The management systems currently used in the Italian healthcare sector provide fragmented and incomplete information on this system and are generally unlikely to give accurate information on the performances of the healthcare processes. The present paper introduces a combined discrete event simulation (DES)/business process management (BPM) approach as innovative means to study the workflow of the activities within the Department of Laboratory Medicine of the "San Paolo" Hospital in Naples

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... y). After a first "As-Is" analysis to identify the current workflows of the system and to gather information regarding its behaviour, a following DES-based "What-If" analysis is implemented to figure out alternative work hypotheses in order to highlight possible modifications to the system's response under varying operating conditions and improve its overall performances. The structure of the simulation program is explained and the results of the scenario analysis are discussed. The paper starts with a brief exploration of the use of DES in healthcare and ends with general observations on the subject. A. Torri et al. 94 technological complexity. Accordingly, managers should rely on management systems in order to: (i) appropriately meet the operational needs of the structure they supervise; (ii) find out the most suitable solutions to accomplish the objectives defined in the business plan [1] . The present work aims at introducing a simulation-based operational paradigm [2] [3] that, along with classical management control systems, reproduces the behaviour of a complex structure [4]- [6] , in order to provide useful real-time indicators to improve the quality of the management control [7] . The case study examined relates to the Department of Laboratory Medicine of the "San Paolo" Hospital in Naples (Italy), whose management methodology suffered from: • staleness of data: the results of the business management activities were tied to a specific period in the past, corrective actions were based on past information and it was difficult to get real-time feedback regarding the effectiveness of such actions; • weakness of stored data: the stored data were often incomplete, inaccurate and not related to the work activities carried out within the health service. Analyses of these data did not provide correct information. The purpose was therefore to provide alternative workflows to be compared with those already performed in the department in order to improve the overall performances [8] [9] .