Desired improvements in the delivery of quality healthcare drive healthcare managers toward lean technologies. Sustaining efficiencies gained from lean-associated process reengineering requires managers to address human factors in lean implementation. Drawing from the existing research literature, the authors identified three human factors essential to successful lean implementation: communication, leadership, and workload. Using case-study and qualitative methods, the authors identified relevant key concepts from each construct. To account for variation among organizations' behavior and explain the interaction between the sociotechnical factors, they used concepts from complexity theory, other case studies, and semi-structured interviews with two healthcare managers responsible for process improvement. They found that elements of communication, leadership, and workload are interactive, interrelated, and dynamic. Managers of successful lean implementations have well-developed shared vision and implementation plans that are adaptive to workforce stress arising from management's drive toward the efficient delivery of healthcare. Leaders using timely two-way communication through organizational hierarchy and across departments find successful implementations of their initiatives. The consolidation of literature and interpretation of interactions between communication, leadership, and workload through triangulation and cross-case evaluation has potential to provide realistic and relevant information to managers working toward a successful lean implementation in their healthcare facility.