A lean-TOC approach for improving Emergency Medical Services (EMS) transport and logistics operations

Jose Arturo Garza-Reyes, Bernardo Villarreal, Vikas Kumar, Jenny Diaz-Ramirez

Research output: Contribution to journalArticle

2 Citations (Scopus)


The improvement of transport and logistics performance of Emergency Medical Services (EMSs) systems has been mainly addressed through mathematical modelling, operations research, and simulation methods. This paper proposes an alternative and/or complementary improvement approach based on the adaptation and simultaneous deployment of lean thinking and Theory of Constraint (TOC) methods and tools. The paper briefly reviews key aspects of the application of lean in the logistics and healthcare industries and conceptually develops the proposed lean-TOC approach. The approach is then tested, through an individual detail case study, in the EMS transport and logistic system of the Red Cross operating in the metropolitan area of Monterrey, Mexico. The results obtained from the case study suggest that the proposed systematic lean-TOC approach may be an effective alternative and/or complement to mathematical modelling, operations research, and simulation methods to improve EMS transport and logistics operations.

Original languageEnglish
Pages (from-to)253-272
Number of pages20
JournalInternational Journal of Logistics Research and Applications
Issue number3
Publication statusPublished - 4 May 2019


All Science Journal Classification (ASJC) codes

  • Management Information Systems
  • Control and Systems Engineering
  • Information Systems
  • Computer Science Applications
  • Management Science and Operations Research

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