A global snapshot is helpful, but practices are dynamic, and the demand and supply can fluctuate on a daily, weekly, or seasonal basis. These fluctuations can lead to demand and supply mismatches resulting in delay. Identifying and anticipating these fluctuations enables a team to be proactive and implement strategies to shape supply and demand during these time periods.
Identifying these patterns may require some daily supply and demand measurement. Some patterns may be identified by typical patterns of TNA fluctuation during certain times of the year (indicating a growing imbalance between supply and demand).
Example 1: Shaping weekly supply and demand
The above demand and supply run chart shows a common pattern of weekly supply/demand mismatch. Often, provider supply is fixed (e.g. 8 hours/day, Mon-Fri) but patient panel demand may fluctuate during the week. In this example, we see that demand early in week is higher than later in the week. This may be due to the clinic being closed during the weekend and having to ‘catch-up’ on the pent-up patient demand that was waiting to be seen over the weekend. In this example, supply and demand may be perfectly balanced over the week but the variation in daily demand causes a mismatch over the course of the week which can lead to delays.
Question
WHAT STRATEGIES CAN BE USED TO BETTER MATCH DAILY SUPPLY AND DEMAND?
- 'Shape' supply to match demand (e.g. work longer hours Monday/Tuesday, shorter hours Thursday/Friday).
Alternatively, a provider may utilize a “flex scheduling” strategy whereby they leave a few appointments open at the end of the day that only get filled if demand is high that day.
If no excess demand exists, the provider goes home at their regular time (note: this strategy only works well if supply and demand are relatively balanced, otherwise these “flex” slots will always be filled, and the provider will end up working longer hours on a permanent basis) - ‘Shape” demand to better match weekly supply patterns.
This may be accomplished by:
- booking appointments you can control later in the week (i.e. internal demand like requests for patients to come for follow-up appointments).
- strategically shaping demand by attempting to fill appointment slots that are less preferred first (e.g. early in the day, late in the week) helps to prevent demand/supply mismatches and resulting delay
Example 2: Shaping SEASONAL supply and demand
The above TNA run chart shows two spikes in delay. One leading into October and another through the months of January and February. You have been tracking TNA in your clinic for a number of years and have recognized this consistent pattern of increased delay over these months. Inferring from the spikes in TNA you come to the conclusion there must be a demand/supply mismatch at these times of the year. After consulting with your clinic team, you identify a few possible reasons why the mismatch may be occurring:
| Demand Surge | Supply Loss |
| Your panel consists of a large number of snow-birds who tend to book appointments for prescription renewals and last minute needs in September-October prior to travelling south for the winter. | Many clinic providers regularly take several weeks off in January-February for warm weather vacations. |
| January-February is the height of the flu season in your community and you have many patients requesting appointments for flu-related symptoms. |
Recognizing this seasonal pattern of demand/supply mismatch, the clinic decides to employ the following strategies to better manage the variation in demand and supply:
- Performing pro-active panel management to identify the snow-bird patients and reach-out early to this sub-population to address their care needs earlier.
- Communicating to your patient panel about the importance of flu-vaccination and the various options available to them to get vaccinated (e.g. at the clinic, at a local pharmacy).
- The clinic implements a vacation policy to prevent multiple providers from taking vacation at the same time over these months of increased patient panel demand
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