Improving the performance of Canada’s health care system requires a deep exploration of value and the redesign of health care delivery processes. Otherwise, improved quality will continue to be tied to a need for added investment. “Lean,” based on the Toyota Production System, focuses on maximizing customer value through the elimination of “waste.” Its ultimate goal is to create a culture that empowers employees to eliminate waste through everyday problem solving. This philosophy, combined with a powerful methodology, supports process redesign and improvements in safety and quality. At the same time, it delivers health care at a lower cost while enhancing employee morale (or engagement).