Book excerpt: This book gives healthcare leaders a practical guide to implementing the 4 key components of lean daily management system - 1. LDM boards; 2. Leadership rounds 3. Leader daily disciplines and 4. Lean projects. Although lean is not new to healthcare, effective LDM is just now taking hold with the best lean healthcare organizations in the U.S. and Canada. Leaders are realizing that sustaining their lean projects over time has proven to be a challenge without first addressing the organizations management system/model. LDM gives leaders a straightforward approach to do just that as well as improve their ability to spread and deploy lean to other areas of the organization and tie back to strategy.