Introducing lean thinking in an organization must be a whole-system strategy.  Those at the very top of the organization must lead it. It requires significant change management throughout an entire organization, which can be traumatic and difficult. Strong commitment and inspiring leadership from senior leaders is essential to the success of an effort this challenging. One of the challenges of implementing lean in healthcare is that it requires people to identify waste in the work in which they are so invested. All workers want to feel their work is valuable, perhaps most especially healthcare workers. Recognizing that much about their daily tasks is wasteful and does not add value can be difficult for healthcare professionals.