This paper presents a structured approach to building a high-fidelity simulation for an emergency department. Our approach has three key features. First, we use the concept of modules as a building block for modeling. A module is a minimum unit that has clinical or administrative meanings in ED operation, and it consists of low level operational activities. Second, we use a structured template to formally represent modules, and we adopt notations and grammars from the business process modeling notation. This provides an enhanced clarity and transparency, which proves very useful in extracting necessary data from a hospital database or from interviewing ED staff. Finally, we define an interface, specifically data structure and handler, for converting information represented in the modules into simulation languages. This interface makes it possible to seamlessly link the modeling process to the implementation process in the simulation construction.