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Downtime as Design: Planning for the Moments When Systems Fail
True resilience shows when everything shatters; what happens next reveals your system’s soul.
We tell ourselves that downtime is a rare beast, an exception. Then it happens at 3 a.m. on a snowy Tuesday, and you learn which plans were sketches and which were muscle. Downtime is not an emergency to be endured; it’s a design problem to be rehearsed.
At Mercy North, a sudden network partition knocked out access to the central EMR for ninety minutes. The team activated a practiced plan: paper-lite quick forms, a sync queue on portable tablets, and a single coordinator who triaged phone requests. Nothing dramatic, no lives lost, but the difference was felt in the smoothness of handoffs and the quiet confidence of staff who had practiced the ritual.
Make downtime a ritual
- Design degraded workflows, not just backups. Paper based fallbacks should mirror the data you truly need in a crisis (allergies, current meds, code status), not full charts.
- Test, test, and test again. Live drills with clinicians reveal the real failure modes. Time the drills; measure reconciliation time afterward.
- Create reconciliation tools that aren’t painful. Offline entries should sync and reconcile without duplicating work or losing narrative context.
- Communicate widely and kindly. Staff and families need clear, calm updates. Treat transparency as a clinical duty.
A simple downtime play
- Pre-pack bedside “critical info” cards for every inpatient.
- Train two people per unit to run manual med reconciliation.
- Run quarterly simulated outages and record time-to-safe state.
- After each drill, run a blameless post-mortem and publish one fixable change.
Downtime reveals compassion under pressure. Treat it as a design problem, and your hospital’s humanity will show up in the dark.
Go Back
Downtime as Design: Planning for the Moments When Systems Fail
True resilience shows when everything shatters; what happens next reveals your system’s soul.
We tell ourselves that downtime is a rare beast, an exception. Then it happens at 3 a.m. on a snowy Tuesday, and you learn which plans were sketches and which were muscle. Downtime is not an emergency to be endured; it’s a design problem to be rehearsed.
At Mercy North, a sudden network partition knocked out access to the central EMR for ninety minutes. The team activated a practiced plan: paper-lite quick forms, a sync queue on portable tablets, and a single coordinator who triaged phone requests. Nothing dramatic, no lives lost, but the difference was felt in the smoothness of handoffs and the quiet confidence of staff who had practiced the ritual.
Make downtime a ritual
- Design degraded workflows, not just backups. Paper based fallbacks should mirror the data you truly need in a crisis (allergies, current meds, code status), not full charts.
- Test, test, and test again. Live drills with clinicians reveal the real failure modes. Time the drills; measure reconciliation time afterward.
- Create reconciliation tools that aren’t painful. Offline entries should sync and reconcile without duplicating work or losing narrative context.
- Communicate widely and kindly. Staff and families need clear, calm updates. Treat transparency as a clinical duty.
A simple downtime play
- Pre-pack bedside “critical info” cards for every inpatient.
- Train two people per unit to run manual med reconciliation.
- Run quarterly simulated outages and record time-to-safe state.
- After each drill, run a blameless post-mortem and publish one fixable change.
Downtime reveals compassion under pressure. Treat it as a design problem, and your hospital’s humanity will show up in the dark.
Go Back
Downtime as Design: Planning for the Moments When Systems Fail
True resilience shows when everything shatters; what happens next reveals your system’s soul.
We tell ourselves that downtime is a rare beast, an exception. Then it happens at 3 a.m. on a snowy Tuesday, and you learn which plans were sketches and which were muscle. Downtime is not an emergency to be endured; it’s a design problem to be rehearsed.
At Mercy North, a sudden network partition knocked out access to the central EMR for ninety minutes. The team activated a practiced plan: paper-lite quick forms, a sync queue on portable tablets, and a single coordinator who triaged phone requests. Nothing dramatic, no lives lost, but the difference was felt in the smoothness of handoffs and the quiet confidence of staff who had practiced the ritual.
Make downtime a ritual
- Design degraded workflows, not just backups. Paper based fallbacks should mirror the data you truly need in a crisis (allergies, current meds, code status), not full charts.
- Test, test, and test again. Live drills with clinicians reveal the real failure modes. Time the drills; measure reconciliation time afterward.
- Create reconciliation tools that aren’t painful. Offline entries should sync and reconcile without duplicating work or losing narrative context.
- Communicate widely and kindly. Staff and families need clear, calm updates. Treat transparency as a clinical duty.
A simple downtime play
- Pre-pack bedside “critical info” cards for every inpatient.
- Train two people per unit to run manual med reconciliation.
- Run quarterly simulated outages and record time-to-safe state.
- After each drill, run a blameless post-mortem and publish one fixable change.
Downtime reveals compassion under pressure. Treat it as a design problem, and your hospital’s humanity will show up in the dark.