In the late 1990s, treatment-related deaths or ''complications'' were the fifth leading cause of death for Americans. Yet healthcare practitioners decried attempts to standardize treatment. ''We're working with people, not cars,'' they said. The result: an epidemic of preventable mistakes in a medical landscape where patients wait for hours in ''emergency'' rooms, fill out the same paperwork at each visit, and increasingly run the risk of being dosed with the wrong medication or having the wrong limb amputated. These problems spurred a group of dedicated physicians like Paul Batalden and Don Berwick to study the concepts of ''quality improvement'' used at Toyota and NASA, and to dare to apply them to the practice of medicine. This book tells their story, and how these ''heretical'' ideas have blossomed into a movement, bringing the focus back to where it should have always been: the patient.