Build · Park · Clear.
The shift lives on a card instead of in working memory. Three moves hold the routine work, so judgment is free for the work only judgment can do.
Get the routine work out of working memory.
Build
The routine work — assessments, charting, checks — written into a grid you can see at a glance, instead of carried.
Park
The non-routine work — referrals, callbacks, follow-ups — set down in a visible queue, not lost and not looping.
Clear
A clean end to the shift. Every open item gets a destination — done, handoff, or tomorrow — so the day actually ends.
PAUSE·CHOOSE·ACT·RETURN
Repeated at every new demand. Return feeds Pause.
What actually needs me right now?
Four places friction accumulates.
Naming them is the first step to addressing them — for a fellow, a unit, or a whole program.
Load
The volume of routine, non-judgment work that must be tracked across every patient.
Signal
The clarity of what needs the clinician's judgment right now.
Sequence
The order the work gets done in across the shift.
Return
The recovery to where the work was after each interruption.
Miller (1956) · Cowan (2001) · Zeigarnik (1927) · Leroy (2009) · Gollwitzer (1999) · Wolfe (1994) · Pennebaker (1986) · see the evidence →
One method.
Made into software.
The same moves a clinician runs on a card, turned into a system a whole program can run on.
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