The United States ranks among the worst of industrialized countries for indicators of health such as infant mortality and life expectancy,1 despite spending $2 trillion annually on health care,2 more than any other nation per capita. However, higher health care spending does not correlate with higher quality of care or better patient outcomes.3-5 These sobering indicators suggest that an opportunity exists to close the value gap in the day-to-day delivery of health care by eliminating actions that impede optimal systematic performance, which result in less than perfect outcomes, extra work, or corrective work, otherwise described as waste.