„Lean Production“ is a known as successful production concept increasing productivity of a company in the long-term. Implementing lean principles in production can be challenging for the organizational structure of a company. Insufficient holistic process models, missing interface definitions and inflexible management structures can be major limitations. This article analyses - with the example of a Swiss production site of a company in the medical engineering sector - the challenges for the organization associated with the implementation of lean principles in operations. Requirements for an adapted organizational structure are highlighted and alternative organizational structures outlined. Advantages and disadvantages of these alternatives are presented and a solution for the case-study example developed. Companies in a similar environment can get suggestions for the adaption of their own organizational structure when implementing lean management principles in their production.