ArticleBMC emergency medicine2026
Initiatives to reduce ambulance offload delays in emergency departments: a scoping review.
Article in BMC emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmergency departments (EDs) globally are experiencing increased pressure from crowding and ambulance offload delays (AODs), exacerbated by high hospital occupancy rates and insufficient bed capacity. Despite the significance of AODs, limited research exists on interventions to target such delays. This scoping review aims to identify evidence-based interventions to mitigate AODs and seeks to pinpoint gaps in existing literature, with a particular focus on the effectiveness of ED-based initiatives.
methodsGuided by the Joanna Briggs Institute methodology for scoping reviews, a systematic search was conducted across MEDLINE, AMED, Embase Classic+, Emcare, and CINAHL including articles to April 2025. All articles were screened in Covidence©. The inclusion criteria focused on initiatives within the ED setting, excluding studies on ambulance diversion, infrastructure changes and effective handover.
resultsSixteen articles were identified with interventions spanning the ED input, throughput, output concept. Some strategies showed potential in reducing both AODs and ED crowding, while others demonstrated effectiveness in only one of these outcomes. Ambulance offload zones were shown to reduce AODs, four-hour key performance standards reduced ED crowding, and early clinician assessment reduced both AODs and ED crowding.
conclusionBy mapping existing interventions and highlighting knowledge gaps, this scoping review provides a comprehensive overview of strategies to mitigate AODs. Front-loading patient care through multi-interventional methods can reduce AODs. The identified interventions hold promise, however, ongoing innovation, evaluation and exploration of system-wide approaches and advancements in healthcare technology are necessary to enhance ED efficiency. Future research should prioritise systemwide initiatives and the potential of emerging technologies to offer scalable solutions for AODs.
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Registered trials
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