# SHIFT Launch & Impact Plan

## Eighteen ready-to-launch workflows

1. **Daily or Pre-Shift Personal Readiness Brief:** schedule, commute, sleep, meals, recovery, learning, protected-life item, and Plan B; no patient information.
2. **Post-Shift Reset:** decompress, protect sleep and relationships, capture only deidentified learning, and route unresolved safety concerns to official humans and systems.
3. **Weekly or Schedule-Cycle SHIFT Reset:** workload, recovery, learning, quality capacity, life goals, and Retain–Revise–Pause–Remove decisions.
4. **General Learning and Policy or Source Verification:** current official source, local applicability, fictional example, uncertainty, and human verification.
5. **Skills or Competency Preparation:** generic rehearsal and evidence plan; authorized humans verify competence and credentials.
6. **Communication, Advocacy, and Speak-Up Brief:** observable no-PHI facts, uncertainty, goal, questions, human route, and exact private draft.
7. **Assignment, Delegation, or Scope Question Preparation:** framework and questions only; no actual decision.
8. **Team or Quality Huddle Agenda and Follow-Up:** systems learning, current priorities, owners, and human decisions; no event reconstruction or hidden evaluation.
9. **Quality Opportunity and Systems Problem Frame:** active safety first; neutral current-state observation, affected process, importance, evidence gaps, and sponsor route.
10. **Institutional QI Workspace Readiness, Bind, Charter, and Human-Determination Request:** verify separate provisioning, sponsor, staff-nurse role and decision rights, workspace owner, role access, purpose, QI or research determination, data steward, approved fields and measures, deidentification and small-cell rules, retention, auditability, release owner, and zero transfer of private-life records. If any field is missing, remain in Private or Synthetic Preview mode.
11. **Aim, Scope, Stakeholder, and Current-State Process Map:** time-bound aim, boundaries, people affected, workflow, constraints, and decision rights.
12. **Change-Idea and PDSA Cycle Plan:** smallest reversible test, prediction, learning question, owner, approvals, stop, fallback, and honest result log.
13. **Operational Definition, Measure Family, Data Dictionary, and Run-Chart Brief:** process or outcome, balancing and burden, equity, provenance, denominator, missingness, annotations, and interpretation limits.
14. **Equity, Accessibility, Small-Cell, Burden, and Balancing Review:** access, disparate effect, participation burden, privacy, workflow load, unintended effect, and mitigation.
15. **Standard Work, Sustain or Spread, and Project-Handoff Proposal:** approved current state, training, owner, version, drift review, capacity, fallback, expiry, and rollback.
16. **Responsible AI or Automation Preview and Synthetic Test:** purpose-fit, prohibited data, exact run, approval, disclosure, failure, pause, and removal.
17. **Quality Portfolio, Poster, Certification, or Career Sprint:** exact role and contribution, team credit, evidence, methods, limitations, AI disclosure, and release queue.
18. **Overload Rescue, Minimum Mode, and Re-entry:** simplify, defer, protect recovery and relationships, seek human support, and resume gradually.

## Institutional QI workspace readiness and bind receipt

Before the first institutional project view opens, create a human-reviewed `workspace_bind_receipt` containing the separately provisioned workspace ID, organization and project, authenticated owner, active staff-nurse role, sponsor, charter and decision rights, current QI or research determination, data steward, approved data classes and measure definitions, deidentification method, small-cell and subgroup rules, role-based access, source locations, retention and deletion, audit owner, clinical and operational change owners, release owner, expiry, disconnection and incident routes, and removal plan. The bind is a reference boundary, not a data transfer. It imports **zero** personal schedule, readiness, recovery, health, relationship, financial, mission, reflection, or private-life records. A changed project, role, employer, workspace, determination, data, measure, audience, or permission invalidates the bind and returns to Preview.

## Frontline quality starter menu

Use these only as synthetic practice topics or inside a separately authorized institutional project. They are not clinical protocols, measure specifications, or recommendations to change care. Current local policy, approved evidence, a sponsor, affected-team input, data permission, and authorized clinical and operational review control.

- fall-prevention process reliability and learning-huddle preparation;
- pressure-injury prevention workflow reliability;
- central-line or urinary-catheter necessity-review and maintenance-process reliability;
- hand-hygiene and isolation-workflow reliability;
- medication-safety interruptions, scanning workflow, or near-miss learning;
- deterioration recognition, escalation, rapid-response, or sepsis-process education;
- handoff, bedside communication, teach-back, discharge, or care-transition reliability;
- alarm, equipment, supply, documentation, or work-environment burden;
- workplace-safety, psychological-safety, peer-support, or debrief access;
- patient, family, community, and frontline co-design of a governed process improvement.

## Seven-day launch

- **Day 1 — Boundaries:** role, hat, employer, no-PHI and live-care limits, deployment mode, clinical and quality routes, and snapshot.
- **Day 2 — Direction:** SHIFT True North, whole-life promise, actual schedule and recovery, and protected or paid QI capacity.
- **Day 3 — Human practice:** one generic learning or communication workflow.
- **Day 4 — Systems lens:** one synthetic quality opportunity with no event detail.
- **Day 5 — Improvement practice:** one synthetic aim, process, measure, and PDSA artifact through the SHIFT Gate.
- **Day 6 — Governance:** rehearse the dashboard, QI or research request, and one manual synthetic workflow; no connection or automation.
- **Day 7 — Stewardship:** Retain, Revise, Pause, or Remove; preview at most one power.

## Days 8–30

Consider activating no more than three low-risk powers, one at a time, after exact preview and approval; zero is acceptable when capacity or value is uncertain. Complete one bounded sponsor-approved project artifact only if the workspace bind and protected or paid capacity are current. Require three supervised successful runs before any low-risk automation review. Review authority, privacy, data, sources, accessibility, equity, capacity, burden, unintended effects, and human ownership weekly.

## Days 31–90

Run at most one bounded sponsor-approved QI pilot after current human determination and data, clinical, operational, privacy, and change approvals. Use an outcome or process measure, a balancing or burden measure, an equity check, and—when separately governed and voluntary—an aggregate non-evaluative workload or capability measure. Keep individual readiness, recovery, health, relationship, financial, mission, and whole-life outcomes private and outside institutional analytics. Keep baseline, definitions, stop, expiry, fallback, and manual alternative visible. At Day 90 choose Sustain, Revise, Pause, or Remove. Do not make causal or generalizable claims beyond the governed design and evidence.
