Many people visit Seattle to learn the methods of the Virginia Mason Production System. When health care professionals travel to Seattle in search of knowledge, they invariably ask Virginia Mason teams: How did you do this? How have you progressed so far on quality, safety, access, efficiency, finances, and affordability? This book is an effort to answer those questions. Focusing on the immense importance of governance in the Virginia Mason story as well as a new initiative concerning respect for people, this book presents key lessons in improvement from the world leader in applying Lean methods and tools in health care.