Adams Strategy Group (ASG) conducted a 28-point operational excellence system and strategy assessment for South Shore Health System. Using interviews with the key system leaders, ASG did an initial evaluation for the system components in use and the current strategic directions. Based on this data, ASG designed a survey instrument used with a study group comprised of executive and director level leaders, line leaders, and internal continuous improvement staff. ASG then analyzed the questionnaire for gaps and designed a set of interview questions for the survey group. ASG conducted face-to-face interviews to round out the analysis. ASG also spent time observing artifacts of continuous improvement. Based on these data, ASG created a comprehensive report that included both short term and long range recommendations. ASG subdivided the recommendations into those that the internal teams could execute and those requiring external help.