Boarding of pediatric psychiatric patients is a no-fly zone for value.

Evolving concepts about the interwoven nature of physical and mental health have slowly, but incompletely, chipped away at the “reductionistic anachronism of mind/body dualism”1 that has historically separated them. The article, “Impact of Boarding Pediatric Psychiatric Patients on a Medical Ward,” in this edition of Hospital Pediatrics, however, highlights a series of challenges in which a patient’s body occupies a medical bed, but the mind is not getting the therapy it needs. The authors describe how psychiatric patients boarding on a medical fl oor receive little of the care they need while incurring high costs. Psychiatric boarding, which delays treatment when patients are most vulnerable, directly compromises all domains of quality (including safety, effectiveness, effi ciency, timeliness, patientcenteredness, and equity) and is far from the high-value care we seek to deliver.