This article discusses how one hospital identified patient flow delays in its PACU By using lean methods focused on eliminating waste, the team was able to improve patient flow. Lean thinking required the team to keep issues that were important to patients at top of mind. The improvements not only saved staff time, but they also helped the department prepare for the addition of six beds by focusing on methods to eliminate delays. The team, assigned by the vice president of surgical services, included a process engineer two decision support analysts, the PACU charge nurse, the nursing manager and ad hoc department nurses. The team recommended and implemented changes to improve operational effectiveness.