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Lean emergency medical operationsThe 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.
A lean transportation approach for improving emergency medical operations.This paper extends the approach of Lean transportation to improve the performance of emergency medical processes (EMP) by adapting its main concepts into the main characteristics of the EMP environment. The paper is based on an inductive theory-building process initiated from a case study in the field of emergency medical services. The development of the suggested performance improvement approach triggered from an exhaustive analysis of a process involved and an exploratory review of the existing improvement approaches available. The process of concern can be described as a specialized transportation process, where human lives are at risk. Its characteristics led to a natural application of Lean transportation. The results include, a novel approach for improving the agility and efficient EMS processes. This is validated with an application for improving ambulance response times and turnaround times of the Red Cross operations located in Monterrey, Mexico. The approach proved to be an integrated scheme for identifying waste opportunities at a systems level. This characteristic is important to let operations management prioritize improvement efforts in a limited budget situation. This work suggests the application of the emerging Lean transportation approach for increasing the agility performance of EMS processes.
A lean-TOC approach for improving emergency medical services (EMS) transport and logistics operations.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.