In 2010, patient activity was on the rise for the Community Health Center of Buffalo, Inc. (CHCB) with the recent expansion of its general practice, dental and psychosocial services. Leaders were anticipating 2,000 extra patients each year over the following two years, resulting from a new facility acquisition in Niagara Falls, N.Y. Efforts were being focused on creating one operational system for both the addition and original Buffalo site. Administrators knew that assessing the organization to gain operational clarity, and utilizing the Lean Six Sigma methodology to achieve greater efficiency, would set them on the right path. They turned to UB TCIE to support their endeavor.