This book reveals and describes the leadership and culture change required to remove waste from healthcare processes and eliminate the root cause of soaring costs, poor quality and safety, and limited access. The book’s delivery strategy revolves around personal and organizational stories and case studies told by physician and administrative leaders, all students of the Toyota Production System. This revised edition uniquely blends updated case studies with practical theory to describe how the healthcare value proposition can be changed by reducing waste, variation and complexity in healthcare. New to the book are chapters on clinical standard work and integration of lean and safety.