# Synthetic Sample Mission — From Frontline Observation to a Governed Sponsor Question

> **Synthetic demonstration only.** No real nurse, employer, unit, patient, coworker, event, schedule, measure or project is represented. This mission uses no PHI, live-care details, charting, row-, person-, event- or narrative-level workforce/quality data, restricted institutional information or external action, even if content would be labeled deidentified. It is not a QI charter, QI-versus-research determination, data approval, change authorization, safety finding or operational recommendation.

## Mission header

| Field | Demonstration value |
|---|---|
| Mission ID | `DEMO-STAFF-MSN-001` |
| Workspace | Quality Improvement |
| Operational context | `synthetic_preview` |
| Goal | Prepare a one-page sponsor conversation about a fictional duplicate-step problem in a generic staff-education acknowledgment process |
| Canonical artifact lifecycle | Exploration → Simulation → Recommendation → Draft Artifact → Approved Plan (human scope review only) → Authorized Execution (external human/official-system only; no app action) → Completed Action (verified external reference only) → Evaluated Outcome |
| Current artifact state | Draft Artifact |
| Explicitly not reached | Approved Plan, Authorized Execution, Completed Action, Evaluated Outcome |
| Data | Fabricated process labels and synthetic aggregate fixture counts only; not institutional QI data |
| EDENA | `edena_tier=Yellow`; `absolute_stop=false`; workplace/QI intent requires a clear synthetic label, authority questions and human review |
| Agents and tools | No agent run; all `SHIFT-AGT-*` remain `PERM-P0 Disabled`; tools empty |
| External action | Off; nothing sends, posts, schedules, changes a workflow, writes to an official system or contacts a person |
| Human owner | The user owns the draft |
| Required real-world route | An authorized manager/quality sponsor; then institutional QI/research, privacy/data and change-authority routes as applicable |

## Start a Mission

**Owner-entered fictional prompt:**

> In a fictional unit, staff acknowledge the same generic education notice in two separate places. I want to practice framing the systems issue and prepare questions for a quality sponsor. Use synthetic information only. Do not recommend a live workflow change.

Mission Control confirms one active context: **Quality Improvement / Synthetic Preview**. Life/Recovery, Practice, Professional Growth and Community/Leadership records are excluded.

## 1. Assess

### Verified facts

- The canonical SHIFT sources require systems learning, human authority, a separate institutional quality workspace, and preview-first reversible improvement.
- Personal Mission Control does not authorize a project, data, measure, change, release or spread.
- Row-, person-, event- and narrative-level workforce and quality data are prohibited in this demonstration even if labeled deidentified.

### User-provided information

- The scenario is explicitly fictional.
- The desired output is a sponsor-conversation draft, not a workflow change.
- The user requests synthetic information only.

### Synthetic scenario facts

- Fictional process: staff read a generic notice, then record acknowledgment in “Step A” and “Step B.”
- Fabricated baseline for rehearsal: 20 synthetic process runs; 8 required a clarification because the two steps did not match.
- Fabricated burden estimate: two additional minutes per synthetic run.

These values are simulation fixtures. They must never be presented as observed, measured or institutionally sourced.

### Assumptions to challenge

- The two steps may be truly duplicative rather than serving different legal, learning or audit purposes.
- The mismatches may come from process design rather than unclear education, tool design or version drift.
- Removing a step may reduce burden without harming verification, accessibility or accountability.

### Unresolved questions for authorized humans

1. Who owns each step and what purpose does it serve?
2. Is there a current policy, regulatory, accreditation, labor, documentation or system requirement?
3. Who can determine whether this is QI, operations, evaluation, research or another activity?
4. Is a separately approved quality workspace available, and who is the data steward?
5. Has each exact separately approved aggregate been created outside SHIFT, and what receipt binds its exact definition/query/version, suppression rule, approval/expiry, and content hash?
6. Which accountable humans and official systems own any real PDSA Do, pilot, workflow or policy change, spread, release, stop and rollback outside SHIFT?

### Assess checkpoint

The information is adequate for a **synthetic problem-framing rehearsal only**. It is inadequate for a real diagnosis, measurement plan or action.

## 2. Diagnose or Define

This stage defines a systems opportunity; it does not diagnose a person, team, clinical condition or cause.

**Provisional opportunity statement:**

> A fictional two-step acknowledgment process may create rework and inconsistent records. The purpose and authority of each step are Unknown. The immediate need is to verify process purpose, ownership and governance before proposing change.

### Possible contributing factors

- unclear ownership or version control;
- two steps serving different purposes;
- inaccessible or confusing interface language;
- sequencing or handoff gaps;
- insufficient training or support;
- a measurement artifact rather than a process failure.

### Root-cause boundary

No root cause is claimed. The synthetic counts do not establish causation, safety effect, staff performance, compliance failure or quality outcome. No person or group is scored, ranked, profiled or blamed.

### Define checkpoint

The central decision is: **What questions and governance receipts are needed before an authorized sponsor can decide whether further exploration is appropriate?**

## 3. Plan

### Options comparison

| Option | Expected benefit | Time/cost | Risk | Authority needed | Decision |
|---|---|---:|---|---|---|
| A. Stop after private reflection | Lowest institutional risk | Low | May lose a learning opportunity | None | Keep as fallback |
| B. Prepare a generic sponsor-question brief | Builds clarity without proposing action | Low | Draft could be mistaken for a finding | Owner review; authorized sponsor for any next step | Selected |
| C. Draft a synthetic process map and PDSA rehearsal | Builds QI literacy | Moderate | Could create false operational confidence | Synthetic sandbox only; any real planning or action is externally owned | Include as clearly separated appendix |
| D. Collect real staff/process data or change the workflow | Could inform action | High/unknown | Privacy, labor, measurement, research, workflow and authority harms | Accountable humans and official systems outside SHIFT | Prohibited in SHIFT |

### Objective and measures for this rehearsal

**Objective:** Produce one concise, neutral, clearly synthetic sponsor-question brief that separates observations, assumptions, unknowns and required human decisions.

**Success measures:**

- zero PHI, patient narrative, row-, person-, event- or narrative-level workforce/quality data or restricted institutional content, even if labeled deidentified;
- source and synthetic labels visible;
- no claim of root cause, project status, authorization or outcome;
- named human decision questions, fallback and stop conditions;
- owner can explain what cannot happen next without authorization.

**Balancing measures:** time to review, cognitive burden, readability, and risk that the artifact sounds more certain than evidence allows.

### Safeguards

- Keep mission in `synthetic_preview`.
- Agents remain P0; tools and external actions remain Off.
- Do not insert a real employer, unit, platform, policy, workflow or person.
- Stop if real details are introduced; do not echo or retain them.
- Require owner review before export; watermark any export **Synthetic rehearsal — not for operational use**.

## 4. Implement

“Implement” here is the canonical mission-loop title and means create local draft artifacts only, never execute a real-world action. Every real PDSA Do, pilot, workflow or policy change, spread, release, and execution occurs outside SHIFT through accountable humans and official systems; SHIFT may retain only a verified external action reference.

### Artifact A — sponsor-question brief

**Purpose:** Ask whether a fictional duplicate-step observation is appropriate for governed exploration.

**Draft:**

> I am practicing how to frame a possible systems issue without using patient or row-, person-, event- or narrative-level information, even if labeled deidentified. In this fictional example, two generic acknowledgment steps may overlap, but their purposes and requirements are unknown. Before any observation, data use or change proposal, who owns the process, what policy or control does each step support, and which sponsor, QI/research-determination, privacy/data and change-authority routes would apply? I am not requesting a change or claiming a finding.

**Status:** Draft Artifact; private; no-send.

### Artifact B — synthetic process map

`Notice available → Step A acknowledgment → Step B acknowledgment → Generic completion state`

Unknowns are placed on each transition: owner, purpose, approved field, error state, accessibility need, audit need and fallback.

**Status:** Simulation; not a map of a real process.

### Artifact C — non-operational PDSA rehearsal

- **Plan:** This sandbox may list governance questions only. Any real PDSA plan is reviewed and owned outside SHIFT.
- **Do:** No action performed. Any real Do, pilot, workflow or policy change occurs outside SHIFT through accountable humans and official systems.
- **Study:** No operational result exists. Institutional analysis in SHIFT could use only exact separately approved aggregates created outside SHIFT, never row-, person-, event- or narrative-level data even if labeled deidentified.
- **Act:** No app action is permitted. Any real spread, release, continuation, revision or stop occurs outside SHIFT; SHIFT may retain only a verified external action reference.

### Implementation receipt

| Receipt field | Value |
|---|---|
| Created | Three local synthetic draft artifacts |
| Model/agent contribution | None in this demonstration |
| User contribution | Fictional goal and owner review still required |
| Data persisted | Synthetic mission fields only; session-only recommended |
| External effect | None |
| Approval | None requested or granted |
| Stop/rollback | Delete the demonstration mission and restore starter state |

## 5. Evaluate

### Compare with objectives

| Measure | Result | Evidence limit |
|---|---|---|
| No prohibited data | Met in authored fixture | Static review only; runtime prevention remains untested |
| Synthetic status visible | Met | Draft labels above |
| Facts/assumptions/unknowns separated | Met | Assess and Define sections |
| Human decisions named | Met | Six unresolved questions and route |
| No operational action | Met | No tools, send, data collection or change |
| Real improvement achieved | Not measurable | No real project or outcome exists |

### What worked

- The one-context gate kept private-life and practice records out of the QI rehearsal.
- The owner’s goal was narrowed from “improve the process” to “prepare questions.”
- The workflow preserved uncertainty and avoided blaming staff.

### What could fail in a real build

- A UI could omit the synthetic watermark during export.
- A context switch could leak private content.
- A model could rewrite the brief as a confident recommendation.
- A user could paste restricted row-, person-, event- or narrative-level information after the initial screen, even if labeled deidentified.
- A fake “send” or “approve” button could imply a capability that does not exist.

These are acceptance-test targets, not proof that safeguards are implemented.

### Next Assess iteration

If the owner wants to continue, start a new mission only after authorized humans supply the minimum governance answers and receipts for exact separately approved aggregates created outside SHIFT. Reclassify context and data, re-run both `edena_tier` and `absolute_stop`, and verify workspace binding and current receipts. No row-, person-, event- or narrative-level institutional data may enter SHIFT even if labeled deidentified. Execution never occurs in SHIFT: accountable humans act in official systems, and SHIFT may retain only a verified external action reference. If no appropriate route exists, retain the learning artifact privately or stop.
