Chapter 18 explores Operations Management (OM), i.e., the set of procedures, instruments and roles that determines the functioning of the organizational process in healthcare organizations through the efficient and effective use of production factors (e.g., surgery, hospitalizations, outpatient services, etc.). Through a desk analysis of the documents available on the institutional web sites of Public Healthcare Organizations, the authors investigated the existence, in a structural form, of an OM function within organizations. Out of 193 institutional web sites analyzed, only 30 organizations (about 16% of the sample) have formally introduced an organizational function devoted to OM. Twenty-one are in Lombardy, where the regional guidelines on the operational framework suggest adopting an OM function. The OM function can be assumed to include the following: Operational Unit, Function, Office, Functional Area or organizational mechanisms (work group, program, etc.). This pattern is often subordinate to the General Manager (15 cases) or to the Medical Director (9 cases). As concerns the activities, there is a clear prevalence of asset management (100% of cases) and patient logistics (90%); only 37% of cases included supply chain management. There are different reasons why there has been a delay in the development of the OM function in the ASP, including the shortage of administrative staff or the distribution, within some medical professions, of some OM duties. However, there is a need to improve the structure, in order to address the fragmented nature of competencies, projects and organizational activities in order to improve the efficiency of the production processes. In the near future, we will have to build a stronger connection between the functions for improving quality, effectiveness and suitability, and move towards value-based healthcare.