War-game a therapy minute target by proving each minute lane has a named owner, a measured age-out, and a reverse path before draft clocks start governing every rehab session.
Therapy minute targets fail when "on target" means a status without a decision artifact, when teams dual-count a draft minute goal as both aspirational and live, and when high-acuity therapy families still pin to one thin scheduling desk because the lane inventory is incomplete. The review needs one written inventory of minute lanes, one owner who can deny a risky shortcut, and a documented consequence when a failed target ages past the deadline.
Write the target as a decision artifact
State which therapy families the target covers, the effective date, which minute lanes change, how versions are stored, and what happens to patients already in flight. Name the clinics that feel it first and the care promises that depend on coherent minute handling. If the memo mixes a therapy minute target with a wound care backlog and a same-day discharge rule, split them.
Write the decision you will make if the war game finds nothing new. Also write the reverse criteria: the missed lane, staffing gap, or patient deadline that would force a therapy minute target rollback within a stated window.
Failures to surface before go-live
- A high-acuity therapy class stays soft while the aggregate minute 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 case without a trusted minute state.
- The primary therapy export lags beyond the planned observation window.
- An operator skips a minute gate because a payer cutoff is near.
For each failure, require detection time, clinic impact, containment, and the authority to force a therapy minute target rollback. Commands and export links belong in the runbook.
Hostile chairs on the minute clocks
Feed Pingpong the target memo, the lane exhibits, and seating briefs for therapy ops, rehab, nursing, and finance. First pass steelmans the target. 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 a wound care backlog stress test, a same-day discharge rule, the LTACH ops lead seat, and an outpatient therapy backlog stress test. More operating decisions live in the war-game decisions hub.
Ship the target only when approved and blocked minute labels can be reproduced from stored therapy exports without a verbal override.