This paper emerged from a study of change in a major teaching hospital subsequent to the introduction of casemix-based funding--a management tool designed to support the development of industrial practices in hospital management. A clinical unit had been advised to become more financially efficient. The unit staff redefined the task as becoming more clinically effective, as well as more efficient. One of the important themes to emerge was the importance of time. The resultant changes in the provision of care reflected a sophisticated approach to time.