A LEAN Healthcare System is an organization of healing professionals whose Patient Care, Service Delivery and Operational Processes are waste free1. The people in a LEAN Healthcare System think, act, solve problems, plan and manage differently than people in any other organization. They understand and apply LEAN tools and analysis methods toward eliminating waste and nonvalue added work on a daily basis. LEAN Systems were pioneered by Henry Ford beginning in 1908 and later expanded by Toyota beginning in the 1950's. The goal of a LEAN System is the error-free and uninterrupted flow of Patients and value-add services2. Achieving flow requires perfecting the performance of each process and using resources more effectively than organizations who do not yet understand "LEAN". Building a LEAN System is a never-ending process requiring great courage by its leaders and practitioners3. There are no spectators in a LEAN System; everyone has a responsibility4. Any focus on Departmental performance is replaced by a focus on "value stream" or system performance5. LEAN Systems are measured and managed on an hour-by-hour basis since one of the key indicators of performance in a LEAN System is Time6. As LEAN Systems are implemented throughout the organization, Safety, Quality, Operating Costs, Timeliness of Care Systems and Patient and Staff Satisfaction7 approach world-class levels of performance.