Supply-and-Demand Testing Scale-Up
Expand testing capacity while actively driving eligible people to use it
- Difficulty
- Advanced
- Time to result
- ~weeks to results
- Steps
- 7
- Confidence
- 97%
The method separates a scaling challenge into supply and demand. Supply covers the underlying capacity, required materials, providers, and geographic access points; demand covers eligibility, awareness, prioritization, and whether intended users actually participate. Leaders set a quantified target, divide each side into tactical work streams, and use frequent stand-ups to expose bottlenecks. Policy changes must accompany infrastructure expansion: opening sites accomplishes little if restrictive guidance prevents people from using them. California applied the approach by expanding laboratory capacity, establishing testing centers, broadening eligibility, and prioritizing essential workers. The mechanism works because it prevents teams from treating installed capacity as equivalent to delivered service.
Origin
Extracted from Masters in Business, where Charity Dean described co-leading California's COVID-19 Testing Task Force and scaling from roughly 2,000 to 140,000 tests per day.
Core principles
- 01Treat capacity and utilization as separate but interdependent problems
- 02Translate an ambitious outcome into tactical work streams
- 03Remove restrictive policies that suppress legitimate demand
- 04Run a short, intense operating cadence during emergencies
- 05Expand physical access and eligibility in parallel
How to run it
- 1
Define the measurable objective
Establish the current baseline, target capacity, and required timeframe so every work stream is aligned around the same outcome.
Pro tip Choose a daily throughput metric that can be reviewed at every stand-up.
Watch out Do not define success only as infrastructure installed; measure services actually delivered.
- 2
Split supply from demand
List everything required to produce the service under supply and everything required to make intended users participate under demand.
Pro tip Assign separate owners while maintaining one shared operating dashboard.
Watch out Solving only one side can leave capacity idle or demand unserved.
- 3
Create tactical work streams
Break laboratory capacity, materials, sites, staffing, eligibility, prioritization, and outreach into accountable work streams.
Pro tip Give each work stream a near-term deliverable and escalation route.
Watch out Avoid broad committees without named owners or deadlines.
- 4
Run a crisis cadence
Use frequent stand-ups to review throughput, blockers, dependencies, and decisions requiring immediate escalation.
Pro tip Keep meetings operational and centered on changes since the previous stand-up.
Watch out A high meeting frequency becomes counterproductive if decisions are not made.
- 5
Remove access barriers
Rewrite policies or guidance that unnecessarily restrict legitimate users, then communicate the expanded eligibility clearly.
Pro tip Prioritize groups whose exposure creates the greatest community risk.
Watch out Do not broaden demand beyond the capacity that can be delivered safely.
- 6
Expand distributed access
Deploy service locations across the target geography and direct eligible users toward them.
Pro tip Monitor geographic utilization to reposition resources quickly.
Watch out A statewide total can conceal severe local access gaps.
- 7
Track and exceed the target
Measure daily output, investigate shortfalls, and continue removing constraints until throughput is sustainable.
Pro tip Treat the target as a minimum once the system demonstrates additional capacity.
Watch out Do not sacrifice accuracy or safety merely to increase reported volume.
In the wild
California began with capacity for roughly 2,000 PCR tests per day. The task force separated supply from demand, established work streams, held twice-daily stand-ups, broadened eligibility, prioritized essential workers, and stood up 80 testing centers across the state in two weeks.
→ Daily testing rose to approximately 140,000 tests, exceeding the original 100,000-test target.
A health network seeking to increase rural screenings could treat mobile clinics, staff, and diagnostic equipment as supply while treating eligibility rules, appointment design, and community outreach as demand. Daily reviews would reveal whether shortages or low attendance were limiting completed screenings.
→ The network can increase completed screenings rather than merely adding nominal clinic capacity.
Common mistakes
Scaling supply without participation
Adding laboratories or service locations does not deliver results if guidance, access, or awareness prevents people from using them.
Using restrictive legacy rules
Rules designed for scarce capacity can become counterproductive after capacity expands and should be reassessed quickly.
Managing at committee level
Emergency scaling stalls when leaders discuss strategy without converting it into owned tactical work streams and measurable daily output.
Is it for you?
Best for
It is best for emergency programs that must expand physical capacity and user participation simultaneously.
Not ideal for
It is not ideal for routine operations where demand is stable and rapid expansion is unnecessary.
From the transcript
“Essentially, I'd break it down in terms of supply and demand.”
“And so the supply part is you need to actually have the testing, you need to have testing locations throughout the state. And the demand…”
“we broke it down into project management. We had task forces and work streams, and we had daily stand up meetings twice a day.”
From the episode
Charity Dean on the Lessons of Covid-19
Charity Dean