Through this exemplar, we have shown that strong leadership is needed to build a culture of Lean within an organization. This has previously been reported by Wood.11 Engaging frontline staff and developing individual responsibility through the use of daily huddles, visibility walls, and Gemba walks provide the constant engagement that is necessary to ensure that continual improvement processes are forthright in the mind of clinical staff. In a Lean organization, the everyday goal is to attempt to provide ever-increasing value to patients through the provision of patient care that is efficient and of high quality.