War-game a tray turnaround SLA by proving each tray lane has a named owner, a measured age-out, and a reverse path before draft clocks start governing every instrument set.
Tray turnaround SLAs fail when "ready for case" means a status without a decision artifact, when teams dual-count a draft clock as both aspirational and live, and when specialty tray families still pin to one thin decontam desk because the lane inventory is incomplete. The review needs one written inventory of tray lanes, one owner who can deny a risky shortcut, and a documented consequence when a failed clock ages past the deadline.
Lock one tray family before scale
State which tray classes the SLA covers, the effective date, which clock lanes change, how versions are stored, and what happens to sets already in flight. Name the specialties that feel it first and the safety promises that depend on coherent tray handling. If the memo mixes a tray turnaround SLA with a sterile processing rewrite and an instrument tray shortage, split them.
Write the decision you will make if the war game finds nothing new. Also write the reverse criteria: the missed lane, specialty gap, or case deadline that would force a tray turnaround SLA rollback within a stated window.
| Lane | Owner | Age-out | Reverse path |
|---|---|---|---|
| General set | Named sterile charge | Measured hours | Documented hold |
| Specialty loaner | Central sterile ops | Measured hours | Documented restore |
| Implant dual path | OR lead | Measured hours | Documented re-route |
Fill the table from stored exports, not from memory. Empty cells are blockers, not notes for later.
Turnaround break points
- A specialty tray class stays soft while the aggregate sterile 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 set without a trusted clock state.
- The primary tray export lags beyond the planned observation window.
- An operator skips a clock gate because a first-case cutoff is near.
- Sterility claims lack a stored exhibit at release time.
For each break point, require detection time, specialty impact, containment, and the authority to force a tray turnaround SLA rollback. Commands and export links belong in the runbook.
Hostile seats on the tray clocks
Feed Pingpong the SLA memo, the lane exhibits, and seating briefs for central sterile, OR ops, perioperative, and quality. First pass steelmans the SLA. 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 central sterile ops lead seat, an instrument tray shortage stress test, a sterile processing rewrite, and the perioperative lead seat. More operating decisions live in the war-game decisions hub.
Ship the SLA only when approved and blocked clock labels can be reproduced from stored tray exports without a verbal override.