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Dr Mandar Marathe

Air Traffic Control (ATC) Principles for Area Leads in the Emergency Department

📅 Thu 2 April 2026 at 22:36 BST

Mandar Marathe Mandar Marathe DOI: 10.64393/adt.57513.atc
📁 Medicine

The Emergency Department doesn’t have a staffing problem. It has a runway problem.

The Emergency Department is a busy place. For the senior doctor in charge, at any given moment, dozens of tasks compete for attention: patients to review, results to interpret, colleagues asking questions, decisions waiting to be made. But there is only one place where all of this work ultimately happens – your mind.

Like an airport with a single runway, the Emergency Department depends on how effectively that limited resource is managed. When access to the runway is controlled, the system flows. When it isn’t, delays, confusion, and errors follow.

I have created a framework of good practices – Air Traffic Control (ATC) Principles for Area Leads in the Emergency Department – where:

  • the airport and airspace controlled by the ATC is the Emergency Department’s clinical area,
  • the many different types of aircraft arriving and departing are the people in the clinical area,
  • the airport’s radar system is the Area Lead’s situational awareness,
  • access to the runway must be controlled through prioritisation,
  • the runway is the Area Lead’s cognitive processing ability, and
  • ground control is the Emergency Department’s team and environment.

To  help Area Leads, the framework also identifies common failure modes and cognitive hazards that degrade performance.

I’ve written the full framework in more detail — including practical strategies for prioritisation, managing interruptions, and avoiding common cognitive traps.

You can read it here:
👉 Air Traffic Control (ATC) Principles for Area Leads in the Emergency Department [Download PDF]

 

Mandar Marathe

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