As the largest transport medicine organization in Canada, Ornge provides patient care and transportation services across Ontario, covering a vast area of one million square kilometers. Ornge carries out approximately 19,000 patient transfers annually – with different priorities and required levels of care – using a fleet of land critical care transfer vehicles, rotor-wing aircraft (helicopters), and fixed-wing aircraft (airplanes) located in different bases across the province. Efficient deployment of these resources can enhance access to critical care while potentially decreasing costs. In this session, we discuss the development process of three decision support tools, including (1) an optimization/simulation model to determine optimal base locations which improves the response times for emergent and urgent patient transports province-wide, (2) an optimization tool for long-term (next day) patient transfers to optimize the transportation costs of non-urgent patients on a daily basis, and (3) an optimization/simulation model to determine optimal base locations for non-urgent patient transfers. We present how applying these tools helps Ornge make evidence-based vehicle allocations and dispatch decisions in order to improve patient care and response times while augmenting operations efficiency in a fiscally responsible manner. This is a long-lasting collaboration (from 2008 until now) with Dr. Russell MacDonald (Medical Director, Ornge), Dr. Shane Henderson, Dr. David Shmoys, and a group of 30 graduate students from the Cornell Graduate School of Operations Research and Information Engineering (ORIE).