When a hospital for children was influenced by Ferrari's pit crew

Aniruddh P Rao

Formula one has consumed more lives than it has saved ever since its inception in 1950. From Cameron Earl, Gilles Villenauve, Ayrton Senna to Jules Bianchi, the latest victim to be taken by the sport. The toll of death of drivers from United kingdom is the highest - 14 drivers coming from there alone, yet this hospital from Bristol, England has found a way to cut down the mistakes that are caused during hand-offs of patients from surgical unit to intensive care, through Formula one.

Great Ormond Street hospital for children, founded in 1852 was the first of its kind on English soil. The hospital treats around 100,000 kids per year who suffer from various heart diseases and it is a field where a lot can go wrong, death being a common customer. But in the mid-1990s, this hospital saw a very high rate in mortality than the usual average mortality rate.

After subsequent studies, it was found that the handover of patients from surgical unit to the intensive care unit was at a high risk. Besides the surgical processes even factors like exhaustion of staff were looked into for problems, but still a high amount of threat to the patient's life was posed to the doctors in the handover procedure. The hospital and the staff desperately needed a change to overcome this threat to life of the patients. With public pressure piling on them and questions shot at them by the press, help came ironically from a sport that fed on death.

Operation theatre

Unexpected finding

Dr. Leval, in 1994 published a paper on what might have actually gone wrong. This paper exposed the blatant operations of the surgical team which lacked co-ordination. The doctor invited human factors experts and analysts to look into the 21 member team's operations. The study found that small mistakes made by the team which often went unnoticed added up strongly to produce a bad outcome. This prompted the doctors to look hard on their team work and how they transferred patients from the surgical unit to the intensive care unit.

Two such doctors, Drs. Goldman and Martin Elliot, after a hard day sat staring at the solution in front of a TV. Big motor sport fans themselves, found striking similarities between the Ferrari's pit crew and the handover procedures in the hospital. Although the handover procedure need not be rushed unlike the pit crew, it held the same scenario. The 'lollipop man' ushers the car into a halt and the crew changes the tires, replaces the damaged parts and clears the air vents and in a staggering 4-7 seconds the car is good to go back onto the track. In the hospital, the patient comes in, he is operated on by the group of surgeons and nurses and then he is handed over to the Intensive Care Unit (ICU). This comparison of the pit crew to the doctor's team was all similar but the work done by the doctor's team was downright shabby. When a machine that housed a coffin had such clean cut tasks, why not have clean tasks cutout to a child's life?


Ferrari’s Pit Crew at work(Picture courtesy: Sky Sports)

The duo, Dr. Goldman and Dr. Elliot, linking the similarities between the two procedures, decided to go the Formula One way. They invited the British driving team, Mclaren to give them insights into pit stop maneuvers. The team brought slides and videos with them and explained how they hired human factors experts to look into the pit crews performances. The team explained how the small errors were stressed on instead of the big ones that are obvious.

The hospital also got in touch with the Ferrari's pit crew who invited them to take a look at their practice sessions prior to the race weekend in the British Grand Prix. Looking at the positive outcome of the past two meetings, Dr. Goldman and Dr. Elliot also paid a visit to Scuderia Ferrari's headquarters in Maranello, in Italy where they showed Nigel Stepney, technical director, videos and pictures of the hospital's handover procedures. Instead of being amazed, Nigel was rather surprised to see how messily the operations were carried out.

He pointed out that there was no basic person in-charge unlike the 'lollipop man' who had the responsibility of the flow of the car in and out of the team's pit. He also pointed out that different members of the pit crew had specific tasks given to them which were performed in a sequence whereas the team of surgeons and nurses were in disorder.

And the most important point made by the technical director of Ferrari was that the whole procedure throughout the seven seconds was carried out in absolute silence by the crew. This was in total opposition to the procedure in the operation theater where it was chaotic with a lot of conversations exchanged between the doctors and the nurses.

Dr. Goldman and Dr. Elliot were convinced with the loopholes and were influenced to change the way of working out the procedure in the theater. They did succeed in bringing the changes over, though, it was seen as a total lunacy to the critics. But as the saying goes – Desperate times call for desperate measures.

Proceeding on the measures taken by them, the doctors submitted a paper where they had conducted 23 operations out of 50 prior to the inspiration from Ferrari and 27 operations conducted after their inspiration from Ferrari. According to the paper, after adopting the new method, a significant fall by 42% was seen in the technical errors caused during the handover. Unfortunately, the study did not attempt to measure the reduce in deaths in the hospital.

Dr. Goldman and Dr. Elliot were so influenced by the Ferrari's pit crew that they even had surgeons and nurses standing in positions with their tasks cut out in sequence like the technicians in the pit crew. Although this was prevented by a certain skeptic, Dr. McEwan. Many skeptics like Dr. McEwan are not in agreement with this procedure. Still, the hospital has adopted this systematic method of carrying out the operations and handover methods to reduce the technical errors.

This has been a boon to the hospital's error crisis and many young kids have been cured of their conditions. Also, the errors in the handover procedure has been minimized ever since the hospital has adopted the new method. Formula One technology has been reviewed all over the world by engineers and scientists, and some have even found a way to inculcate them in betterment of innovation and the ever changing world provided to the public.

Edited by Staff Editor


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