Interviewing Dr. Guarisco on Improving E.D. Patient Flow


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You might recall that I interviewed Dr. Joe Guarisco for episode #160 of my podcast series, talking about operations improvement and emergency department patient flow.

I was invited by the American Academy of Emergency Medicine (AAEM) to interview Dr. Guarisco for a two-part series that goes much more in depth on queuing theory, split track flow, operational excellence, and other patient flow principles.

Learn more and see the links on their website to both parts of the podcast discussion.

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Mark Graban
Mark Graban is an internationally-recognized consultant, author, and professional speaker, and podcaster with experience in healthcare, manufacturing, and startups. Mark's new book is The Mistakes That Make Us: Cultivating a Culture of Learning and Innovation. He is also the author of Measures of Success: React Less, Lead Better, Improve More, the Shingo Award-winning books Lean Hospitals and Healthcare Kaizen, and the anthology Practicing Lean. Mark is also a Senior Advisor to the technology company KaiNexus.


  1. Thanks for this. Dr. Gaurisco has a great command of the subject. In addressing demand variation I’ve done my own studies that show variation in ED patient care needs of plus or minus 150% at the same time of day and day of week over a six month period.

    Another way I describe why the ED is such a difficult place is that it is inherently unstable because of transient bottlenecks that we purposefully introduce into the ED in the pursuit of “efficiency” for each resource.

    He also framed well his recommendation that we either reduce utilization, improve throughput, or increase resources.


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