War-game a length of stay target by proving each floor class has a named owner, a measured age-out, and a reverse path before draft floors start governing every stay claim.
Length of stay targets fail when "on target" means a status without a decision artifact, when teams dual-count a draft floor as both approved and live, and when high-risk service lines still pin to one thin reviewer because the floor inventory is incomplete. The review needs one written inventory of floor classes, one owner who can deny a risky shortcut, and a documented consequence when a failed floor ages past the deadline.
Pin the target under fire
State which stay classes the target covers, the effective date, which length floors change, how versions are stored, and what happens to admissions already in flight. Name the units that feel it first and the access promises that depend on coherent length handling. If the memo mixes a length of stay target with a prior auth backlog cut and a room utilization freeze, split them. A war game needs one move under fire at a time.
Write the decision you will make if the war game finds nothing new. Also write the reverse criteria: the missed floor, coverage gap, or patient deadline that would force a target rollback within a stated window.
Seat the length room
- Utilization review. Floor timing, age-out math, and what the length forecast hides if exceptions soften after the policy.
- Clinic ops. Turnover lag, dual-counted stays, and the message that would leave orphan admissions open past lock.
- Claims ops. Authorization capacity, denial load, and relationship damage with payers when floors jump overnight.
- Finance. Stay-cost load, forecast promises that break in process, and the first ninety days of thinner remedies after a soft target.
- Skeptic. The claim that looks strongest and is least sourced.
Give every seat the same exhibits: open stays, floors in flight, protected stay classes, coverage commitments, and the age-out policy you intend to use. Private data for one seat invents agreement that will not survive the real room.
Pressure the soft floors
Feed Pingpong the target memo, the floor exhibits, and the seating briefs. First pass steelmans the target. Later passes attack from utilization review, clinic, claims, and finance seats. Final pass turns surviving objections into phased floor rules, mitigations, or a changed recommendation. Agreement across passes is not proof. Keep the objections that still have evidence gaps.
Pair with the utilization review lead seat, a prior auth backlog cut, the claims ops lead seat, and a room utilization freeze. More operating decisions live in the war-game decisions hub.
Ship the target only when approved and blocked floor labels can be reproduced from stored length exports without a verbal override.