Approaching Process Improvement.

Process improvement begins with the process view: understanding patient care from the patient's point of view. Organizations must also clearly articulate for themselves how they define operational excellence so that the tradeoffs taken in process improvement can be clearly made. Constructing a process map allows application of powerful analytical tools, such as Little's law, which in turn uncovers targets for process improvement from the patient's point of view.

Resident Supervision and Patient Care: A Comparative Time Study in a Community-Academic Versus a Community Emergency Department.

Objective: The objective was to compare attending emergency physician (EP) time spent on direct and indirect patient care activities in emergency departments (EDs) with and without emergency medicine (EM) residents.

Methods: We performed an observational, time-motion study on 25 EPs who worked in a community-academic ED and a nonacademic community ED. Two observations of each EP were performed at each site.