Elective surgery is a surgery that is a planned, nonemergency surgery, that can be scheduled at the convenience of the patient or the physician. The surgical procedure may extend life or improve the quality of life. In the year 2000, there were over 40 million inpatient surgical procedures performed in the United States, and 31.5 ambulatory or outpatient surgeries in 1996, based on the National Center for Health StatisticsStatistics of the U.S. Centers for Disease Control CDC ( http://www.healthtools.com , 2012). Typically, a complete health history, physical examination, lab and diagnostic tests may be part of the preparation of the surgical patient prior to the elective surgery. Additionally, typing and screening of the patient’s blood is also performed prior to surgery ( http://www.healthtools.com , 2012). A percentage of the patients who receive the elective surgery, may already be a patient in the hospital, and this preparation for the surgery is performed under the guidance of the inpatient nurse. A patient that is not already in the hospital but has scheduled their elective surgery is considered an outpatient from the perspective of the surgical preparation, even though the patient may be admitted after the surgery. This case will describe how the LeanLean SixSix Sigma SigmaLean Six Sigma team at an acute care hospital improved the pre-screening process for surgical outpatients applying LeanLean tools, with the Six SigmaSix Sigma DMAICDefine, Measure, Analyse, Improve, Control (DMAIC) problem solving approach.