| About the Authors | p. vii |
| Acknowledgments | p. x |
| Introduction: Why the ED Matters | p. xiii |
| Why Improvement is Necessary | p. xv |
| A Quest for Excellence | p. xix |
| A Design for Operational Excellence | p. 1 |
| Key Components | p. 1 |
| Make a Plan and Stick to it | p. 11 |
| Optimizing High-Quality Care | p. 14 |
| Leadership | p. 17 |
| Persuading the High Cs | p. 17 |
| What is Leadership? | p. 19 |
| What Leadership isn't | p. 32 |
| The Effective Healthcare Improvement Leader | p. 34 |
| Developing a Shared Governance Model | p. 41 |
| Carrying Through: A Seminar is Never Enough | p. 46 |
| Fielding Your Best Team | p. 49 |
| Hire Right: A Team Vs. B Team | p. 50 |
| A Critical Step: Hiring the Medical Director | p. 53 |
| The Rest of the Team | p. 62 |
| Teamwork Attributes, Tools, and Techniques | p. 62 |
| Improving Patient Flow | p. 69 |
| Matching Demand with Capacity | p. 71 |
| Shaping Demand | p. 75 |
| Constraints and Variations in the System | p. 78 |
| Teaming Up for Better Flow | p. 83 |
| Tools for Smoothing Flow | p. 84 |
| The ED is not an Island | p. 92 |
| Flow in the ED: A Final Look | p. 96 |
| Ensuring Patient Satisfaction | p. 105 |
| The Cost of Dissatisfied Patients | p. 107 |
| Improving Patient Satisfaction | p. 112 |
| Techniques to Satisfy Your Patients | p. 115 |
| It Takes a Team | p. 125 |
| Implementing the Plan | p. 135 |
| Where they go Wrong | p. 135 |
| Project Management 101 | p. 136 |
| Reaching the Goal | p. 141 |
| Methods and Pacing | p. 144 |
| Pointers for the Journey | p. 149 |
| Culture and Change Management | p. 157 |
| Breaking Free of Gravity | p. 158 |
| How to Change a Culture | p. 161 |
| Owning Part of the Team | p. 165 |
| Envisioning the Future | p. 167 |
| Cementing the Changes | p. 168 |
| Patient Safety and Risk Reduction | p. 171 |
| Perfection Vs. Improvement | p. 172 |
| A Systematic Approach | p. 175 |
| Reducing Errors and Preventing Harm | p. 178 |
| The Role and Necessity of the Dashboard | p. 191 |
| Where to Start | p. 192 |
| Clinician Dashboard Metrics | p. 197 |
| Summary | p. 198 |
| Physician Compensation: Productivity-Based Systems | p. 203 |
| Role in the ED | p. 205 |
| Heading Off Potential Roadblocks | p. 207 |
| Billing, Coding, and Collections | p. 213 |
| Capturing Missed Revenue | p. 215 |
| Cash on the Line | p. 220 |
| The Business Case | p. 223 |
| Building the Business Case | p. 224 |
| Operational Quality and Effectiveness | p. 228 |
| Customer Satisfaction | p. 232 |
| Sound Financial Management | p. 233 |
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