Purpose The purpose of this paper is to improve the mammography and ultrasound screening processes to increase the healthcare system quality and patients' pleasantness while decreasing costs. Design/methodology/approach The data storage system is very insufficient so that data are collected from hospital staff and by personal observations. A lean management tool, value stream mapping is used to see the general view of the radiology department with its problems at a glance. Data and the map are used as a guide to conduct a quality house to make a prioritization between the problems, to decide which one to solve first, of patients at the hospital. Findings Problems of the radiology department related to mammography and ultrasound and suggestions to these problems according to the quality house conducted. Originality/value The paper consequently focuses on the value creation process and on how to revisit managing for quality in the systems perspective.