This book deals with a hospital’s struggle to secure and maintain financial stability. In the story, the leadership team of a fictional hospital adopts the tools and principles associated with the Toyota Production System or Lean. The story takes the reader through leadership’s arduous journey from rejecting the methodology to embracing it, to successful implementation. This book is important because many of our nation’s hospitals are besieged with financial difficulties with declining reimbursement and the public is losing confidence in our hospital’s ability to provide quality care without error. Lean can provide relief from these issues but only if it is properly implemented.