Initiatives to reduce ambulance offload delays in emergency departments: a scoping review

Background: Emergency 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. Methods: Guided 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.