Stress-test an NPO status mismatch by proving that each hold window and restore rule can place mismatched NPO flags inside the planned lane, survive override pressure, and avoid trapping meal teams inside a green diet slide that hides long-lived soft flags.
NPO status mismatches often list a diet checklist while leaving restore behavior, override authority, and abort ownership implicit. Those edges decide whether a late flag stays inside the dietary packet or leaves a broken meal path live under peak volume. The exercise should follow actual NPO inventories, unit maps, and escalation paths rather than a clean diet board.
Build the mismatch packet
List every NPO mismatch 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 NPO status mismatch incidents with raw timelines and any waivers. Include the source of truth for open mismatch counts during the observation window.
- A minority unit keeps a side-channel while the aggregate NPO dashboard stays green.
- A restore has already left a dietary team without a trusted flag state.
- The primary NPO dashboard lags beyond the planned observation window.
- An operator skips a mismatch gate because a meal cutoff is near.
- Automated and human divert messages collide under the new mismatch rule.
- Nursing and dietary claim different freeze owners for the same NPO class.
For each drill, identify detection time, unit impact, containment, and the authority to force an NPO status mismatch rollback. Require commands and dashboard links in the runbook.
Name detect and restore owners
Name detect, hold, divert, abort, and restore owners with exit conditions. Write the point after which a stuck NPO flag would require a different meal plan, then review whether that action is still permitted. Capture maximum acceptable dwell in measurable units, including which diet classes are excluded from the mismatch path and why.
Run the package in Pingpong with dietary, nursing, perioperative, and quality seats. Ask dietary which patient decision becomes unsafe first if mismatches still stick after the claimed window. Ask nursing whether macros can absorb a forced override. Ask owners to show the exact NPO version or export used as the exit condition.
Related reviews include the dietary ops lead seat, a trayline backup rule, a menu allergy rewrite, and the perioperative lead seat. Browse the war-game decisions hub for adjacent controls.
Authorize the published mismatch path only after a timed drill restores usable flag hygiene inside the documented budget without an undocumented manual step.