This study was conducted in a 955-bed hospital group, HospitalUniversitario Virgen Macarena y Área (AHVM), located in Seville,Spain between December 2012 and March 2013. At that time, theAHVM had 2 hospitals, 3 specialized centres, and 27 operating the-atres. In 2006, the AHVM developed a comprehensive logistics planthat included the creation of a logistics platform in 2007 and theimplementation of a kanban system (Aguilar-Escobar & Garrido-Vega, 2013).