Patient handover from surgery to intensive care: using Formula 1 pit-stop and aviation models to improve safety and quality

A few years ago I was watching one of the learning channels and a story came on about how a formula 1 pit-stop team taught a hospital crew in a London hospital how to improve on their turn over in pediatric intensive care.    The fact that the hospital is saving more children because they have refined their process is great.  I think there is another story hidden here, it is the story of how people in one industry opened their minds to the possibilities and allowed others to help.

Today is Memorial_Day we honor and remember are fallen defenders.   The people who have fought to protect our interests, our values, our morals and our way of life.  The best way to thank them is to continue to protect their families and protect our freedom and our country.   To do this we have to be smarter and think more about what we are doing.  We have to take the time to think .

More often than not we don’t think, we just DO.  We don’t think about the consequences of our actions and we as a society are become more self obsessed and absorbed.   There is less willingness to listen to each other or talk about difficult subjects and work out our talks in ways that are productive.

What I find very interesting today is that people are willing to listen to stories if they read like or sound like something that comes from a TED event.  See Reggie Watts for an example of something that totally makes no sense but it is “an idea worth spreading.”

We aren’t willing to think ourselves but we are compelled to listen to those who appear to think.  This concept applies to every aspect of our lives including our personal lives.  Facebook is a great example, it is potentially worth more than Disney and it gives us individually very little except that immediate feedback that we so desire.

So, today please allow me to inspire some thought in you.  When looking for answers, think about the right questions and if you don’t know the answer or you can’t come up with something that makes sense ask around and extend your reach concerning who you should ask for help.  You may find your answer with Reggie Watts “in the negative space” or whatever, but moreover you may find the right answer in exactly the wrong place.   After all, who knew that a pit crew could save newborns.

Patient handover from surgery to intensive care: using Formula 1 pit-stop and aviation models to improve safety and quality

Summary

Background:  We aimed to improve the quality and safety of handover of patients from surgery to intensive care using the analogy of a Formula 1 pit stop and expertise from aviation.

Methods:  A prospective intervention study measured the change in performance before and after the implementation of a new handover protocol that was developed through detailed discussions with a Formula 1 racing team and aviation training captains. Fifty (23 before and 27 after) postsurgery patient handovers were observed. Technical errors and information omissions were measured using checklists, and teamwork was scored using a Likert scale. Duration of the handover was also measured.

Results:  The mean number of technical errors was reduced from 5.42 (95% CI ±1.24) to 3.15 (95% CI ±0.71), the mean number of information handover omissions was reduced from 2.09 (95% CI ±1.14) to 1.07 (95% CI ±0.55), and duration of handover was reduced from 10.8 min (95% CI ±1.6) to 9.4 min (95% CI ±1.29). Nine out of twenty-three (39%) precondition patients had more than one error in both technical and information handover prior to the new protocol, compared with three out of twenty-seven (11.5%) with the new handover. Regression analysis showed that the number of technical errors were significantly reduced with the new handover (t = −3.63,P < 0.001), and an interaction suggested that teamwork (t = 3.04, P = 0.004) had a different effect with the new handover protocol.

Conclusions:  The introduction of the new handover protocol lead to improvements in all aspects of the handover. Expertise from other industries can be extrapolated to improve patient safety, and in particular, areas of medicine involving the handover of patients or information.

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