The key to this book comes in its subtitle: "Golfing buddies go beyond lean Six Sigma and the Balanced Scorecard," as the structure of the book (paced like a novel) revolves around the work and play experiences of four operations-type executives who work out their frustrations with their jobs (and, presumably, their lives) on the golf course. This could quite possibly be the first "lean" book that tells you as much about how to hit out of a sand trap as it does about performance metrics.
The book owes an obvious (and acknowledged) debt to Goldratt's The Goal, which was one of the first manufacturing management books constructed as a novel rather than as typical nonfiction. While Goldratt and his co-author, Jeff Cox, used the conceits of storytelling to their advantage (mostly; the marital problems of the main character were a bit over the top), Breyfogle could probably have dispensed with the golf game entirely and still had a readable primer on the tenets of integrated enterprise excellence. It's difficult to imagine four golfing buddies stopping play in the middle of a game to exhaustively analyze the merits of a Six Sigma DMAIC roadmap (Define, Measure, Analyze, Improve, Control), a conversation that would take at least a half-hour in real-time. At the very least, the book should have included some scenes where disgruntled golfers ask to play through.
At any rate, the meat of the book comes in the charts scattered throughout the text, as well as in the appendix, which offers no-nonsense tips on starting and sustaining a Six Sigma initiative (e.g., "What magnitude of resources/dollars should be committed for the first three years of a Six Sigma initiative?"). While Breyfogle's credentials to write a lean/Six Sigma book are solid (two decades at IBM, numerous books and articles published, etc.), his bio neglects to tell us what his golfing handicap is. In a book all about performance metrics, that number is curiously missing.