In this paper, we propose an extension of classical finite state machine as it called a timer embedded finite state machine (TEFSM) with its formal modeling methods. In the proposed state-based approach, a discrete event system is modeled as a coupled TEFSM. Also presented is a systematic procedure and architecture of developing a simulation executor with a synchronization manager for the coupled TEFSM model. A TEFSM toolkit for modeling and simulation of the proposed TEFSM model has been implemented and a ping pong system was developed as an illustrative example. AUTHOR BIOGRAPHICS Duckwoong Lee is a post doctor in the Department of Industrial and Systems Engineering at KAIST. He received a BS from Ajou University in 2002, a MS from KAIST in 2004, and a Ph.D. from KAIST in 2010, all in Industrial Engineering. His research interests are in the area of business process management system (BPMS), system modeling and simulation, and parallel and distributed simulation.

Recently, the growth of outpatient clinic capacity has not matched the increasing demand on outpatient clinics, which has led to long waiting times for patients and overtime work for clinic staff. This has three significant negative effects on patients and staff: (1) patients' distrust of the procedures for treating outpatients increases, (2) nurses' stress from patient complaints increases, and (3) doctors' pressure to shorten treatment times while maintaining high levels of service quality increases. Presented in this paper is a simulation-based operation management method that provides the stakeholders with future visibility in outpatient departments. The future visibility is obtained from the current situation of the outpatient department using a simulation-based scheduling system and is shared by a business process management system that informs patients of their expected waiting time in order to lower the workload and pressure on clinic staff and to allow staff to manage exceptions proactively.

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