Dr Stevan Bruijns 🏥🚑🤕🌍🏳️🌈
@codingbrown.bsky.social
PhD, UK A&E consultant (CESR), AfJEM past chief editor, NHSE South West & CQC UEC clinical advisor.
Strong views on: autonomy, mastery & belonging.
Views in posts are my own.
Strong views on: autonomy, mastery & belonging.
Views in posts are my own.
How about this: Become the self you’d be proud to be. Hang out with people and ideas that help you become that self. Act like that self every chance you get.
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(2/2)
March 31, 2025 at 10:32 AM
How about this: Become the self you’d be proud to be. Hang out with people and ideas that help you become that self. Act like that self every chance you get.
(2/2)
(2/2)
𝗕𝗲 𝘆𝗼𝘂𝗿𝘀𝗲𝗹𝗳
by Seth Godin
Which self?
The self you were when you were two years old, almost out of diapers?
The self you were when you were screaming with the fans at the big game?
The self you were after a long night?
(1/2)
by Seth Godin
Which self?
The self you were when you were two years old, almost out of diapers?
The self you were when you were screaming with the fans at the big game?
The self you were after a long night?
(1/2)
March 31, 2025 at 10:32 AM
𝗕𝗲 𝘆𝗼𝘂𝗿𝘀𝗲𝗹𝗳
by Seth Godin
Which self?
The self you were when you were two years old, almost out of diapers?
The self you were when you were screaming with the fans at the big game?
The self you were after a long night?
(1/2)
by Seth Godin
Which self?
The self you were when you were two years old, almost out of diapers?
The self you were when you were screaming with the fans at the big game?
The self you were after a long night?
(1/2)
February 28, 2025 at 10:44 AM
𝗧𝗵𝗲 𝗹𝗼𝗻𝗲𝗹𝘆 𝘂𝗻𝗶𝗰𝗼𝗿𝗻
... 𝘧𝘳𝘰𝘮 𝘚𝘦𝘵𝘩 𝘎𝘰𝘥𝘪𝘯
If there’s at least one unicorn in the world, it’s likely not the only one.
And if one can make a valid English word from seven Scrabble tiles, it’s likely that more than one word can be found.
1/3
... 𝘧𝘳𝘰𝘮 𝘚𝘦𝘵𝘩 𝘎𝘰𝘥𝘪𝘯
If there’s at least one unicorn in the world, it’s likely not the only one.
And if one can make a valid English word from seven Scrabble tiles, it’s likely that more than one word can be found.
1/3
February 28, 2025 at 10:37 AM
𝗧𝗵𝗲 𝗹𝗼𝗻𝗲𝗹𝘆 𝘂𝗻𝗶𝗰𝗼𝗿𝗻
... 𝘧𝘳𝘰𝘮 𝘚𝘦𝘵𝘩 𝘎𝘰𝘥𝘪𝘯
If there’s at least one unicorn in the world, it’s likely not the only one.
And if one can make a valid English word from seven Scrabble tiles, it’s likely that more than one word can be found.
1/3
... 𝘧𝘳𝘰𝘮 𝘚𝘦𝘵𝘩 𝘎𝘰𝘥𝘪𝘯
If there’s at least one unicorn in the world, it’s likely not the only one.
And if one can make a valid English word from seven Scrabble tiles, it’s likely that more than one word can be found.
1/3
February 6, 2025 at 6:37 AM
⭐NHSE planning guidance published 30 January⭐
Much of investment to improve flow through ED to be targeted outside ED.
Have a read and post your thoughts.
🏥🚑🚑🚑 🚑...
#Medsky #EMedsky #EMsky
🔗https://www.england.nhs.uk/long-read/2025-26-priorities-and-operational-planning-guidance/
Much of investment to improve flow through ED to be targeted outside ED.
Have a read and post your thoughts.
🏥🚑🚑🚑 🚑...
#Medsky #EMedsky #EMsky
🔗https://www.england.nhs.uk/long-read/2025-26-priorities-and-operational-planning-guidance/
January 31, 2025 at 7:27 AM
Mitigating the harm from delayed initial A&E assessment when ambulances cannot offload...
🏥🫸 🚑🚑🚑 🚑... 🚑...
A thread
.../1
🏥🫸 🚑🚑🚑 🚑... 🚑...
A thread
.../1
December 20, 2024 at 7:17 AM
Mitigating the harm from delayed initial A&E assessment when ambulances cannot offload...
🏥🫸 🚑🚑🚑 🚑... 🚑...
A thread
.../1
🏥🫸 🚑🚑🚑 🚑... 🚑...
A thread
.../1
The Arrival by Shaun Tan weaves a beautiful, thought-provoking, human perspective on belonging.
It teaches that our personal journeys are big but unseen, and it is how we treat each other that defines us.
It is the perfect gift for reflection for this festive season.
www.shauntan.net/arrival-book
It teaches that our personal journeys are big but unseen, and it is how we treat each other that defines us.
It is the perfect gift for reflection for this festive season.
www.shauntan.net/arrival-book
December 4, 2024 at 8:30 AM
The Arrival by Shaun Tan weaves a beautiful, thought-provoking, human perspective on belonging.
It teaches that our personal journeys are big but unseen, and it is how we treat each other that defines us.
It is the perfect gift for reflection for this festive season.
www.shauntan.net/arrival-book
It teaches that our personal journeys are big but unseen, and it is how we treat each other that defines us.
It is the perfect gift for reflection for this festive season.
www.shauntan.net/arrival-book
The challenge with weekend discharges is probably closely linked to the state of the hospital's staff car park on a Friday afternoon.
🚗... 🚙... 🏥 🚑🚑🚑 🚑...
#MedSky
🚗... 🚙... 🏥 🚑🚑🚑 🚑...
#MedSky
November 8, 2024 at 6:19 PM
The challenge with weekend discharges is probably closely linked to the state of the hospital's staff car park on a Friday afternoon.
🚗... 🚙... 🏥 🚑🚑🚑 🚑...
#MedSky
🚗... 🚙... 🏥 🚑🚑🚑 🚑...
#MedSky
Missing clinical voices in urgent and emergency care
🫥🩺
Clinicians are one of the three core groups necessary to lead change in healthcare. The others are nurses and managers. Each brings a particular perspective to the leadership table that is important for balance.
🩺+😷+🧑💼=⚖️
.../1
🫥🩺
Clinicians are one of the three core groups necessary to lead change in healthcare. The others are nurses and managers. Each brings a particular perspective to the leadership table that is important for balance.
🩺+😷+🧑💼=⚖️
.../1
November 6, 2024 at 7:30 PM
Missing clinical voices in urgent and emergency care
🫥🩺
Clinicians are one of the three core groups necessary to lead change in healthcare. The others are nurses and managers. Each brings a particular perspective to the leadership table that is important for balance.
🩺+😷+🧑💼=⚖️
.../1
🫥🩺
Clinicians are one of the three core groups necessary to lead change in healthcare. The others are nurses and managers. Each brings a particular perspective to the leadership table that is important for balance.
🩺+😷+🧑💼=⚖️
.../1
🏥🚑🚑🚑🚑😎
The harm from delay in urgent and emergency care is largely invisible.
📅 This is because the true effect is only seen after 30 days. Specifically:
.../1
The harm from delay in urgent and emergency care is largely invisible.
📅 This is because the true effect is only seen after 30 days. Specifically:
.../1
September 2, 2024 at 9:47 AM
🏥🚑🚑🚑🚑😎
The harm from delay in urgent and emergency care is largely invisible.
📅 This is because the true effect is only seen after 30 days. Specifically:
.../1
The harm from delay in urgent and emergency care is largely invisible.
📅 This is because the true effect is only seen after 30 days. Specifically:
.../1
A&E's two workflows explained:
👆👇
You'll struggle to work out A&E flow if you don't separate it into these two workflows...
.../1
👆👇
You'll struggle to work out A&E flow if you don't separate it into these two workflows...
.../1
August 31, 2024 at 2:28 PM
A&E's two workflows explained:
👆👇
You'll struggle to work out A&E flow if you don't separate it into these two workflows...
.../1
👆👇
You'll struggle to work out A&E flow if you don't separate it into these two workflows...
.../1
🏥
Perhaps they can offload in Acute Assessment Units (AAUs)
🩺
Although design guidance is less clear about AAU turnover, the Society for Acute Medicine, recons around 12 hours is reasonable.
Sadly we've seen the same decrease in turnover on AAUs.
.../3
Perhaps they can offload in Acute Assessment Units (AAUs)
🩺
Although design guidance is less clear about AAU turnover, the Society for Acute Medicine, recons around 12 hours is reasonable.
Sadly we've seen the same decrease in turnover on AAUs.
.../3
August 22, 2024 at 7:25 AM
🏥
Perhaps they can offload in Acute Assessment Units (AAUs)
🩺
Although design guidance is less clear about AAU turnover, the Society for Acute Medicine, recons around 12 hours is reasonable.
Sadly we've seen the same decrease in turnover on AAUs.
.../3
Perhaps they can offload in Acute Assessment Units (AAUs)
🩺
Although design guidance is less clear about AAU turnover, the Society for Acute Medicine, recons around 12 hours is reasonable.
Sadly we've seen the same decrease in turnover on AAUs.
.../3
A quick 🧵 on why 🚑s get stuck at 🏥s
TLDR: too little 🤏 Majors & Resus (M&R) capacity.
💉
M&R space is set through national design guidance. It is roughly calculated using attendances, priority and a 2-3 hour M&R turnover.
It is your main designated bedded/ monitored space in A&E.
.../1
TLDR: too little 🤏 Majors & Resus (M&R) capacity.
💉
M&R space is set through national design guidance. It is roughly calculated using attendances, priority and a 2-3 hour M&R turnover.
It is your main designated bedded/ monitored space in A&E.
.../1
August 22, 2024 at 7:23 AM
A quick 🧵 on why 🚑s get stuck at 🏥s
TLDR: too little 🤏 Majors & Resus (M&R) capacity.
💉
M&R space is set through national design guidance. It is roughly calculated using attendances, priority and a 2-3 hour M&R turnover.
It is your main designated bedded/ monitored space in A&E.
.../1
TLDR: too little 🤏 Majors & Resus (M&R) capacity.
💉
M&R space is set through national design guidance. It is roughly calculated using attendances, priority and a 2-3 hour M&R turnover.
It is your main designated bedded/ monitored space in A&E.
.../1
Fascinating article, with plenty of application in healthcare (UEC in my perspective).
🏥 🚑 🔢
Where Data-Driven Decision-Making Can Go Wrong - Michael Luca and Amy Edmondson
hbr.org/2024/09/wher...
🏥 🚑 🔢
Where Data-Driven Decision-Making Can Go Wrong - Michael Luca and Amy Edmondson
hbr.org/2024/09/wher...
August 20, 2024 at 3:26 PM
Fascinating article, with plenty of application in healthcare (UEC in my perspective).
🏥 🚑 🔢
Where Data-Driven Decision-Making Can Go Wrong - Michael Luca and Amy Edmondson
hbr.org/2024/09/wher...
🏥 🚑 🔢
Where Data-Driven Decision-Making Can Go Wrong - Michael Luca and Amy Edmondson
hbr.org/2024/09/wher...
Risking our lives in the river Stour 😯🥽🌊
August 18, 2024 at 4:52 PM
Risking our lives in the river Stour 😯🥽🌊
Remember:
🚑 Ambulances ramp in front of A&Es.
🏥 Admitted caseload board in corridors and A&E majors and resus spaces.
👉 Neither has much to do with emergency medicine's productivity in A&E.
2/2
🚑 Ambulances ramp in front of A&Es.
🏥 Admitted caseload board in corridors and A&E majors and resus spaces.
👉 Neither has much to do with emergency medicine's productivity in A&E.
2/2
August 18, 2024 at 4:27 AM
Remember:
🚑 Ambulances ramp in front of A&Es.
🏥 Admitted caseload board in corridors and A&E majors and resus spaces.
👉 Neither has much to do with emergency medicine's productivity in A&E.
2/2
🚑 Ambulances ramp in front of A&Es.
🏥 Admitted caseload board in corridors and A&E majors and resus spaces.
👉 Neither has much to do with emergency medicine's productivity in A&E.
2/2
Productivity is most meaningfully assessed *across* the whole UEC pathway.
🏁
The operational default is to start by measuring productivity in A&E. And then get stuck there as productivity usually appears lower than expected. There is a reason for that, and that reason lies largely outside A&E.
1/2
🏁
The operational default is to start by measuring productivity in A&E. And then get stuck there as productivity usually appears lower than expected. There is a reason for that, and that reason lies largely outside A&E.
1/2
August 18, 2024 at 4:25 AM
Productivity is most meaningfully assessed *across* the whole UEC pathway.
🏁
The operational default is to start by measuring productivity in A&E. And then get stuck there as productivity usually appears lower than expected. There is a reason for that, and that reason lies largely outside A&E.
1/2
🏁
The operational default is to start by measuring productivity in A&E. And then get stuck there as productivity usually appears lower than expected. There is a reason for that, and that reason lies largely outside A&E.
1/2