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What do emergency physicians in charge do? A qualitative observational study

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Boyle, A 
Ahmed, V 

Abstract

INTRODUCTION: The emergency physician in charge role has developed in many large EDs to assist with patient flow. We aimed to describe and classify the problem-solving actions that this role requires. METHODS: We interviewed senior emergency physicians and performed iterative, qualitative observations, using continuous reflective inquiry, in a single centre. We reviewed and classified these approaches by consensus. RESULTS: Nine different problem-solving approaches were identified. These are deflecting, front loading, placing, plucking, flooding, targeting, chasing, guiding and juggling. These are useful for training and developing our understanding of how to manage an ED. CONCLUSIONS: Emergency physicians in charge have a number of problem-solving approaches that can be readily defined. We have described and categorised these. These results are potentially useful for developing decision support software.

Description

Keywords

crowding, management, emergency department management, safety, heuristics, patient flow, overcrowding

Journal Title

Emergency Medicine Journal

Conference Name

Journal ISSN

1472-0205
1472-0213

Volume Title

Publisher

BMJ Publishing Group
Sponsorship
Engineering and Physical Sciences Research Council (EP/M000273/1)
This work was funded by Cambridge University Health Partners and Cambridge University Hospitals Foundation Trust. The research was also part funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care East of England (CLAHRC EoE) at Cambridge and Peterborough NHS Foundation Trust. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.