A provisional way of breaking the capacity problem apart.
Capacity State → Expansion Threshold → Marginal Demand Absorption → Capability Requirement → Delivery Constraints / Architecture Fit → Titration
1. Capacity State
What is the present relationship between demand and available capability? CCI is exploring whether states such as adequate, fragile, threshold and under-capacity can be made operationally useful.
2. Expansion Threshold
When does additional capability become warranted? The question includes the consequences of expanding too early and waiting too long.
3. Marginal Demand Absorption
Where does the next increment of meaningful clinical work go before formal capacity is added? This is a working term with prior art still under review.
4. Capability Requirement
What amount and characteristics of capability does the work require—including scope, latency, continuity, physical presence, context, escalation and redundancy?
5. Delivery Constraints / Architecture Fit
Given the requirement, which arrangements can actually supply it under real clinical, operational, economic and regulatory constraints?
6. Titration
What evidence should cause capacity to be maintained, increased, decreased, paused, or supplied through a different architecture? These are assessment categories, not automatic contract rights.
Five possible titration decisions
Working decision vocabulary for matching capacity to changing requirements. These are provisional assessments; implementation depends on actual clinical, operational, financial, and contractual conditions.
INCREASE
Add capacity when evidence indicates a sustained requirement beyond the current arrangement.
HOLD
Maintain current capacity while monitoring demand, reliability, and thresholds.
TAPER
Consider a planned reduction when requirements decline, subject to notice and continuity obligations.
PARK
Consider suspending or deferring expansion while preserving an appropriate path to reassessment; not a unilateral right to stop funded commitments.
GRADUATE
Transition to a different, potentially permanent or scaled architecture when evidence supports it, with deliberate handoff.
Capacity adjustment can improve institutional reversibility, but costs may move to physicians or other parties rather than disappear. Examine reversibility and risk allocation →
Why separate the questions?
“We need another physician” can contain several unexamined propositions: that demand exists, current capacity cannot adequately absorb it, the demand is durable, physician capability is required, the amount has been defined, and a particular staffing architecture is appropriate.
The value of the architecture, if it has any, is in making those propositions visible enough to test separately—not in preserving the diagram.