In 2001, Virginia Mason Medical Center was searching for a new management method that could help us achieve our vision to be the quality leader in health care. Through a chance meeting, a Virginia Mason executive began chatting with a Boeing executive about the Toyota Production System. The two discussed how Toyota's system of creating a product without defects and the concept of kaizen, or continuous improvement, could be adapted to the world of health care. And so began our journey. Soon our leadership team was actively researching the Toyota Production System and planning a trip to Japan to learn more. Seven years and several trips later, foreign words such as muda (waste) and poka-yoke (mistake-proofing) are now part of our everyday language. Our gastroenterology department was one of the first departments to benefit from the continuous improvement concepts using what has became known as the Virginia Mason Production System. The results have included dramatic improvements in GI procedure volumes. Here's how we did it.