Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 54 8 2025 09 02 1754 1764 Seyed Hadi Hosseini 1. Department of Healthcare Services Management, School of Health, Alborz University of Medical Sciences, Karaj, Iran 2. Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran Amirhossein Takian 1. Centre of Excellence for Global Health (CEGH), Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2. Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran 3. Department of Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 4. National Center for Health Insurance Research, Iranian Health Insurance Organization, Tehran, Iran Mohammad Amerzadeh Non-communicable Diseases Research Center, Research Institute for Prevention of ‎Non-Communicable Diseases, Qazvin Uni-versity of Medical Sciences, Qazvin, Iran Yasaman Poormoosa Department of Health Management, Policy & Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran 2023 07 15 2025 07 08 Background: Enhancing the performance of healthcare provider units, such as Health Houses (HHs) and Health Posts (HPs), is vital for improving service delivery. We aimed to develop simulation-based scenarios to optimize performance and minimize risks associated with decision-making. Methods: Conducted in 2021, this empirical study utilized operational research methods at one HH and one HP in southern Tehran. The operational characteristics of these units were modeled using Arena 20 simulation software. Additional performance scenarios were iteratively developed based on expert recommendations. Key performance metrics from the simulations were evaluated and ranked using the nominal group technique and Expert Choice software. Results: Four distinct scenarios were developed for both units. The fourth scenario emerged as the optimal model, receiving the highest expert scores for both the HH (score: 349) and HP (score: 418). This scenario demonstrated significant improvements in key indicators, including the number of patients admitted (HH: 24; HP: 31), patients served (HH: 23; HP: 33), health worker productivity (HH: 95%; HP: 47%), and reduced patient waiting times (HH: 4.45 min; HP: 0 min). Conclusion: The study recommends adopting the fourth scenario as a benchmark for HHs and HPs in suburban areas of major Iranian cities. The employed simulation methodology and evidence-based scenarios can be applied to other healthcare units, aiding in performance forecasting and system optimization.  https://ijph.tums.ac.ir/index.php/ijph/article/view/32567 https://ijph.tums.ac.ir/index.php/ijph/article/download/32567/8630