I obtained a copy of the complete paper and have the following observations:
1. The authors already knew the waiting times and LOS were long.
2. They developed a mathematical model based on patient surveys to prove what they already knew.
3. The waiting time data were based on “…a random sample of 96 patients…measured over two random months and shifts.” The LOS data were from “…a random sample of 67 patients…measured over two random months and shifts.” The method of randomization was not stated. The number of patients studied represents 0.075% of all patients seen per year in their ED.
4. There are complex tables and flow charts.
5. Verification that the process was improved was based solely on simulation, not actual performance.
6 The impact factor of the International Journal of Six Sigma and Competitive Advantage is just about zero.
7. Don’t look for this article in PubMed.
So, you might ask, why was this paper featured on Science Daily? This is important because a posting on Science Daily is read by far more people than those who read most journals. Most of the information posted on Science Daily is from press releases generated by the authors of papers or their institutions. When describing how to contribute material, Science Daily states "Please note that we cannot guarantee posting of all the releases we receive, since we try to select those which we think would be of most interest to our readers." Someone from Science Daily is choosing what to post and we don't know how or why.
An email, the only way to contact Science Daily, sent on 8/31/10 asking about this has yet to be answered.