War-game a chair utilization freeze by proving each slot lane has a named owner, a measured age-out, and a reverse path before draft clocks start governing every dialysis chair assignment.
Chair utilization freezes fail when "held" means a status without a decision artifact, when teams dual-count a draft clock as both aspirational and live, and when high-acuity treatment lanes still pin to one thin charge nurse because the lane inventory is incomplete. The review needs one written inventory of chair lanes, one owner who can deny a risky shortcut, and a documented consequence when a failed hold ages past the deadline.
Freeze one chair family first
State which treatment families the freeze covers, the effective date, which slot lanes change, how versions are stored, and what happens to patients already in flight. Name the units that feel it first and the access promises that depend on coherent chair handling. If the memo mixes a chair utilization freeze with a water system alarm and an access infection ladder, split them.
Write the decision you will make if the war game finds nothing new. Also write the reverse criteria: the missed lane, capacity gap, or patient deadline that would force a chair freeze rollback within a stated window.
| Lane | Owner | Age-out | Reverse path |
|---|---|---|---|
| In-center chronic slot | Named charge nurse | Measured hours | Documented re-slot |
| Acute overflow slot | Dialysis ops | Measured hours | Documented escalate |
| Isolation chair slot | Infection control | Measured hours | Documented re-route |
Fill the table from stored exports, not from memory. Empty cells are blockers, not notes for later.
Break points to rehearse
- A high-acuity treatment class stays soft while the aggregate chair dashboard stays green.
- Two teams claim the same lane ownership and neither can force a freeze at week end.
- A restore has already left a shift without a trusted chair state.
- The primary chair export lags beyond the planned observation window.
- An operator skips a slot gate because a transport cutoff is near.
For each break point, require detection time, shift impact, containment, and the authority to force a chair utilization freeze rollback. Commands and export links belong in the runbook.
Run the slots through hostile seats
Feed Pingpong the freeze memo, the lane exhibits, and seating briefs for dialysis ops, nursing, infection control, and materials. First pass steelmans the freeze. Later passes attack from those seats. Final pass turns surviving objections into phased lane rules, mitigations, or a changed recommendation. Agreement across passes is not proof. Keep the objections that still have evidence gaps.
Pair with the dialysis ops lead seat, a water system alarm stress test, an access infection ladder, and a room utilization freeze. More operating decisions live in the war-game decisions hub.
Ship the freeze only when approved and blocked slot labels can be reproduced from stored chair exports without a verbal override.