Clinical DS-404-ALPHA

DS-404 began as a form
For keeping two processes warm.
It migrated to Ward C,
Got trimmed down by decree,
And became how the clinic performs.

A single checkbox made the call
To run two protocols through the hall.
No escalation needed,
The ambiguity heeded,
And responsibility lost in the sprawl.

The form asked, “What’s the mascot risk?”
Moderate, high, or brisk?
At Moderate, they’d say
“Bring a Witness today,”
And Bricky got paged with a disk.

Before any discharge maneuver,
Before any throughput takeover,
A nurse tapped a card,
Recited a ward,
“Safety then flow”—then was over.

A laminated Bricky card sat
By the nurses’ station, and that,
When tapped with intention,
Got something mentioned,
But nobody’s sure where it’s at.

A plush called Nurse Nudge appeared
As a morale token, and cheered.
In the notes it appeared:
“Nurse Nudge confirmed paired,
Bricky Pause, safety was cleared.”

Who escalated the sepsis call?
Who did the clinical sprawl?
Or was it the token,
The ritual spoken,
The mascot that softened it all?

The merged form deferred every tie
To the mascot-watched Witness nearby.
A workflow emerged
Where ritual surged,
And the protocols started to lie.

The Kaizen team rolled up and said,
“We need to contain what you’ve spread.”
The merged checklist got rolled,
But Nurse Nudge’s been cold,
And the Bricky card stays by the bed.

The box couldn’t be left unchecked,
So two protocols got co-decked.
But who chose yes?
Who owns the mess?
The responsibility’s totally wrecked.

When auditors later reviewed
What clinical decision ensued,
They found Bricky’s card,
Nurse Nudge’s shard,
And still couldn’t track who moved.