Ibrahim A, Ndeti K, Bur A, et al. - In this cohort study involving 210 patients, researchers ascertained if using Lean methodology improve operative efficiency for head and neck free flap reconstruction. Using Lean methodology, a single intervention, the free flap plan of the day, was created. Findings suggested an association of use of the plan of the day with a clinically meaningful reduction in operating room times. For head and neck free flap reconstruction, the free flap plan of the day can improve operating room efficiency.