We are examining the workflow processes within a large, urban general internal medicine practice in order to understand task inefficiencies that can lead to medical errors. We are performing a time-motion study looking at task management of check-in, check-out clerks, nurses, nurse's aides and physicians. Our pilot data suggests that there is significant variability in the task burden at different times of the day due to several factors, including patient-show rates, time allotted to late arrivals, multi-tasking by check-in clerks and inefficient intra-clinic communication processes. Our initial data suggests that a streamlined check-in process, more effective communication strategies and better time-task utilization can improve patient flows in this clinic.