Healthcare networks are struggling to deliver proper care with low cost and high efficiency. Success experiences with Lean healthcare (LH) arouse the interest of a public Brazilian hospital that decided to start a LH implementation project. The strategy went through Kaizen. 91 opportunities were identified, and 66 Kaizen implemented in a three-month project. The opportunities are related to Organization of the environment, Process standardization, People, Structure, Communication, Bed turnover, Healthcare network, Layout, Information systems and Others with low frequency. Results show there is alignment between opportunities and improvements made. The implemented Kaizen were mostly type I, individual-oriented. Although, main issues are more complex themes that need to be addressed in with a dedication to investigation in a time frame greater that three month.