If a problem occurs in a lean hospital's operating department, for example, management will put resources toward identifying where in the process the breakdown occurred and what can be done to improve it. "If an instrument is missing from the cart during a procedure, in a traditional hospital, someone would run and scramble to get the needed instrument and move on, leaving the exact same problem to occur the next day," says Mr. Graban. "In a lean hospital, you look for the root cause. You recognize there is a problem in the instrument sterilization process, and you put together a process improvement group to improve it."