title: Computer simulation and discrete-event models in the analysis of a mammography clinic patient flow.
abstract: OBJECTIVE
  This work develops a discrete-event computer simulation model for the analysis of a mammography clinic performance.
  
  
  METHODS
  Two mammography clinic computer simulation models were developed, based on an existing public sector clinic of the Brazilian Cancer Institute, located in Rio de Janeiro city, Brazil. Two clinics in a total of seven configurations (number of equipment units and working personnel) were studied. Models tried to simulate changes in patient arrival rates, number of equipment units, available personnel (technicians and physicians), equipment maintenance scheduling schemes and exam repeat rates. Model parameters were obtained by direct measurements and literature reviews. A commercially-available simulation software was used for model building.
  
  
  RESULTS
  The best patient scheduling (patient arrival rate) for the studied configurations had an average of 29 min for Clinic 1 (consisting of one mammography equipment, one to three technicians and one physician) and 21 min for Clinic 2 (two mammography equipment units, one to four technicians and one physician). The exam repeat rates and equipment maintenance scheduling simulations indicated that a large impact over patient waiting time would appear in the smaller capacity configurations.
  
  
  CONCLUSIONS
  Discrete-event simulation was a useful tool for defining optimal operating conditions for the studied clinics, indicating the most adequate capacity configurations and equipment maintenance schedules.
authors.affiliation: Program of Biomedical Engineering, Luiz Alberto Coimbra Institute - Coppe, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Fernando C
authors.initials: FC
authors.lastname: Coelli
authors.forename: Rodrigo B
authors.initials: RB
authors.lastname: Ferreira
authors.forename: Renan Moritz V R
authors.initials: RM
authors.lastname: Almeida
authors.forename: Wagner Coelho A
authors.initials: WC
authors.lastname: Pereira
mesh_terms: D001071:Appointments and Schedules; D003198:Computer Simulation; D003695:Delivery of Health Care / Q000458:organization & administration*; D017598:Efficiency, Organizational; D008327:Mammography; D008403:Mass Screening / Q000458:organization & administration; D017146:Models, Organizational; D008962:Models, Theoretical; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D010940:Plant Proteins; D017064:Process Assessment, Health Care; D012984:Software; D013996:Time and Motion Studies
chemical_list: D010940:Plant Proteins; C090521:brazzein protein, Pentadiplandra brazzeana