Using Lean methods, the entire process for measuring the documentation of obesity treatment plans, from the identification of obesity to the production of the metric, was mapped out. After waste in the process was identified, root cause analysis was performed. Countermeasures were then developed and tested to eliminate waste in the process, and a new process was created. This was used to create standard work documents for training and reference. This paper will show how Lean quality improvement methods can be used in healthcare to improve pediatrician performance on a quality metric tracking development of plans for addressing obesity in children at well-child checks