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A lean-TOC approach for improving emergency medical services (EMS) transport and logistics operations.Garza-Reyes, Jose Arturo; Villarreal, Bernardo; Kumar, Vikas; Diaz-Ramirez, Jenny; University of Derby; Universidad de Monterrey; University of the West of England; Centre for Supply Chain Improvement, The University of Derby, Derby, UK; Engineering Department, Universidad de Monterrey, San Pedro Garza Garcia, Mexico; Bristol Business School, University of the West of England, Bristol, UK; et al. (Taylor and Francis, 2018-08-21)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.