 The United States healthcare system today faces many tough challenges. Among the toughest is consistently delivering high-quality patient care with waning human and financial resources. Despite government efforts to improve quality of care, the state of U.S. healthcare has remained much the same for over a decade. Hundreds of thousands of patients continue to die every year from preventable medical errors. So where should the journey to improved healthcare begin? A recent study suggests that the top of the hospital management chain is a good place to start. Research shows that one of the factors that most strongly affects quality of healthcare is the behaviour of managers. While some studies have looked at the effects of leadership and employee motivation in general, few have focused on the traits of individual managers. In the current study, therefore, researchers surveyed CEOs and other employees or followers to understand how hospital managers are perceived by those around them and how they perceive themselves. To determine whether certain traits set top-level hospitals apart, the researchers surveyed employees from three different tiers of hospitals, low-performing hospitals, high-performing hospitals, and hospitals adopted in a management style called LEAN. Increasingly popular among healthcare facilities, LEAN is a business philosophy that aims to maximise customer value while minimising work and costs. The only differences the researchers found were between the responses of followers from low-performing and LEAN management hospitals. According to the responses, there are four traits that set managers of LEAN hospitals apart from managers of low-performing hospitals. Delivering results and creating a learning environment for employees, taking action when things don't go according to plan, developing as a manager through on-the-job training and making decisions by analysing data and gathering first-hand information. Although further research is required to validate their findings, the researchers suggest that hospitals could potentially boost the quality of care they deliver by adopting LEAN management practices. But they were careful to note that the transformation into a LEAN organisation doesn't happen overnight. The journey toward reducing medical errors, increasing patient capacity and saving on costs can be long and often involves a complete change in management culture.