Stress-test an anesthesia delay spike by proving that each hold window and restore rule can place delayed starts inside the planned lane, survive override pressure, and avoid trapping OR teams inside a green start-time slide that hides long-lived soft holds.
Anesthesia delay spikes often list a readiness checklist while leaving restore behavior, override authority, and abort ownership implicit. Those edges decide whether a late induction stays inside the anesthesia packet or leaves a broken start path live under peak volume. The exercise should follow actual delay inventories, room maps, and escalation paths rather than a clean quality deck.
Map the delay hold windows
List every anesthesia delay 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 anesthesia delay spike incidents with raw timelines and any waivers. Include the source of truth for open delay counts during the observation window.
Name detect, hold, divert, abort, and restore owners with exit conditions. Write the point after which a stuck start would require a different procedure, then review whether that action is still permitted. Capture maximum acceptable dwell in measurable units, including which case classes are excluded from the delay path and why.
Delay drills to time on purpose
- A minority OR keeps a side-channel while the aggregate anesthesia dashboard stays green.
- A restore has already left an anesthesia team without a trusted delay state.
- The primary anesthesia dashboard lags beyond the planned observation window.
- An operator skips a delay gate because a block-time cutoff is near.
- Automated and human divert messages collide under the new delay rule.
For each drill, identify detection time, room impact, containment, and the authority to force an anesthesia delay spike rollback. Require commands and dashboard links in the runbook.
Close the spike with named owners
Run the package in Pingpong with anesthesia, OR ops, PACU, and quality seats. Ask anesthesia which patient decision becomes unsafe first if delays still stick after the claimed window. Ask OR ops whether macros can absorb a forced override. Ask owners to show the exact delay version or export used as the exit condition.
Related reviews include a PACU boarding cut, the OR ops lead seat, a turnover target cut, and an add-on case spike stress test. Browse the war-game decisions hub for adjacent controls.
Authorize the published delay path only after a timed drill restores usable hold hygiene inside the documented budget without an undocumented manual step.