PT - JOURNAL ARTICLE AU - Gary S Kaplan AU - Sarah H Patterson AU - Joan M Ching AU - C Craig Blackmore TI - Why Lean doesn't work for everyone AID - 10.1136/bmjqs-2014-003248 DP - 2014 Dec 01 TA - BMJ Quality & Safety PG - 970--973 VI - 23 IP - 12 4099 - http://qualitysafety.bmj.com/content/23/12/970.short 4100 - http://qualitysafety.bmj.com/content/23/12/970.full SO - BMJ Qual Saf2014 Dec 01; 23 AB - Popularisation of Lean in healthcare has led to emphasis on Lean quality improvement tools in isolation, with inconsistent results. We argue that delivery of safer, more efficient, and higher quality-patient focused care requires organisational transformation of which the Lean toolkit is only one component. To successfully facilitate system transformation toward higher quality care at lower cost, Lean tools must be part of a comprehensive management system, within a supportive institutional culture, and with committed leadership.