This thesis outlines the development of a standard methodology for performing a time and motion study in a lean healthcare environment. Time and motion studies have been used in healthcare environments in the past, however they have nearly all been exclusive to a particular healthcare enterprise. To develop the time and motion study methodology, a study was designed to examine how resident doctors spend their time. This study was performed in response to coming changes in the work hours for all residents. Once the methodology was developed, trial observations were conducted. The data from these observations was analyzed to determine the effectiveness of both the time and motion study methodology and its usefulness for process improvement activities.