title: Desktop microsimulation: a tool to improve efficiency in the medical office practice.
abstract: Because the economic crisis in the United States continues to have an impact on healthcare organizations, industry leaders must optimize their decision making. Discrete-event computer simulation is a quality tool with a demonstrated track record of improving the precision of analysis for process redesign. However, the use of simulation to consolidate practices and design efficiencies into an unfinished medical office building was a unique task. A discrete-event computer simulation package was used to model the operations and forecast future results for four orthopedic surgery practices. The scenarios were created to allow an evaluation of the impact of process change on the output variables of exam room utilization, patient queue size, and staff utilization. The model helped with decisions regarding space allocation and efficient exam room use by demonstrating the impact of process changes in patient queues at check-in/out, x-ray, and cast room locations when compared to the status quo model. The analysis impacted decisions on facility layout, patient flow, and staff functions in this newly consolidated practice. Simulation was found to be a useful tool for process redesign and decision making even prior to building occupancy.
authors.affiliation: Carilion Clinic, Roanoke, Virginia, USA. bmontgomery@carilionclinic.org
authors.forename: James B
authors.initials: JB
authors.lastname: Montgomery
authors.forename: Beth A
authors.initials: BA
authors.lastname: Linville
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Slonim
mesh_terms: D000553:Ambulatory Care / Q000191:economics* / Q000458:organization & administration / Q000639:trends; D003198:Computer Simulation / Q000191:economics / Q000639:trends; D020000:Decision Support Systems, Clinical / Q000191:economics*; D057172:Economic Recession; D017598:Efficiency, Organizational / Q000191:economics / Q000592:standards / Q000639:trends; D006801:Humans; D008838:Microcomputers / Q000191:economics / Q000639:trends; D017146:Models, Organizational; D019982:Organizational Case Studies; D009985:Orthopedics / Q000191:economics* / Q000379:methods / Q000458:organization & administration; D014481:United States