HCSE 2019 provides an opportunity to discuss operations management issues in health care delivery systems. Scientists and practitioners will have the opportunity to discuss about new ideas, methods and technologies for improving the operation of health care organizations. The event will take place in the mother and child university hospital CHU Saint-Justine of Montréal (with hospital tour) and each session will be co-chaired by a discussant coming from the clinical practice. HCSE 2019 is the fourth edition of the HCSE conferences, coming for the first time in North America.