Purpose: To implement Toyota Production System (TPS) lean tools and techniques in the Department of Radiation Oncology to maximize the individual productivity, process efficiency, deliver high level of quality and safe patient treatments. Methods: To continuously and relentlessly improve the performance of individuals and processes to an acceptable level of operation we have categorized the departmental operations into safety, quality, deliverability, cost and morale. We had issues with all aspects of the radiation therapy process that affect the quality and deliverability of treatment to our patients. To address these areas we adopted TPS lean principles and tools with existing resources such as gemba walk, visual controls and daily huddle where therapists, dosimeterists, physicists and physicians participate towards the lean management of the processes until the requested resources are available. These issues are addressed with clear communication through simple tools and with individuals in the department. To make this process and progress transparent, we have placed a huddle boards consisting of daily update of issues, actions needed to address the issues, and progress in safety, quality, deliverability, cost and morale, and effects of these progressions to the department. Results: With the implementation of simple, direct and effective TPS lean techniques in the department and hard stop policy of postponing IMRT patients not ready by the noon of the day before the first treatment, the work flow has become more streamlined and has helped in timely start of the patient treatments. With the availability of an assigned physicist to answer questions during the clinical hours, physicians, dosimeterists, and therapists concerns were also addressed in timely and orderly fashion and boosted the morale among the departmentConclusion: TPS lean techniques have been effective in decreasing the patient delays while increasing quality and safety to the patients with same cost and improved staff morale.