Dr. Tibbles  is the director for Graduate Medical Education at Beth Israel Deaconess Medical Center and specializes in the implementation of lean practices in the ED and lean team training program development. She completed an emergency medicine residency at Hennepin County Medical Center in Minneapolis, Minnesota. As the director of clinical innovations, Dr. Tibbles has expertise in the application of lean principles in the emergency department. Lean methodology, based on the Toyota Production System, is a proven process improvement and management strategy focused on cutting costs by improving efficiency, eliminating waste, and streamlining and standardizing processes. Dr. Tibbles has also focused much of her career on risk management strategies and has led two multi-center projects designed to improve communication among providers in the emergency department. She currently works as a risk management consultant for CRICO/ Harvard Risk Management implementing education programs and risk mitigation strategies to address current trends in malpractice data. Dr. Tibbles has served as the associate residency director of the Harvard Affiliated Emergency Medicine Residency for 10 years and completed a fellowship in medical education before assuming her current position.