This book supplies proven concepts and examples to guide radiation oncology centers towards achieving patient safety and quality goals. It portrays the authors’ efforts at the University of North Carolina to address the challenge of keeping patients safe while continuously improving care delivery processes. Requiring no prior knowledge of high reliability and value creation, the book begins by introducing the basic concepts, methods, and tools that underlie the authors’ approach to high reliability and value creation. Part two provides an in-depth account of their journey to high reliability and value creation.