Author: David Jones / Editor: Charlotte Davies / Codes: / Published: 14/07/2026
One of the biggest challenges with the EPIC role is that it can feel unstructured and personality-dependent. One way to make the role more consistent is to use a simple framework that covers the entire shift.
This is not a guide to doing the role perfectly – no one does that. These are simply practical strategies that help maintain oversight, flow, and safety during an EPIC shift.
A structure I created that works for me is the acronym: SO SOLID
This is a simple way to remember the key components of the EPIC role across the whole shift.
S Start properly (4 Ss)
Start your shift by building situational awareness:
- Safety huddle Check in with Nurse in Charge and outgoing EPIC.
- Staffing Understand staffing levels and skill mix.
- Space and flow Identify ED space and ask about flow on to inpatient wards.
- Stroll Walk the floor, see every area, introduce yourself as EPIC.
If you do this properly, you will understand the department within the first 30 minutes.
O Overview (During the Shift)
The biggest mindset shift as EPIC is this:
Your job is not to see patients your job is to see the department
This includes:
- Monitoring flow
- Identifying risks early
- Moving staff to pressure areas
- Watching waiting times
- Actively managing and staggering resident doctor breaks
- Think in 60 minute time horizons
A key part of the overview is break management. Good break management during the day sets the evening and night teams up for success.
On twilights be cautious about multiple breaks occurring during the early evening period (typically 2000-2200) when staff fatigue peaks and working pace naturally slows. It may seem counterintuitive not to send people on break when they are tired, but when EVERYONE is tired, everyone is needed on the floor supporting each other to reduce the risk of error.
S SitRep (End of Shift)
Before handover, prepare a short written SitRep (in addition to the board round) for the incoming EPIC:
- Total number of patients in ED
- Overall waiting time
- Breakdown of numbers and waits by area (waiting room, majors, paeds)
- Staffing/sickness for the next shift
This allows the next EPIC to plan the shift proactively rather than spending the first hour trying to establish situational awareness.
O OVaRMS (Escalation Communication)
When communicating with senior hospital management, use a structured format:
- Occupancy Referred inpatients occupying ED cubicles.
- Vacancies Available cubicles and resus spaces.
- Risks Main operational or clinical concerns.
- Mitigation Actions taken.
- Summary Overall department picture including team factors like morale.
Senior decision-makers do not need every detail they need a clear picture of risk, capacity, and what support is required.
LID Leavers IntroDuction (End of Shift Walk Round)
Before leaving the shift:
- Walk the floor again.
- Thank staff in each area.
- Let them know you are leaving.
- Clearly identify who the new EPIC is.
This is a small thing, but it improves communication, morale, and clarity, and it closes the loop on the shift properly.
Final Thought
The EPIC is not there to be the busiest clinician in the department.
The EPIC is there to protect flow, protect staff, and protect patients.
If you remember nothing else, remember this:
SO SOLID
S Start properly (4 Ss)
O maintain Overview (during shift)
S SitRep (end of shift)
O OVaRMS (escalation)
LID Leavers IntroDuction
Structure creates calm departments. Calm departments are safer departments.
This blog reflects the personal operational practice and experience of the author working as EPIC in a busy Emergency Department.