Arcadia Medical Center's newly appointed medical director of operations for the department of emergency medicine has noticed a gradual increase in the length of time it take for patients to be seen and their care completed. He frequently examines patients who are waiting in their stretchers in hallways in an effort to expedite patient care. It is becoming increasingly difficult to maneuver through the overcrowded emergency department to perform routine patient care activities. Having considered how to improve the crowding issue, the medical director of operations has created a team to analyze the situation and make recommendations to implement change.

In this B case, the emergency department crowding team analyzes and summarizes the data presented in the A case and then proceeds to collect qualitative data on 15 different issues known to cause delays in the emergency department treatment area. As the team members interpret the data, they wonder how to best present it to their other colleagues and how to pick the top two or three areas to focus their improvement initiatives on. They also wonder what further analysis is needed to ensure that their process improvement efforts are headed in the right direction.