How can Formula 1 be useful for healthcare?

Looking at processes in a very different sector can provide valuable insights that can inspire innovation.

The leaders of Great Ormond Street Hospital for Children NHS Trust's surgical and intensive care units were aware that they needed to improve and speed up the handover process of patients from their operating theatre to the intensive care unit (ICU) following heart surgery.  In a crowded space, where typically three or four conversations could be taking place at once, it could take 30 minutes to untangle and unplug all the wires and tubes from a patient and then transfer them to the ICU.

Great Ormond Street's head ICU doctor, Allan Goldman, and heart surgeon, Professor Martin Elliott, were watching a Formula One race in the hospital's staff common room having completed a 12-hour emergency transplant operation.  As a car pulled into the pit stop, they noted that a 20-member crew changed the car's tyres, filled it with fuel, cleared the air intakes and sent it off in seven seconds in a manner that was coordinated, efficient and disciplined.

Assessing old problems with a fresh pair of eyes

Recognising the similarities with the handover disciplines visible in the pit of a Formula One racing team, they invited the McLaren and Ferrari racing teams to work with them to examine how their processes could be more structured and effective.  They went out to the pits of the British Grand Prix, met Ferrari's technical managers at their base in Italy and invited some of them to come and observe their handovers at Great Ormond Street.

Professor Elliott feels the team enabled them to review what they did with a fresh pair of eyes: "They saw us operating on a solid table with the child under a heating or cooling blanket and all the vital connections to various bits of equipment, and then having to unplug everything and use a hand-operated ventilator as we took the patient out of the theatre, into the lift and along the corridor to intensive care.

"Their first thought was why didn't we do everything on a bed trolley that was equipped with everything we needed and didn't require disconnecting and reconnecting.  I pointed out that the manufacturer did not exist who would invest that sort of money in such a specialised product and that's when they started investigating human solutions and training methods to solve our problems."

Borrowing processes from other disciplines

The input of the Formula One pit technicians resulted in a major restructuring of their patient handover from theatre to the ICU.  This involved adopting a new protocol, better training and rehearsals.  The protocol outlined who should be the leader throughout the process (the anaesthetist), provided a step-by-step checklist covering each stage of the handover process and included a diagram of the patient surrounded by the staff so that everyone knew their exact position as well as their precise task.

As Nigel Stepney, Ferrari's then technical manager, asserts: "It's not about having the best people and just putting them together.  It's about a group of people who can work as a team."

Following the adoption of the protocol, an industrial psychologist monitored 27 operations and found that the number of technical errors and information handover mistakes had almost halved.

The process is now being adapted to other areas of this hospital and others and the team want to examine how hospitals can learn from other high risk industries, including NASA and the Navy.