Need 2 know: How to get beyond start-up intensive care

Many years ago I spent some time in one of Australia’s premier intensive care wards.

Thankfully, I wasn’t there as a patient – I was gathering facts to help me create an advertising campaign to raise money for research into intensive care medicine.

As I think about what insights and advice I can offer a start-up approaching its third year of life, I am reminded of what the director of that intensive care ward had to say to me about his job.

When a critically ill patient is being rushed into the emergency room for whatever reason – a car crash, an acute illness, a serious assault – the emergency room team has a very clear and simple goal.

However they do it, their job is to keep the patient alive. It’s frantic and busy. It’s loud and scary to watch.

An emergency room is the absolute definition of organised chaos.

For the team involved, the only key performance indicator that matters is whether the patient lives. It’s seat-of-your-pants, balls-to-the-wall medicine.

Running an early-stage start-up is very similar. In the first year or so, the key task is keeping the business alive.

Whatever you do and however you do it is irrelevant. The only metric that matters is whether the business lives.

After that first year or two (assuming you make it), the business is effectively stabilised. People are buying the product. People are talking about the business.

A competitor or two have entered the market. The business is alive, even if its vital signs are still weak.

It’s not dissimilar to a patient going from the emergency room to the intensive care ward. The business is still in need of critical care but that moment-to-moment pressure of the business dying on the trolley has passed.

The pace of the intensive care ward is entirely different to the emergency room. Things are much quieter. And while there is still an intensity, it’s a different kind of intensity.

In intensive care, the doctors observe the patient in minute detail and think slowly, deeply and methodically about what needs to be done – using the latest ideas from every branch of medicine – to restore the patient to complete health.

That is exactly what a start-up approaching its third year needs to do.