It was 2:35 am on a Saturday morning. Wiki Lim, process specialist from the Process Innovation Centre (PIC) of Hippi Care Hospital (HCH), desperately doodling on her notepad for ideas to improve service delivery at HCH's Emergency Department (ED). HCH has committed to the public that its ED would meet the service quality criterion of serving 90% of A3 and A4 patients, non-emergency patients with moderate to mild symptoms, within 90 minutes of their arrival at the ED. The ED was not able to meet this performance goal and Dr. Edward Kim, the head of the ED at HCH, had approached the PIC team for help. Lim and her team would study the issues and provide possible solutions. The ED experienced demand surges on Sunday evenings and Mondays. On some days, the patients may experience long wait of two hours before seeing a doctor. In these situations, Dr. Edward Kim would request his off-duty colleagues to come and help out with surges-- but such requests were often made too late and with little success. Hence, he ended up extending his own shift to attend to the patients. On Mondays, Dr. Kim would often find himself totally exhausted from nearly 16 hours of working in the ED. He could plainly see that this way of operating was unsustainable. A solution was needed--and soon. Mr. Viz., the head of PIC and Lim's boss, was interested in exploring innovative ways to improve ED operations by making only minimal changes to the process. Lim would have to be creative.