{"id":1320,"date":"2012-03-03T08:25:43","date_gmt":"2012-03-03T08:25:43","guid":{"rendered":"http:\/\/www.saasoft.com\/blog\/?p=1320"},"modified":"2012-03-03T08:25:43","modified_gmt":"2012-03-03T08:25:43","slug":"resetting-our-systems","status":"publish","type":"post","link":"https:\/\/hcse.blog\/?p=1320","title":{"rendered":"Resetting Our Systems"},"content":{"rendered":"

\"\"<\/a>\u00a0Our bodies are amazing self-monitoring and self-maintaining systems – and we take them completely\u00a0for granted!<\/p>\n

The fact that it is all automatic is good news for us\u00a0because\u00a0it frees us up to concentrate on other things\u00a0– BUT – it has a sinister side too.\u00a0\u00a0Our automatic monitor-and-maintain\u00a0design\u00a0does not imply what is maintained is\u00a0healthy\u00a0– the system is just designed to keep\u00a0itself stable.<\/p>\n

Take our blood pressure\u00a0as an example. We all have\u00a0two monitor-and-maintain systems that work together – one that stablises short-term changes in blood pressure (such as when you recline,\u00a0stand, run,\u00a0fight,\u00a0and flee)\u00a0and the other that stablises long-term changes. The image above\u00a0is a very simplified version of the long-term regulation system!<\/p>\n

Around one quarter\u00a0of all adults\u00a0are classified as having high blood pressure – which means that it is consistently higher than\u00a0is\u00a0healthy\u00a0– and billions of \u00a3 are spent\u00a0every year on\u00a0drugs to reduce blood pressure in millions of people.\u00a0 Why\u00a0is this an issue? How does it happen? What lessons are there for the student of Improvement Science?<\/p>\n

High blood pressure (or hypertension)\u00a0is dangerous – and the higher it is the more dangerous it is. It is called the silent killer<\/em>\u00a0and the reason is that it is called silent is because there are\u00a0no symptoms. The reason it called a killer is because over time it causes irreversible\u00a0damage to vital organs – the heart, kidneys and\u00a0arteries in the brain.<\/p>\n

The vast majority of hypertensives have what is called essential hypertension – <\/em>which means that there is no\u00a0obvious single cause.\u00a0\u00a0It\u00a0is believed\u00a0that\u00a0this is the result of their system gradually becoming reset so that\u00a0it actively maintains the high blood pressure.\u00a0 This is just like gradually increasing the setting on the thermostat in our house – say by just 0.01 degree per week – not much and not\u00a0even measurable – but over\u00a0time the cumulative effect would have a big impact on our heating bills!<\/p>\n

So, what resets our long-term blood pressure regulation system? It is believed that the main culprit is stress<\/strong>\u00a0because when we feel stressed our bodies react in the\u00a0short-term by pushing our blood pressure up – it is called the fright-fight-flight response.\u00a0If\u00a0the stress is repeated time and time again\u00a0our\u00a0pressure-o-stat<\/em> becomes gradually reset and the high blood pressure is then maintained, even when we do not feel stressed. And we do not notice – until something catastrophic happens! And that is too late.<\/p>\n

The same effect happens in organisations except that the pressure is\u00a0emotional\u00a0and is created by the stress of continually fighting to\u00a0meet\u00a0performance targets.\u00a0The result is a\u00a0gradual resetting of\u00a0our expectations and behaviours and\u00a0the organisation develops emotional hypertension<\/em> which leads to\u00a0irreversible damage to\u00a0the organisations culture.\u00a0This\u00a0emotional creep goes largely unnoticed until\u00a0a catastrophic event happens – and if severe enough the organisation\u00a0will be\u00a0crippled and may\u00a0not survive. The Mid Staffs Hospital patient safety catastrophe is a\u00a0real and recent example of cultural creep in a healthcare organisation driven by incessant target-driven behaviour. It is a stark lesson to us all.\u00a0<\/p>\n

So what is the solution?<\/p>\n

The first step is to realise that we cannot just rely on hope, ignore the risk and wait for the early warning\u00a0 symptoms – by that time the damage may be irreversible; or the catastrophe may get us without warning. We have to actively look for the signs of the creeping cultural change\u00a0– and we have to do that over a long period of time because it is gradual. So, if we\u00a0have just be jolted out of denial by a too-close-for-comfort expereince\u00a0then we need to adopt a different strategy and\u00a0use an external\u00a0absolute\u00a0reference – an emotionally and culturally\u00a0healthy organisation.<\/p>\n

The second step is to\u00a0adopt a method that will tell us reliably if there\u00a0is\u00a0a significant shift\u00a0in\u00a0our\u00a0emotional pressure\u00a0and a method that is sensitive eneough to alert\u00a0 us\u00a0before it\u00a0goes outside a safe<\/strong> range – because we\u00a0want to\u00a0intervene as early as possible and only when\u00a0necessary. Masterly inactivity and cat-like\u00a0observation<\/em> according to one wise medical mentor.\u00a0\u00a0<\/p>\n

The third step is to actively remove as many of the stressors<\/em> as possible – and for an organisation this means replacing DRATs (Delusional Ratios and Arbitrary Targets) with\u00a0well-designed specification limits; and replacing reactive fire-fighting with proactive feedback. This is the role of the leaders.<\/p>\n

The fourth step is to actively\u00a0reduce the emotional pressure but<\/strong> to do it gradually because the whole system needs to adjust. Dropping the emotional pressure too quickly is as\u00a0dangerous as discounting its importance.<\/p>\n

The key to all of this is the appropriate use of data and time-series analysis because the smaller long-term shifts are hidden in the large\u00a0short-term variation.\u00a0This is where many get stuck because they\u00a0are not aware that there two different sorts of statistics. <\/strong>The\u00a0\u00a0correct sort for\u00a0monitoring systems is called time-series statistics and it\u00a0not\u00a0<\/strong>the same as the statistics that we learn at school and university. That is called comparative statistics.\u00a0This is a shame really because time-series statistics is much more applicable to every day life problems such as managing our blood pressure, our weight,\u00a0our finances, and the cultural health of our organisations.<\/p>\n

Fortunately time-series statistics is\u00a0easier to learn and use than school statistics\u00a0so\u00a0to get started on resetting your personal and organisational\u00a0emot-o-stat\u00a0<\/em>please help yourself to the complimentary\u00a0guide by clicking here<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

\u00a0Our bodies are amazing self-monitoring and self-maintaining systems – and we take them completely\u00a0for granted! The fact that it is all automatic is good news for us\u00a0because\u00a0it frees us up to concentrate on other things\u00a0– BUT – it has a sinister side too.\u00a0\u00a0Our automatic monitor-and-maintain\u00a0design\u00a0does not imply what is maintained is\u00a0healthy\u00a0– the system is just … <\/p>\n

Continue reading “Resetting Our Systems”<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[22,35,43,45],"tags":[],"class_list":["post-1320","post","type-post","status-publish","format-standard","hentry","category-healthcare","category-reflections","category-why","category-what"],"_links":{"self":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/1320","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1320"}],"version-history":[{"count":0,"href":"https:\/\/hcse.blog\/index.php?rest_route=\/wp\/v2\/posts\/1320\/revisions"}],"wp:attachment":[{"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1320"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1320"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/hcse.blog\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1320"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}