title: What do emergency physicians in charge do? A qualitative observational study.
abstract: BACKGROUND
  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.
authors.affiliation: Engineering Design Centre, Cambridge University, Cambridge, England.
authors.forename: Ian
authors.initials: I
authors.lastname: Hosking
authors.affiliation: Cambridge University Hospitals Foundation Trust, Cambridge, England.
authors.forename: Adrian
authors.initials: A
authors.lastname: Boyle
authors.affiliation: Cambridge University Hospitals Foundation Trust, Cambridge, England.
authors.forename: Vazeer
authors.initials: V
authors.lastname: Ahmed
authors.affiliation: Engineering Design Centre, Cambridge University, Cambridge, England.
authors.forename: John
authors.initials: J
authors.lastname: Clarkson
mesh_terms: D003441:Crowding; D004636:Emergency Service, Hospital / Q000458:organization & administration; D004739:England; D006801:Humans; D010559:Personnel Management / Q000379:methods / Q000592:standards*; D008486:Physician Executives / Q000639:trends*; D011340:Problem Solving; D036301:Qualitative Research; D000078329:Workforce
keywords: Emergency department crowding; heuristics; management; overcrowding; patient flow; safety