This book should really be read as a package with the author's companion book, Transforming Health Care, as both books center on the significant heath care management adjustment by the Virginia Mason Medical Center modeled after the production system used by the Japanese automobile manufacturer, Toyota. The first book concisely and rather dramatically points out the nitty-gritty of applying a management system working famously well in a manufacturing setting in Japan and applying it to heath care in America. This book follows up on the first book by concentrating on the leadership that choose, introduced, implemented, and has maintained that system for over a decade now. As someone who has been a patient at this medical facility for over 30 years, and married to a recently retired medical provider at the facility, I can vouch first hand for the transition the subject of this book addresses. Most, if not all people who read this book will be centered on the health care setting. What did it take to put the system into place? How has it been functioning? Is there something unique about Virginia Mason that makes the system less applicable or less successful for other medical centers? Are there inherent flaws in the system that will eventually lead to failure? In short, why should any other medical center buy into the concept? I don't need to ask can it work. I've seen it work. This medical center was well-respected before the transition, but it was being graded on the curve that applies only to those medical centers that don't know better. Look at this way. This production system is a bit like "Moneyball" was for major league baseball. Someone takes a significantly different approach to how they succeed in their line of business. Everyone else is doing things the old way. The new way succeeds over the old way and others buy into the new approach and a whole business transforms its management style. This is much the same for the health care production system highlighted in this book, with one very important difference. Unlike "Moneyball" which focuses on how the "managers" manage their team, this system goes well beyond that to how the organization -- the whole organization -- manages itself with strong, consistent, persistent guidance from its leaders. This comes through particularly clearly toward the end of this book. I mean there's a good reason the system is so comprehensive and self-sustaining. It has to be to work well with both automobiles and medical patients. Right? ( )