Evaluating the capability and cost of a mass influenza and pneumococcal vaccination clinic via computer simulation.

Objective: To determine if a mass influenza/pneumococcal vaccination clinic could vaccinate 15,000 clients in 17 h; optimize personnel configuration to maximize number of clients vaccinated; and estimate costs (opportunity and clinic) and revenue.

Method: The author used a discrete event simulation model to estimate the throughput of the vaccination clinic as the number of clients (arrival intensity) increased and as staff members were reassigned to different workflows. We represented workflows for 3 client types: "Medicare,'' "Special,'' and "Cash,'' where "Special'' designates Medicare clients who needed assistance moving through the clinic. The costs of supplies, staff sal-aries, and client waiting time were included in the model. We compared the "original'' model based on the staffing and performance of an actual clinic to an ;;optimized'' model in which staff were reassigned to optimize number of clients vaccinated.

Results: A maximum of 13,138 and 15,094 clients in the original and optimized models, respectively, were vaccinated. At the original arrival rate (8300 clients vaccinated in 17 h), supplies cost about $191,000 and were the most expensive component of the clinic operation in both models. However, as the arrival intensity increased to 140%, the "Medicare'' client opportunity cost increased from $23,887 and $21,474 to $743,510 and $740,760 for the simulated original and optimized models, respectively.

Conclusion: The clinic could reach their target of 15,000 vaccinees with 2 fewer staff members by rearranging staff assignments from "Special" to "Medicare'' and "Cash'' stations. Computer simulation can help public health officials determine the most efficient use of staff, machinery, supplies, and time.