The lean approach is an idealizing improvement approach that has an enormous impact in the field of operations management. It started in the automotive industry and has since been widely applied in discrete manufacturing. However, extensions to the (semi-) process industry have been much slower....

This paper, using detailed time measurements of patients complemented by interviews with hospital management and staff, examines three facets of an emergency room's (ER) operational performance: (1) effectiveness of the triage system in rationing patient treatment; (2) factors influencing ER's...