The natural variation in supply and demand that occurs as part of the everyday functioning of a practice often creates problems that contingency plans can address. Even if the supply and demand in a clinic are generally in balance, there will be times when there is a surge in demand (demand outstrips supply) that is either expected (e.g., flu season) or unexpected (e.g., many walk-ins on one day). Expected and unexpected variations in supply can also occur (e.g., vacations or emergency sick leaves). In a traditional system, patients are often made to absorb the consequences of the mismatch between supply and demand (i.e., they have to wait).  To better manage variation in supply and demand on a daily basis, a practice needs to develop contingency plans.

In addition, a number of situations occur relatively infrequently but not completely unexpectedly, such as the need for a patient to be admitted directly from the clinic to the hospital, or a parent who brings three children to an appointment scheduled for one child. The practice knows these events happen with some frequency — they just don't know exactly when they will occur. To avoid disrupting the normal flow of clinic practice, clinics agree upon a standard protocol to follow for each event, including clear responsibilities for each staff member (e.g., the clinic manager notifies the Emergency Department of a probable admission as soon as a patient arrives in the clinic). This pre-planning helps the clinic to continue functioning as smoothly as possible, and allows for some adjustments in the supply to meet the unanticipated demand.

Related Tools
Script for Late Patients
Scripts for Appointment Scheduling