A scoping review on scheduling models in emergency departments: factors influencing design and intended outcomes

This scoping review maps the existing literature on scheduling models in emergency departments, with a specific focus on two domains: the factors that influence how scheduling models are designed, and the outcomes those models are intended to achieve. Emergency departments globally face persistent capacity-demand mismatches. Crowding, delayed care, staff burnout, and workforce attrition are well-documented consequences. Scheduling models are a primary lever for managing these mismatches, yet most scheduling decisions in resource-limited settings are driven by fiscal constraints and historical precedent rather than evidence. In South Africa specifically, current scheduling models in district-level emergency departments are based on anecdotal and eminence-based approaches with no formal link to defined outcomes or contextually appropriate benchmarks. This review uses the Arksey and O'Malley framework, refined by JBI guidelines, and reports according to PRISMA-ScR. Five databases are searched (MEDLINE via PubMed; CINAHL, Africa-Wide Information, and EconLit via EBSCOhost; and EMBASE via Scopus), supplemented by a targeted grey literature search of seven professional organisational websites and a national expert consultation with provincial emergency medicine clinical leads across all nine South African provinces. Three expected outputs: a descriptive map of the literature by study design, geography, and clinical context; a content analysis of input variables and intended outcomes organised using an inductively derived framework; and an identification of knowledge gaps, with particular attention to resource-limited and LMIC settings. This review is Phase 1 of a four-phase PhD project. Findings will directly inform subsequent studies involving group model building, nominal group technique, and implementation framework development for district-level emergency departments in South Africa.