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Urology Lean work reduced new patient clinic access time (119 to 21 days) and Bacillus Calmette-Guérin (BCG) in clinic treatment time (180 to 105 min). The average proportion of urology on-time surgeries was better than the overall surgery on-time surgeries (71% v 61%). CONCLUSIONS Urology Lean work successfully applied DMS in a service specific yet holistic approach. Urology Lean work improved resident engagement in quality and safety endeavors and served as a DMS model throughout perioperative and clinic areas. In the United States, fir