How Scuderia Ferrari Improved a Hospital ICU [!]

♠ Posted by Emmanuel in , at 11/14/2012 01:59:00 PM
Longtime readers will know from my blog FAQs that I am most excited about the field of IPE borrowing from different social science disciplines and beyond--anthropology, human geography, neurology, sociology...even moral philosophy and theology. If you look past largely artificial disciplinary boundaries, you'll often find that others have unique insights of their own about the same phenomena you are investigating.

It was thus a pleasure for me to find out that the same sort of thing is happening in the hard (some would say "real") sciences. This may sound incredible, but a bunch of doctors were watching Formula One during their of time when they noted the speed and efficiency with which teams perform pits stops as all four tires are changed in a matter of seconds. Why not ask these experts how to remove inefficiencies in the operating room, they thought? Hence a unique kind of collaboration was born:
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.
Actually, the art has advanced so much that Ferrari archrivals McLaren set a record this year of a 2.31 second pit stop! These guys are good; these guys are fast. While F1 is perhaps much bigger money, in the overall scheme of things improving emergency health care is a far more important thing to so many people. So, they thought, why not ask the experts and invited F1 pit crews to study operations in an operating theatre to make improvements...
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."
And, fruitfully, there were observable methodological improvements as a result:
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...

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.
What more can you ask of interdisciplinary collaboration? The glamour of F1 rubs off on the medical profession, which in turn gains valuable insights on how to better provide health care in a pinch to those who need it most.  It's a win-win situation all around. And that is my feel-good story du jour. Have a nice day!

PS: Race aficionados will undoubtedly note that the Ferrari racing car above is the 2008 model, but do keep in mind that the collaboration mentioned here happened around that time.