"The book opens with an overview of the state of emergency medicine. This is an important foundation that will help us to understanding the current mess we're in and how to become a learning organization, a community of scientists. This introduction is followed by an in-depth presentation of the tools used in Lean healthcare, queuing theory, basic and advanced flow concepts, and the theory of constraints. We consider these critical building blocks that frame the way we look at ED operations, and we will use this as our basis for ongoing improvement. This academic framework will be followed by a walk-through analysis of best practices in emergency medicine, what they are, and why they work. These will be presented in a flow-based manner with the three commonly referenced intervals in the ED: door to doc (input), doc to disposition (throughput), disposition to departure (output). Finally, we will cover what we feel is the most important element of ED operations: change management. We will present a framework to approach changing one of the most complex and immovable cultures that exists-- medicine. Within this framework, we will discuss change management, leadership, dealing with resistance, and other critical elements of operational improvement, along with five case studies that show how your peers have applied these principles to transform their EDs. Throughout the book, we will provide many examples of the academia applied in the real world, just to show you that this is not just a book. It is a how-to guide that works. We know many readers either will think they know all of the academic material or may simply want to skip ahead to the "beef" of the book"--Provided by publisher.