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The practice of lean production has been documented in detail by production and operations management specialists world-wide [B. B. Flynn, S. Sakakibara, R. G. Schroeder, K. A. Bates and E. J. Flynn, Empirical research methods in operations management, Journal of Operations Management 9(2) (1990) 250–284]. Theoretically, on the other hand, there has been little research that define and quantify what it means to be a lean manufacturer. A typological definition of what it means to be lean has in part been resolved by a model initially developed by Shah and Ward [Defining and developing measures of lean production, Journal of Operations Management 25(4) (2007) 785–805]. This definition was used to determine the underlying concepts of lean production in small to medium size manufacturers (SMMs). While most of the factors found in the Shah and Ward [Defining and developing measures of lean production, Journal of Operations Management 25(4) (2007) 785–805] study remained valid, the model developed for SMMs displayed some new factors.