What makes a service clinically led?
8 min read
Clinically led is a phrase we use loosely. When a patient becomes a breach, then a percentage, do decisions follow the numbers or the patient?
Ghost jams and the seams between the Model UEC papers
9 min read
Why can delays persist even when individual parts of an urgent and emergency care pathway work well? Stevan Bruijns examines the gaps between emergency care, acute care and discharge, and the often unrecognised work of bed and site managers who connect them.
The limits of holding on to realism and hope alone
10 min read
How do emergency clinicians hold on to hope while acknowledging the reality of a struggling system? Stevan Bruijns reflects on the Stockdale paradox, moral injury and the colleagues who help us endure, while keeping responsibility for working conditions with the organisation.
Emergency Department Management
The three-body problem and ED clinical staffing
9 min read
Why is it so difficult to build an emergency department rota that meets weekend demand? Stevan Bruijns explores full-time and part-time staffing, the separation of substantive, locum and longer-term costs, and what a more complete workforce business case should consider.
Emergency Department Management
How many patients should we see per hour?
5 min read
Clinician productivity depends on the conditions in which teams work. This article challenges the use of patients-per-hour targets in isolation and explores how space, staffing, diagnostics and crowding should shape the conversation about emergency department performance.
Emergency Department Management
Explaining Emergency Department Crowding Using a Cognitive Bridge
10 min read
Emergency Department crowding is hard to explain to non-clinical audiences. A cognitive bridge is a three-step tool to help others understand.
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Trauma Team Leader Tips
Practical perspectives on trauma care and team leadership.
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