Applied simulation as a decision support system tool: the design of a new internal medicine facility

Over two-thirds of the US economy is based in the service sector and by some estimates close to ninety percent of the new jobs created since WWII have occurred in service industries. Yet due to the dynamic and complex nature of service systems, the application of decision support tools for the planning, modeling and analysis of these systems has lagged behind traditional manufacturing practices. One such service industry where the financial and strategic implications of proper decision making is especially critical is healthcare systems. The paper presents the application of a decision support system in the form of an applied simulation for designing a new internal medicine facility. Using an original simulation as the decision support system tool, the internal medicine group was able to evaluate various scheduling algorithms; patient queuing disciplines; throughput and productivity metrics; and general system optimization measures of the facility and its operation before construction even took place. In this way, changes to system processes and design were made and analyzed a priori, thus reducing risk and providing all system participants with a better understanding of this healthcare delivery system´s complexity.