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On October 4, 2003, the District of Columbia Department of Health (DOH) held a Strategic National Stockpile (SNS) exercise designed to test its plan for operating mass dispensing centers during a bioterrorist attack or other emergency. The main goals of the exercise were to maximize the throughput of the dispensing plan and improve dispensing procedures. These goals are important for quantifying the resources (eg, numbers and types of staff) necessary to respond to different types and sizes of events, as well as for minimizing the potential for errors or confusion in dispensing medications. We set up the dispensing center according to the District's SNS plan and recruited volunteers to role-play potentially exposed residents. During the exercise, we collected detailed data on the service times for each step in the dispensing process. We also collected observations from exercise participants and observers. We found that the DOH dispensing center could achieve a throughput of 2.5 persons per minute. Using computer modeling, we recommended changes to the dispensing plan that would enable it to achieve a higher throughput of four to five persons per minute. Other recommendations addressed improvements to dispensing plans and procedures. [ABSTRACT FROM AUTHOR]