what is ambulance ramping

Ambulance ramping refers to the situation when paramedics and ambulance crews are forced to wait outside overcrowded hospital emergency departments because they cannot promptly transfer patients into the hospital. This occurs when there is no available clinical space or bed in the emergency department to offload the patient, leading to delays beyond the intended time frame, typically 30 minutes. It is a symptom of systemic healthcare access block and emergency department overcrowding. Ambulance ramping has serious consequences such as delayed patient care, reduced ambulance availability for new emergencies, longer ambulance response times, and in severe cases, can contribute to preventable deaths. It is often driven by hospital capacity shortages, particularly lack of inpatient beds, a high volume of emergency presentations, and systemic issues in patient flow within the hospital system. The term is also known as delayed transfer of care, offload delay, or ambulance queuing. Addressing ambulance ramping requires broad healthcare system reforms focused on improving hospital inpatient capacity, emergency department workflow, and community-based care services to reduce pressure on hospitals.