This course is intended for pathologists, pathologists in-training and laboratory managers/ administrators. We present the principles originally systematized as the basis of lean manufacturing by our founder, Henry Ford at the turn of the century, and more recently incorporating the successful innovations of the Toyota Production System that underlie the continuous quality management method popularly referred to as Lean. We share the leadership, management and worker requirements for effective implementation and illustrate our experiences with reducing waste and rework in the broad spectrum of Surgical Pathology processes. We also present novel data collection techniques to establish baseline states of in-process waste and defects and methods to gauge the success of changes from rapid process improvements. We conclude with lessons derived from culturally transforming the surgical pathology laboratory at Henry Ford Hospital to one where empowered staff view the workplace as an opportunity to do the work better in pursuit of a ‘zero defect’ performance goal. Upon completion of this course, the participant will be able to: 1) Describe and implement effective process improvements based on manufacturing based production principles; 2) Adopt unique measurement tools to identify and analyze defective processes in surgical pathology laboratories; 3) Select leadership and organizational structures for successful transformation to a continuously learning, evolving and improving workforce culture. Pre-registrants will be provided access to recommended readings prior to the course. A syllabus will be distributed at the course, and a CD will be mailed to registrants after the meeting. This course may be used for CME credits or SAM’s credits.