RT Journal Article SR Electronic T1 Why Lean doesn't work for everyone JF BMJ Quality & Safety JO BMJ Qual Saf FD BMJ Publishing Group Ltd SP 970 OP 973 DO 10.1136/bmjqs-2014-003248 VO 23 IS 12 A1 Gary S Kaplan A1 Sarah H Patterson A1 Joan M Ching A1 C Craig Blackmore YR 2014 UL http://qualitysafety.bmj.com/content/23/12/970.abstract 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.