“People often equate “Lean” with the tools that are used to create efficiencies and standardize processes. However, implementing tools represents at most 20 percent of the effort in Lean transformations. The other 80 percent of the effort is expended on changing leaders’ practices and behaviors, and ultimately their mindset. Senior management has an essential role in establishing conditions that enable that 80 percent of the effort to succeed. Their involvement includes establishing governance arrangements that cross divisional boundaries, supporting a thorough, long-term vision of the organization’s value-producing processes, and holding everyone accountable for meeting Lean commitments. This is accomplished through regular, direct involvement. When upper management sets the example, durable Lean success and an increasingly Lean leadership mindset follow.”

David Mann, The Missing Link: Lean Leadership.  Article in “Frontiers of Health Services Management” 26:1  p. 15.