Place two fingers on the inside of your wrist just the below the thumb and feel your heartbeat…every 0.8 seconds your cardiovascular system completes a cycle of complex interactions enabling it to pump 60 – 100 times a minute.
The cardiovascular system is highly intricate with centralised and decentralised operating systems synchronizing a variety of functions. Extensive feedback mechanisms provide constant information on performance and fluctuation in demand. Via continuous small adjustments capacity remains within boundaries whilst meeting the demand. These may include changes to the interval between contractions, the strength of contraction or chemical composition of blood.
The SA node sets the pace for the mechanical actions by initiating impulses or messages within the heart. The messages are sent at regular intervals following a predictable path; hence the rhythmic beating.
When chaos erupts…
In the worst case scenario chaos erupts due to complete failure in the communication cascade. The pacemaker messages are not sent or they are disorganized. With no coordination of the heart function; muscles pull in their own time and direction. The breakdown in feedback mechanisms cause the muscles to work ferociously, stretching and contracting harder than ever. Sadly though, the heart rapidly becomes a quivering mass with no output.
Because there is no output the body’s demand is not met, oxygen starvation occurs, waste accumulates and irreversible cellular damage occurs within minutes.
This state of quivering chaos with no output is called ventricular fibrillation. The exact cause is unknown but it is believed that in most cases warning signs were present.
If ventricular fibrillation is not treated death is inevitable despite prolonged efforts to buy time.
One method to buy time is doing CPR. The main purpose of doing CPR is to restore blood flow to the vital organs until the problem is fixed. During chest compressions the heart is rapidly squeezed between the sternum and vertebrae taking over from the quivering pump to create partial output. For as long as compressions are continued there is hope for survival.
A sacred cow of resuscitation is the administration of medication such as Adrenaline. It is resource intensive on time and people. According to the American Heart Association the value and safety of these drugs remain controversial. Retrospective studies suggest that high dosages are associated with worse outcomes. Yet we continue to use it religiously…because it’s what we’ve always done and everybody has a success story involving Adrenaline!
Treating the root cause
Defibrillation is the administration of a controlled electric shock to the heart. It literally shocks the quivering heart to a standstill for a few seconds until the pacemaker can kick in and restart the functioning of the heart.
So many organizations find themselves quivering! Each department works away frantically, fighting individual battles, pulling in their own direction with little coordination. It ripples throughout the organization producing poor outputs and unhappy customers (internal and external). Projects to resolve issues is implemented, however if it’s not addressing the underlying cause it’s only buying time and the organization remain quivering.
The efficiency lies not in every individual part working in as hard as it can, stretched beyond capacity. Efficiency is created by the perfect harmony of various activities, strengths and functions making every single beat effective.
In organizations a common cause for quivering is lack of shared direction because of communication failure or disjointed messages from leadership. The early warning signs are there, yet ignored. A fire fighting mentality neglects feedback mechanisms leaving the organizations stretched beyond safe boundaries of capacity.
Interventions to buy time include external measures rhythmically squeezing every last little bit of output from of the organization. Or implementation of sacred cows that produce limited (sometimes detrimental) results yet consumes resources (time and people). Think of workarounds, over processing, duplications, inspections and bureaucracies.
In the end people burn out, the organization falter and nobody wins.
What if the quivering was dramatically forced to stop with a brief interlude allowing leadership to restart the organization with clear communication pathways, shared direction and collaborating towards the same outputs. What if?
Tell me; if we had to analyse your organization’s rhythm would defibrillation be advised?