Value Based Health Care, deciding together – these are terms that are high on the Dutch health care policy agenda in 2018 and that guide the decisions of health care managers and health care professionals. However, health care and the health care organization will have to be reinvented in order to give real substance to these concepts. Our journey documents the search of Maastricht University Medical Center for more value for their patients, in other words for Operational Excellence in which the hospital can make the connection between value based health care, care pathways and new systems of work.Maastricht University Medical Center+ is known both nationally and internationally for its focus on prevention and taking an integrated approach to health care: from prevention, promotion of good health, and basic care, to top-level clinical diagnostics and treatment. Patient safety is our top priority in all of our endeavours. Maastricht UMC+ has 715 beds and approximately 7,500 employees and 5,000 students. Maastricht UMC+ is part of The Netherlands Federation of University Medical Centers.