At the author’s hospital, perioperative services perform approximately 7,000 surgical procedures annually with 10% of the cases each year delayed or cancelled because of missing, mislabeled, or defective central sterile services instruments. Delays have the potential to negatively impact patient safety and operating room efficiency. The author and colleagues implemented the lean process, where the target state focused on eliminating cancellations or delays of operating room cases due to missing, mislabeled, or defective central sterile supply instruments. The results showed that when applied to a health care organization, lean principles can have a dramatic effect on improving processes and outcomes, reducing cost and cycle times, and increasing patient and staff satisfaction.