Stress-test a rare-unit shortage by proving that each hold window and restore rule can place unanswered rare requests inside the planned lane, survive override pressure, and avoid trapping blood bank teams inside a green inventory slide that hides long-lived soft holds.
Rare-unit shortages often list a search checklist while leaving restore behavior, override authority, and abort ownership implicit. Those edges decide whether a late rare request stays inside the shortage packet or leaves a broken allocation path live under peak volume. The exercise should follow actual shortage inventories, supplier maps, and escalation paths rather than a clean quality deck.
Inventory the shortage lanes
List every rare-unit class with its response window, waive rule, override behavior, owners, and notification channels. Mark paths that cannot reverse without a manual amendment. Attach the last three rare-unit shortage incidents with raw timelines and any waivers. Include the source of truth for open rare counts during the observation window.
Name detect, hold, divert, abort, and restore owners with exit conditions. Write the point after which a stuck rare request would require a different procedure, then review whether that action is still permitted. Capture maximum acceptable dwell in measurable units, including which phenotypes are excluded from the shortage path and why.
Shortage drills to time on purpose
- A minority phenotype keeps a side-channel while the aggregate rare dashboard stays green.
- A restore has already left a technologist without a trusted shortage state.
- The primary rare export lags beyond the planned observation window.
- An operator skips a shortage gate because an OR cutoff is near.
- Automated and human divert messages collide under the new shortage rule.
- Supplier callback claims lack a stored exhibit at divert time.
For each drill, identify detection time, service impact, containment, and the authority to force a rare-unit shortage rollback. Require commands and dashboard links in the runbook.
Close the shortage with named owners
Run the package in Pingpong with blood bank, OR, anesthesia, and quality seats. Ask blood bank which patient decision becomes unsafe first if rare requests still stick after the claimed window. Ask OR whether macros can absorb a forced override. Ask owners to show the exact shortage version or export used as the exit condition.
Related reviews include a crossmatch SLA, the blood bank ops lead seat, a transfusion reaction drill, and a contrast shortage stress test. Browse the war-game decisions hub for adjacent controls.
Authorize the published shortage path only after a timed drill restores usable hold hygiene inside the documented budget without an undocumented manual step.