A process flow map for a hospital emergency room is given below.

(This example is closely based on an

example in Introduction to Simulation and Risk Analysis by J. R. Evans and D. L. Olson, Prentice Hall,
1998.) To simplify the map, a number of details have been left out, hence all the boxes in the map do
not directly correspond to SimQuick elements. For this model, we focus on the night shift, from midnight
to Sam. During this time, patients arrive at the emergency room according to a fairly stable pattern: on
average, they arrive every 15 minutes according to an exponential distribution. A patient's first stop is
the check-in desk. After describing their situation to the nurse, patients are sent to one of four locations:
historically, 30% are sent to the ambulatory area for immediate care, 20% are sent for x-rays, 5% are
admitted directly to the hospital, and 45% are sent for lab tests. Patients finishing at the ambulatory
area are all released. Of patients finishing with their x-rays, 60% are released, 10% are sent for lab work,
and 30% are admitted to the hospital. Of patients finishing with their lab work, 10% are admitted to the
hospital and 90% are released.

In order to build a model for this process with SimQuick elements, we must add some detail to the
process map. Clearly Door is an Entrance, and Release and Hospital are large Buffers. Ambulatory
represents a Buffer, followed by a single Work Station. Each of the other three boxes represents a
sequence of three elements: a large Buffer, followed by a single Work Station, followed by a Decision
Point. These Buffers represent waiting areas. Work Stations are, of course, where the services are
performed. The working times can be approximated as follows (where we let time units represent
minutes):
Finally, the Decision Points route the objects to their next destination according to the observed
proportions given above. (It is recommended that you read Example 5 to learn about Decision Points.)
Exercise 7:

a. Build a SimQuick model for the emergency room process. Based on historical observations, we can
assume there is initially one object in the Buffer before the lab Work Station and zero objects in the
other Buffers. This model has a lot of uncertainty, so do 200 simulations. (This will go faster if you click
"Other Features" and "Hide Results Details"; SimQuick will then write only the overall means on the
Results worksheet.) Report the overall mean fraction time working (also called the utilization) for each
Work Station and the overall mean cycle time for each Buffer in front of a Work Station. Which Work
Station is a bottleneck according to these statistics (i.e., has the highest values)?

b. Management wants to know the effect of doubling the capacity of the bottleneck, that is, adding an
identical Work Station next to the exiting one in the model. With this additional element, rerun the
model as in part a and report the same statistics. How has the bottleneck been affected?

c. Management also wants to know the effect on the original model of an increase in demand, where
the time between arrivals drops to 10 minutes, on average. Rerun the model as in part a and report the
same statistics. How has the bottleneck Work Station been affected?

Section 4: Advanced Feature's of SimQuick In this section we consider six advanced features of
SimQuick. The first feature, "Buffer Tracking," allows you to see how the inventory in a Buffer changes
over the time of a simulation. The "Unavailable" feature allows disabling Entrances/Exits/Work Stations
for quicker analysis of model variations. The "Changing Distributions" feature allows statistical
distributions to change during the running of a simulation and, when combined with the Unavailable
feature, allows random arrivals, departures and working times during specified time intervals within a
simulation. The "Discrete Distribution" feature allows the input of essentially arbitrary statistical
distributions into SimQuick models. These four features are illustrated in Examples 8 -11 with variations
on our original bank example. Sometimes real-world Work Stations share a person or tool, which is in
limited supply. This can be modeled in SimQuick using the feature called "Resources." The basic idea is
that a Work Station cannot start working on an object unless it has all the Resources that have been
assigned to it. When two Work Stations are competing for a Resource, the Work Station with higher
"Priority" gets it. The Priority of a Work Station is determined by the number of the table in SimQuick
into which it has been entered (the lower the number, the higher the Priority).