The purpose of this chapter is to introduce a holistic process by which TOC can be effectively used in Large Scale Healthcare Systems. By identifying and briefly explaining the TOC processes needed to perform facility/organization wide systemic analyses - Current Reality Tree (CRT) and Core Problem (CP) - through to the training of staff in the Thinking Processes (TP) of the Evaporating Cloud (EC), Negative Branch (NBr) and Ambitious Target (AT), this chapter outlines how TOC can bring clarity to seemingly complex, service oriented, systemic problems. Further definition of this process details why focus is necessary to make the most of the experience and intuition of people within the organization. The clarity and focus provided by these processes empowers participants to contribute to, and take ownership of, strategic and tactical solutions. This is accomplished by equipping them with the personal skills necessary to understand why changes need to be made, and how each participant can make effective contributions through improved communication and feedback processes to benefit patients and stakeholders alike.