Formula 1 Racing and Cardiac Surgeons Join Forces

Formula 1 (F1) expertise is helping surgeons optimize one of the most perilous points in cardiac surgery: patient handover between the surgical and intensive care unit (ICU).

Two surgeons from the Great Ormond Street Hospital for Children (GOSH, London, United Kingdom), while relaxing after a transplant surgery and watching a F1 Grand Prix on the television, were struck by the parallels between the F1 pit-stop crew challenges and their own largely unresolved problems with patient handover to the ICU. Both procedures involved multiple specialists simultaneously carrying out numerous, complex tasks that frequently involved complex interfaces, which had to be completed quickly and accurately. The need for clear organization and swift reaction times is central to the outcome of a F1 race, and this is clearest of all during a pit-stop, when crews of 20 highly-trained individuals come together to refuel, re-tire and fine-tune a car to get it back out on the race track within a matter of seconds.

Upon this realization the two surgeons quickly set about contacting Formula One teams to ask them to lend their expertise and help the hospitals streamline their processes during a patient handover. As a result, senior technical people from the McLaren Group (Woking, United Kingdom) and Ferrari (Maranello, Italy) Formula 1 squads visited the hospital to observe and evaluate Dr. Allan Goldman's and Professor Martin Elliott's teams in action. The two doctors traveled to the Ferrari base of operations, and in addition attended the British Grand Prix to observe the choreography of pit-stop teams at first hand. The observations by the F1 teams generated a host of ideas, from a specially designed trolley to a new systematic protocol, among others. Although practical considerations meant not all could ultimately be adopted, the team did employ the lion's share, including the implementation of a clear chain of command and the adoption of clear contingency plans. The result was a major restructuring of the patient transfer procedure that stemmed directly from the race team lessons. After adopting the new protocol, the medical team compared 50 transfers; half before the new protocol, and half afterwards. The average number of technical errors per transfer fell 42% and information errors fell 49%.

"The key thing we found though was that there was a reduction in multiple errors. You notice when you see clips of Formula One that when things go wrong, like a fuel hose gets stuck, the little errors add up and cascade into a major failure,” said Allan Goldman, M.D., M.Sc., head of the GOSH pediatric cardiac intensive care unit. "It was the same with us and we were very pleased that it caused a reduction of multiple errors. It (the handover process) also takes a shorter time, although that wasn't our aim. In Formula One it is about quickness - every second counts - but for us it is about safety.”

"When we look at the number of critical instances we encounter, they have reduced markedly since we introduced the modified training protocol developed from what we have learned from Formula 1,” said Professor Martin Elliott. M.D. "International, main-stream media interest has widely disseminated our results, engaging many more people in the patient safety agenda, and emphasizing the need to look at the system – not just the individuals – to improve quality of care.”


Related Links:
Great Ormond Street Hospital for Children
McLaren
Ferrari