Sitting in his office in Saint Gabriel's Hospital, Dr. Monteagudo, the head of the hospital's pharmacy, was mulling over his possibilities for reducing spending: "It's the first week of February and the hospital's general manager has already given me an ultimatum. I have no clue how we are to free up resources and achieve the savings we'll need to adjust to the budget cuts that the Ministry of Health has made for 2011." Having to comply with draconian budgeting was not Dr. Monteagudo's only concern. He was also facing some operational challenges that required prompt action, such as the problem of the embarrassingly long lines at the hospital's pharmacy. The lines had been getting longer and more frequent for months and some outpatients had complained that they had had to wait for more than 45 minutes to pick up their medication. The issue was so evident that other department heads even made jokes while chatting over coffee: "Monteagudo, what's going on at your pharmacy? Are you selling soccer tickets?" Monteagudo and his team had tried everything they could to cut back on the workload at the pharmacy in hopes of alleviating the problem. Specifically, some months back they had increased the amounts of medication they dispensed to outpatients at each visit. ("That means they won't have to come back as often."). Though at first it seemed to solve the problem, it also had some serious collateral implications: "It's true that our outpatients are visiting us fewer times per year, which makes the lines shorter. But we also need to consider the amount of drugs that patients will have to throw away at home if their treatment plans change or come to an end in between their visits to the hospital pharmacy."