Lean emergency medical operations

Bernardo Villarreal, Edgar Granda, Samantha Lankenau, Andrea Montalvo, Ana Cristina Bastidas, José Arturo Garza-Reyes

Research output: Chapter in Book/Report/Conference proceedingConference contribution


The fundamental responsibilities of Emergency Medical Service (EMS) systems are to provide urgent medical care, such as pre-hospital care, and to transport the patient to the hospital if needed. The agility and efficiency of EMS systems are major public concerns. Since the EMS process involved is fundamentally a transportation process, the Lean Transportation approach is a viable option for improving Emergency Medical Service (EMS) operations performance. The identification of waste during the ambulance cycle time is the basis for designing an operations improvement strategy. The scheme utilized uses modified versions of the Transportation Value Stream Map (TVSM) and The Operational Vehicle Effectiveness (TOVE) Index. Thus, availability, performance and quality wastes are identified to define the improvement strategy. Results of the application for the Monterrey metropolitan operations of the Mexican Red Cross are provided.

Original languageEnglish
Title of host publicationProceedings of the International Conference on Industrial Engineering and Operations Management
PublisherIEOM Society
Number of pages9
Publication statusPublished - Jul 2017
EventEuropean International Conference on Industrial Engineering and Operations Management.IEOM 2017 -
Duration: 24 Jul 201725 Jul 2017

Publication series

NameProceedings of the International Conference on Industrial Engineering and Operations Management


ConferenceEuropean International Conference on Industrial Engineering and Operations Management.IEOM 2017

Bibliographical note

Funding Information:
European Journal of Cardio-Thoracic Surgery thanks Martin Misfeld, Patrick Myers, Ulrich Otto von Oppell, Richard Weisel, and the other, anonymous reviewer(s) for their contribution to the peer review process of this article. The authors wish to thank Carl Clingman, MA, Senior Medical Illustrator, Biomedical & Scientific Visualization, Mayo Clinic, for his illustrations.

Funding Information:
Victoria Delgado discloses a financial relationship with Abbott Vascular, Edwards Lifesciences, GE Healthcare, MSD, Medtronic, and Novartis. Emmanuel Lansac: patent Extra Aortic ring annuloplasty device with Coroneo Inc. Phillippe Pibarot: funding from Edwards Lifesciences and Medtronic for echocardiography core laboratory services with no personal compensation. Michael A. Borger: discloses a financial relationship with Edwards Lifesciences, Medtronic, Abbott, and CryoLife. John K. Forrest: grant support and consultant to Edwards Lifesciences, Medtronic Inc. John Webb: consultant to Edwards Lifesciences, Abbott, Boston Scientific. Martin B. Leon: institutional clinical research grants from Abbott, BSC, Edwards, and Medtronic. Michael Markl: research support—Siemens Healthineers, Research Grant—Circle Cardiovascular Imaging, Consulting—Circle Cardiovascular Imaging, Research Grant—Cryolife Inc. Victor A. Ferrari: Senior Advisory Board, Journal of Cardiovascular Magnetic Resonance. Philipp Blanke: consultant for Edwards Lifesciences and Circle Cardiovascular Imaging; and provides CT core lab services for Edwards Lifesciences, Medtronic, Neovasc, and Tendyne Holdings, for which he receives no direct compensation. Ruggero De Paulis: patent on aortic root graft with Terumo Aortic. Consultant for Edwards Lifesciences, Medtronic, and Terumo Aortic. Maurice Enriquez-Sarano: consulting fees from Edwards LLC, Cryolife, and ChemImage, Inc. The Department of Cardiology of the LUMC received unrestricted research grants from Abbott Vascular, Bayer, Biotronik, Bioventrix, Boston Scientific, Edwards Lifesciences, GE Healthcare, and Medtronic. The other authors report no conflict of interest.

Publisher Copyright:
© 2017 IEEE.

All Science Journal Classification (ASJC) codes

  • Strategy and Management
  • Management Science and Operations Research
  • Control and Systems Engineering
  • Industrial and Manufacturing Engineering


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