Manufacturing companies constantly improve their manufacturing systems. Yet, the demands of everyday efficiency shifts focus from drastic process innovations to continuous improvement. Using multiple case studies of four Scandinavian manufacturers, this article examines why process innovation is different from continuous improvement, and how it can be managed alongside the companies’ other formal processes. We find the companies lack a vocabulary to talk about process innovation, and have no common methods with which to organize it. Furthermore, process innovation often comes from outside the operational units, and because of this, knowledge integration, ownership and participation needs to be managed actively.