PurposeThe main objective of the research is to propose a method to assess the reliability of hospitals' internal logistics distribution.Design/methodology/approachA structured methodology was defined in five stages: (1) data collection and current state mapping; (2) future state design; (3) identification of the uncertainties and sources of variation; (4) reliability analysis of the proposed future state and (5) identification and prioritization of improvements.FindingsResults show shortcomings of the future state design and propose solutions to obtain a state that is more realistic and possible to perform. Subsequently, the feasibility of these improvements was analysed in order to be implemented in a real context, searching and identifying different uncertainty sources occurring inside the system.Originality/valueStudies that have addressed hospital's internal logistics are scarce. Such gap highlights the need for this research developments that address the reliability enhancement in hospitals internal logistics.