A Rural Hospital Takes on Lean

&NA; The Federal government has initiated an executive order to address quality measurements and incentives promoting quality and efficiency. Healthcare organizations are using Toyota Production System's Lean continuous quality improvement to provide a framework for this. Though large healthcare organizations have the resources to embrace Lean, few rural hospitals have been known to use Lean's process improvement philosophy. This paper discusses the journey a 99‐bed rural hospital took to integrate Lean into its organization and the outcome.