By 2015, Saskatchewan's surgical wait times, once among Canada's longest, were arguably the nation's shortest. This paper highlights the principal strategies that were implemented to address the exceptionally lengthy surgical wait times in Saskatchewan's SHR. These included the province's funding the establishment of a fair operating room allocation system, a centralized provincial surgery registry, integration of priority scoring tools and creation of the Saskatchewan Surgical Care network. This coordinated backdrop facilitated the integration of Lean principles, hospital service consolidation, private third-party surgical care delivery services and policy direction setting by the provincial government.