In 1998 Dr. Gary Kaplan, the CEO of Virginia Mason Medical Center in Seattle received some bad news about his hospital. It was losing money. So Dr. Kaplan started studying how other hospitals were being run to see if there was a better way to manage his hospital. He scoured the country, looking for a hospital with a management system worth adopting, but he never found one. Instead he ended up in Japan. At a Toyota factory. This entire, multiyear overhaul started with a ball of blue yarn. The staff met with a Toyota Production System sensei and he took out the ball of blue yarn and a map of the hospital and told the staff to trace the path a cancer patient would take on a typical visit for chemotherapy treatment. When they were finished, it was an immensely powerful visual experience for everyone in the room. They all stared at this map with blue yarn snaking all over the place, doubling back on itself and making complicated twists and turns from one end of the building to the other. They understood for the first time that they were taking their sickest patients, for whom time was their most precious resource, and they were wasting huge amounts of it. This story was produced by David Weinberg. David spoke with Charles Kenney, author of Transforming Healthcare and Dr. Henry Otero and Nurse Michele Wettland from Virginia Mason.