E, Moeckel M, Slagman A, Christ M, Singer A, Tazarourte K, Rathlev NK, A Grossman S, Bellou A. Association between boarding in the emergency department and in-hospital mortality: A systematic review. PLoS One. 2020 Apr 15;15(4):e0231253. doi: 10.1371/journal.pone.0231253. eCollection 2020.
PubMed 32294111