History of Rethinking the System of Survival for Sudden Cardiac Arrest

In 2007, Dr. Larry Starr, who has been involved in cardiac and emergency care research for more than 25 years, posed this question:

"Why after 40 years of enormous energy and resources is the Sudden Cardiac Arrest (SCA) survival rate low, very low—too low? Are we doing the 'right' things?"

When colleagues Dr. Allan Braslow and Frank Poliafico visited him as part of a meeting with Dr. Lance Becker who had recently come to Penn to direct the Penn Center for Resuscitation Science, he offered a new framework to think about the SCA survival problem. A follow-up meeting was scheduled to continue the discussion and to include Dr. Vinay Nadkarni who was also at Children’s Hospital of Philadelphia.

At this meeting a new mindset and set of assumptions were discussed. These were drawn not from traditional medical or biological science but from management and organization science, and in particular from system and design thinking. The discussion concerned the premise that SCA survival is a complex organizational problem and should be addressed using complex organizational methodologies.

Colleagues including Dr. John Pourdehnad as well as those from other disciplines and organizations began to join the conversation which led to an informal Friday (pizza) lunch discussion group held in the Ackoff Library of the Organizational Dynamics graduate studies program. This evolved into the Special Task Force on Reframing the System of Survival for Sudden Cardiac Arrest which continues to meet and to discuss ideas and research, and to propose and work on projects that have emerged from this new way of thinking. Participants now include thought-leaders, instructors, EMS providers, researchers, scholars, suppliers, manufacturers, community members, and survivors. Our objective is to design, develop, and test a new approach to thinking, planning, and acting—not a revision or update of current clinical protocols—which we hope will save more lives.

A presentation by the Special Task Force was held at the 2008 Emergency Cardiovascular Care Update (ECCU) conference. At ECCU one important point was: "SCA survival is a complex problem which requires a new framework in which we engage all the stakeholders many of whom have never previously been asked to become involved."