Emergency department (ED) crowding is a widespread issue that causes a multitude of negative effects on patient care quality, safety, and efficiency. Lean-based systems engineering, which is often used for industrial manufacturing, is a method for eliminating all forms of waste (including wasted time and other resources) to optimize productivity. Recent studies have begun to demonstrate the use of systems engineering and improvement science on streamlining processes and improving throughput in different medical capacities, but an opportunity remains to refine the application of these tools within EDs in particular.