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This study investigated the impact of LEAN methodologies on door-to-needle (DTN) times in acute stroke centers. Data from 44 centers in the American Heart Association’s Get with the Guidelines registry were analyzed, comparing 23 LEAN-utilizing centers with 21 non-LEAN centers. Independent sample t tests revealed that centers employing LEAN achieved significantly better mean DTN percentages (90.61%) compared to those not using LEAN (78.95%), t(32.37) = 1.98, p = .028, with a moderate effect size (g = 0.611). While post hoc chi-square analyses of ranked data were nonsignificant, the findings suggested that LEAN methodologies are associated with improved timely delivery of thrombolytic medication for acute stroke patients, potentially leading to better outcomes. Further research with larger samples is warranted.