The purpose of this chapter is to provide a roadmap to applying the Lean Six SigmaSix Sigma (LSS) methodology and the key tools that can be applied when implementing LSS in healthcare processes. This chapter was originally published in (Furterer, Lean Six Sigma in service: Applications and case studies, CRC Press, 2009) and adapted for the healthcare enterprise. A little over twenty-one percent (21.3%) of the industrial workforce is engaged in educational services and healthcare, and social assistance occupations (US Census Bureau). Service industries are the fastest growing segment of our economy and now account for almost 70% of economic activity, and over 85 million employees (US Census Bureau North American Product Classification). Healthcare processes include both clinical and nonclinical processes, and both types can be improved using LSS methodologies and tools.