Radnor and Walley (2008) and others have identified a high failure rate in NHS lean rapid improvement events. This paper explores one reason why these failures occur: from the perspective of information processing (Galbraith, 1974), it explores the difficulties facing lean healthcare projects. Using qualitative method (pre-understanding and interviews) with analysis triangulating between data, general theory and sense-making we investigate two lean projects currently running at a Scottish hospital to identity how the absence of adequate information affects the projects. We find that the projects are critically hampered by the absence of project-level, inter-unit level and organisational level information. The practical implications of our research are to suggest that before embarking upon lean projects, hospital leaderships should explore the adequacy and integratedness of their information systems, decision-taking structures and inter-unit coordination mechanisms.