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number of dimensions and are useful in showing precedence, parallel processes and thepassage of time (Langley, 1999).Enterprises embarking on process analysis need to strike a balance between quantitative andqualitative techniques in their approach. Moreover, they must choose to what extent theprocess analysis will be “bottom-up” and “top-down”. Badiru et al. (1993) suggested thatunderlying processes must be improved bottom-up. Others, such as Henriksen and Myrbostad(2004) emphasised the importance of both leadership and employee involvement, suggestingthat a combination of the two approaches may be appropriate in health care organisations andthat it is necessary to evaluate to what extent one should focus on either in each specific case.Badiru et al.’s (1993) approach seems somewhat categorical, yet employee involvement isclearly important, as is leadership involvement. However, it is possible to have a committedand involved leadership even when resorting to a bottom-up approach. It seems both topdownand bottom-up approaches may be suitable for process analysis purposes in health care.METHODOLOGYThis study is a case study based on trailing research (Finne et al. 1995). In the terminology ofYin (2003), this is a single case study. Separate sets of research material have been used,particularly a combination of personal qualitative experience and quantitative decisionsupport information. The most important information sources are:Project documentation and quantitative informationParticipating observation during the process analysisParticipating observation was carried out during the process analysis, as two of the authorswere involved as facilitators. Being involved as facilitators provided insight to thepreparations, execution and the following use of results. The combined role as facilitator andresearcher of the same phenomenon has strengths and weaknesses. The authors’ involvementwas separated in time, which provides an opportunity to reflect on each other’s experiences,without the bias of direct personal involvement.As facilitators for process analysis, the authors had access to a wide range of documentation,including presentations and minutes of meetings, formal reports, data that provided input toprognoses, aggregated decision support data and other types of supporting information. Allthis information was stored in a database, primarily to support the facilitation of processanalysis. The database has also served as a reference database during the research, enablingthe researchers to validate later claims against documentation from each phase of the processanalysis. Such an approach was particularly important as personal experiences may be subjectto judgmental subjectivity.