To achieve flow in healthcare so that patients receive just the care they need, just-in-time (JIT), the author must first create standard work. Standard work stabilizes operations, increases reliability, and begins to make processes predictable. Standard processes are the foundation for high-quality, safe, JIT care for patients and JIT delivery of medicines, test information, meals, and supplies. Most clinical processes contain so much waste that JIT cannot function until standards are set and improvements are made. Poor standardization of workflows gives rise to three types of waste: overproduction, overprocessing and defects. Standard work is the best way the organization knows right now to serve the patient JIT, with the right service. Standard work has five parts: standard task, standard work sequence, standard cycle time, standard patients in process, and standard documentation. Poor process layout is another symptom of poor standardization, and it gives rise to its own set of problems.