Building modern healthcare programs and systems caring for populations requires expert skills in strategy, finance, people operations, workflow, evaluation, and more. Build often connotes adding services and people, but it also includes the concept of subtraction. Give any nurse leader a community health needs assessment, and an organization will likely get a list of additional services or programs that could meet those needs. Maybe the community rightly needs the additional programs and people. Maybe it does not. Maybe it needs someone identifying and eliminating the nonvalue pieces—the waste—in the current programs and services to improve work and care for others, adding value.