Originally from Houston, I spent my healthcare career mostly in primary care outpatient facilities. Our team was fortunate to receive a grant from the Bureau of Primary Care (HRSA) that taught us how to redesign our clinic. Our cycle time dropped from 2 hours and 50 minutes (really!) to 45 minutes. This was an FQHC-like clinic with about 400 patient visits per day. Of course we completely changed the culture along the way, which spurred me to write my dissertation on organizational culture in healthcare. This book grew from that experience.