Book excerpt: Healthcare in the United States is in need of reform. The industry must learn to operate in a fundamentally different way if there is any hope of delivering safer, more reliable, higher quality care with improved patient and staff experience-and accomplish all of this at the lowest possible cost. Advanced Lean in Healthcare is a practical guide for anyone in the healthcare industry. The book presents a novel approach to creating an advanced operating system, breaking it down into simple-to-understand steps. Borrowing from a business system with its roots in manufacturing, Advanced Lean in Healthcare narrates a healthcare industry operational problem through the experience of a patient: a young boy ravaged by terminal illness. By putting a real-world lens on the situation, the book takes the reader through five levels of the increasingly advanced steps of a lean transformation, giving them a bird's-eye view of the required operational and management shifts. By introducing lean strategies one-by-one, the authors provide an easy-to-understand plan for providing higher quality care, improved patient and staff experience, and significant cost savings for healthcare organizations. At its core, lean is a business strategy that aims to increase customer satisfaction and improve staff and corporate productivity by reducing the amount of non-value added work (waste). By engaging everyone in an organization in problem solving to reduce waste, the efficiency and quality of patient care can be optimized. In addition, engaging the entire workforce produces harder-to-quantify results, such as improved morale and greater organizational capability for future problem solving and growth. Advanced Lean in Healthcare introduces the various terms and methodologies of lean and compares them side-by-side with more traditional methods, demonstrating how the five level operating system stacks up against the status quo. In addition, a multitude of colored graphs, photographs, and lists are used to demonstrate and augment the detailed text. By providing specific examples of what works and what doesn't work, the authors make the transformation to a lean system an attainable goal for any organization that is truly committed to change and continuous improvement. The five levels are divided into ten chapters, each building on its predecessor, to provide a clear framework from beginning to end, which healthcare organizations can adapt to their own needs. The end result is a framework that is accessible by anyone in the healthcare industry-including physicians, nurses, technicians, managers, and executives-to create a true transformational shift in their daily operations, making their organization run better, more efficiently, and more affordably, all while maintaining the highest standard of quality and service.