Author name: Stevan Bruijns

I have been a qualified emergency physician since 2008 and was one of the first doctors to hold a degree in Emergency Medicine in South Africa. I am dual registered as a specialist in South Africa and the United Kingdom. My interests include quality improvement, as well as social equality and research access in African low-resourced settings. This has formed the basis of many service improvement projects I have led, notable designing the South African Triage Scale, work on research equity and work during the pandemic. More recently I've been involved in data translation, specifically in urgent an emergency care. I am a person of action and like for things I do to be useful to others. This is strongly reflected in my outputs. I have a strong sense of purpose that greatly influences my desire to improve the world around me. I have worked in both resource-rich and resource-poor settings. I have used this experience to shape my worldview which is best described in several of my blog posts. I am married and we have two children which we home school. We also have one cat and two very naughty chickens that like to raid the vegetable patch.

Sand ambulance

Self-Organised Criticality: Why your ED is like a Sand Pile

By /

Emergency departments (EDs) often seem to shift from calm to crisis in an instant. Why? This article explores ED crowding through the lens of complexity science and self-organised criticality, explaining how minor changes—like a few extra patients—can trigger disproportionate chaos. Using the sandpile analogy and concepts like power law distributions, we reveal why traditional linear models and static targets often fail to manage ED flow effectively. Instead, we offer a data-driven, systems-based approach: identifying tipping points, recognising early warning signs, and implementing proactive, anticipatory interventions. From real-time dashboards to weekly cycle planning and distributed decision-making, this article offers a practical guide for building resilience in emergency care. Learn how your ED can thrive in complexity, not just survive it.

Self-Organised Criticality: Why your ED is like a Sand Pile Read More

Do not fear AI, puny humans…

By /

AI language models, along with AI image and voice generation have arrived in much the same way as calculators did in the 1970s. @codingbrown @stemlyns asks an AI language model how it can help EM thrive and explains how AI will enter our workplaces, schools and homes no matter what policies are put in place to govern them. #FOAMed

Do not fear AI, puny humans… Read More

Scroll to Top