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on Gopher (inofficial)
(HTM) Visit Hacker News on the Web
COMMENT PAGE FOR:
(HTM) Formula One Handovers and Handovers From Surgery to Intensive Care (2008) [pdf]
raphman wrote 1 day ago:
Some more sources I saved recently after learning about Elliott's work:
The original paper by Catchpole et al. (2006): [1] A quite interesting
lecture on the whole project, given by Elliott in a racecar driver's
suit: [2] Annotated transcript of the talk available here: [3] A WSJ
article from 2006: A Hospital Races To Learn Lessons Of Ferrari Pit
Stop: [4] (archived copy: [5] )
Times article from 2024: The surgeon who used F1 pitstop techniques to
save lives of babies: [6] (archived copy: [7] )
(HTM) [1]: https://onlinelibrary.wiley.com/doi/10.1111/j.1460-9592.2006.0...
(HTM) [2]: https://www.youtube.com/watch?v=ZeMGrHcfRjY
(HTM) [3]: https://www.gresham.ac.uk/watch-now/formula-1-and-its-contribu...
(HTM) [4]: http://www.wsj.com/articles/SB116346916169622261
(HTM) [5]: https://archive.is/xEbio
(HTM) [6]: https://www.thetimes.com/sport/formula-one/article/professor-m...
(HTM) [7]: https://archive.is/1iGXK
raphman wrote 1 day ago:
I found this quote from the paper by Catchpole et al. quite
important:
"Whilst it is encouraging that analogies from other industries with
longstanding cultures of safety and reliability may be extrapolated,
it is also important to recognize the unique demands of health care.
One crucial difference that emerged was that Formula 1 and aviation
both have a relatively stable workforce, with minimal staff turnover.
For example, out of about 20 members of a pit team, only one or two
members change annually. In contrast, turnover of staff in health
care is far higher, with six residents rotating every 3 months in the
study unit, and a nurse turnover of approximately 10%."
colechristensen wrote 1 day ago:
Turnover could also be seen as an addressable problem. "People are
dying because of poor staff retention and rotation practices" this
could be studied and improved upon.
A novel mechanism would be for a patient suing a hospital for
malpractice for failing to retain nursing staff which it seems
could be proven to be linked to worse outcomes. And when it comes
to it, liability lawsuits are an adequate last resort to push back
against hospitals cutting corners with staffing levels and staff
pay when it comes to nurses.
alexpotato wrote 1 day ago:
There is a precedent for organizations from wildly different industries
meeting and sharing thoughts, lessons learned and procedures.
Some cases that come to mind:
- The United States Marine Corps spent time with New York City Fire
Department. The USMC was interested to know how the FDNY managed radio
communications, chaotic environments and co-ordinating teams from
different departments in an urban environment
- In one of the Gladwell books he mentions getting financial traders
and generals together to play military simulation games. The idea being
that the traders were used to dealing with streams of fast moving
information and they had to quickly decided what to do next.
dbgrman wrote 1 day ago:
I'm curious how the OP got to this PDF document... like what were they
researching? searching? how?
celticninja wrote 1 day ago:
I actually heard this from my wife who is working with GOSH and
related a version of this to me. So I was really grateful to be able
to read the proper analysis.
sturza wrote 1 day ago:
It was an anecdote or a story shared on HN eariler this year.
zimpenfish wrote 1 day ago:
There's a (TED talk?) reel been doing the rounds the last couple of
days. One of those "interest dies down, someone finds it again,
shares it, there's a new bloom of viral interest, repeat until heat
death" things.
scrollop wrote 1 day ago:
Interesting.
Another take-
"Two F1 fan surgeons found a way to visit Ferrari headquarters as a
business trip."
PaulRobinson wrote 1 day ago:
There's actually a bit of crossover. This paper is quite old, but I
know that other teams and other surgeons have visited each other
plenty since this was published, and there's this cross fertilisation
of ideas.
F1 is "important" in the sense that it is competitive, and so teams
want to iterate and improve constantly. I think the fastest pit stop
in the 2025 season 1.91 seconds, in which: the car is jacked, four
tyres are removed, four new tyres are placed and secured into place,
the car is dropped, the lane is checked for traffic, and then the car
can move. There are thousands of permutations of how to get this
right and that fast. And accuracy is important: get it wrong there is
a risk of injury at worst, or a fine for an unsafe release at best.
ICU is obviously important in a different way. You can't really
"experiment". Iteration needs data. So you need to go out and learn
what good looks like from different disciplines, and then carefully
plan the changes you want to make and get buy-in. Get it wrong, and
people die. Best case scenario you're struck off, worst case you're
going to prison for murder.
In dev speak, F1 can afford to be agile, ICUs need to be waterfall.
But because F1 needs to be precise and they perceive the dangers of
imprecision so acutely from a monetary perspective (where you finish
in the Worldwide Constructors Championship directly affects the
profitability and viability of the team), they want to borrow ideas
too.
It sounds ridiculous that surgeons and F1 garages would have so much
to talk about, but it turns out, they really do feed ideas off each
other sometimes.
jjk166 wrote 17 hours 13 min ago:
> ICU is obviously important in a different way. You can't really
"experiment". Iteration needs data. So you need to go out and learn
what good looks like from different disciplines, and then carefully
plan the changes you want to make and get buy-in.
I would think test runs with simulated patients offer plenty of
opportunity to experiment.
> Get it wrong, and people die. Best case scenario you're struck
off, worst case you're going to prison for murder.
Get it right and people may still die. The whole reason for the
improvement effort is that the current practice is excessively
risky. No one is getting fired, nonetheless going to prison for
trying a sensible improvement to reduce the odds of a child dying
which they were approved to attempt.
lifeisstillgood wrote 1 day ago:
Itâs impressive that surgical teams put aside ego enough to do this -
and I suspect that barely 1 in 1000 businesses and teams could decide
their own work as deeply.
secfirstmd wrote 1 day ago:
So as someone who runs and trains cyber incident response teams. Where
a big focus is on MMTx and reducing chance for adversary breakout
times. Which are gonna get worse thanks to AI. This paper was actually
part of me calling the approach Formula One IR.
Specifically about getting people joining the IR to already have their
assigned speciality and first moves ready to go and to begun, as a way
to support the incident handler. There's really big benefits to
studying the metrics of specific incidents you have to the minute by
minute level. So much time saving to be made, accuracy to be enforced
and duplication to be reduced.
You can find there's less time wasted in an incident dividing out jobs
or lost go inevitable context switching to join the incident. There's
already searches, people and clarity about what should mostly likely be
done in the first few mins, even though the plan will change and
details initially are probably scare. It's really effective and cuts
MMTx down a huge amount.
Obviously then the handover itself is a vital part in IR to get done
accurately and with speed. So that flows into all of the above. It's a
really good paper for thinking through workflows
I must get around to writing it up some day.
t0mas88 wrote 1 day ago:
It may also be relevant to study what in aviation is called MCC,
Multi-Crew Cooperation. That's all about catching errors and making
decisions under pressure as a team.
For example, two crew in the simulator, one as captain and the other
as first officer, with some external resources like a dispatcher on
the ground and air traffic control. The scenario is a flight over
high terrain with zero visibility, the trainer then introduces a
failure for example an engine fire with inability to maintain
altitude.
You could as captain start making decisions immediately but you'll
then loose the input of your FO and not optimally use the resources
you have. Or you could start a long conversation together about what
to do, but you would crash into a mountain (or burn) due to being too
slow.
MCC is about how to get the team on the same page quickly, avoid
tunnel vision and rushed wrong decisions, while being fast enough to
deal with the problem. And making effective use of outside resources
like air traffic contol. Of course it's quite aviation specific, but
there are several concepts that work in other areas as well.
secfirstmd wrote 1 day ago:
Yep totally. It's something I've incorporated. Especially where the
main incident commander gets overwhelmed with decisions, tunnel
vision or distraction. For example getting trapped into threat
hunting rather than commanding.
I actually think most cyber incident responder training for the
commander is pretty weak because it doesn't do a great job of
instituting the stress element. Physical security training does it
in a much better way. The result is the need to create custom
stuff. Because some shitty off the shelf big vendor table top or
similar ain't gonna do it.
t0mas88 wrote 1 day ago:
Exactly, it's that overwhelmed state with resulting tunnel vision
or chasing the wrong thing that is so common in aviation
incidents. If you have a big issue, the ECAM screen lights up
light a Christmas tree. There is logic in the system to ensure
messages are prioritised, but in the end the humans still have to
systematically figure out what's going on.
What causes more issues in flight is that you have to maintain
control of the aircraft while determining the issue and making a
plan. Which in zero visibility doing manual flight has a
significant mental load by itself, so if the automation is
affected by whatever issues you have, one crew member can't sit
back and 100% think.
It's probably hard to simulate that extra load/stress for cyber
incidents. For MCC training it's done in a flight simulator so
all the noise, alarms, and having to maintain control is there.
psidium wrote 1 day ago:
This was 2008 when they were fighting for titles still (turns out they
were robbed and the FIA knew about it and let it play out).
That said I imagine what Jonathan Wheatley would be able to achieve in
a task similar to this since he had the Red Bull team maintain a
consistent sub-2 second pit stop at Red Bull and he was able to
significantly quicken the Sauber one this year.
PhoenixFlame101 wrote 1 day ago:
To play devil's advocate a bit, Ferrari won both championships in
2007 and the constructors in 2008, so it's hard to say they were
robbed when they actually won. Massa though, is another story.
agos wrote 1 day ago:
They made sure it wouldnât happen again though
xeonmc wrote 1 day ago:
2008 -> 2021 bookends
squigz wrote 1 day ago:
"Some aspects of the Formula One handover were not transfer-
able to the medical handover process. When the consultant from
Formula One went to GOSH and looked at the whole handover
process, he said it would be best to engineer out parts and get
new equipment. He noted the complex technical problems with
the handover ... The Formula One consultant asked,
âWhy donât you just have one thing that does both and has its
own power supply and its own ventilator?â This was obviously
what needed to be done, but it turned out not to be feasible
since manufacturers were not interested in producing the needed
equipment. They were not interested because the market is
very small (only children) and hospitals would never be able to
replace all its beds at the same time due to the exorbitant cost of
the proposed new equipment. While the Formula One crew can
count on using technology to improve their handover process,
the hospital team could not; they had to rely more on human
beings and less on state-of-the-art technology."
asplake wrote 1 day ago:
Where I live, ambulances use pulse oximeter probes incompatible with
those used by in hospital and issued to home (my daughter was
ventilated at night and this was a real issue). That one at least
would be solved (and not expensively if only people talked to each
other. It didnât need Ferrari to surface that one!
jll29 wrote 1 day ago:
It's not just oximeters.
I once worked as a paramedic at the German-French border in the
1990s. Cross-border collaboration between us ("DRK RPF 2/83/1") and
the French firefighters ("Samu-67") was cordial but the radio
frequencies were not just different but such that the German radios
could not even be set to the French frequency (this was before
mobile phones were spread beyond C-net phones for business people
that looked like suitcases), and syringe tips and infusion needle
tips had incompatible endings.
So on one occasion, after running out of medicine and lacking a
medic, we called the French colleagues for assistance, and we'd
improvise and put a needle on a syringe and injected atropin,
adrenaline etc. as needed into the plastic infusion bottle instead
of connecting the syringe's ending right to the incompatible
butterfly (nick name for the intravenal needle).
That episode (Saturday, August 1, 1992) remains particularly
memorable since this was my first day on the job, and job #4 on
that 24-hour-shift (now they are banned to work that long) would
become my first primarily successful resucitation after 45 min of
CPR.
Standards (and open borders) can save lives.
squigz wrote 1 day ago:
45 minutes of CPR sounds like it would be really rough on both
you and the patient. Better than dying though :)
dataviz1000 wrote 1 day ago:
> they had to rely more on human beings and less on state-of-the-art
technology.
They would do better to look at the Michelin starred kitchens
starting with leaning to keep their work spaces organized and clean
no matter how fast they are moving. Here is a good example of an
engineered kitchen. "Oui"
(HTM) [1]: https://www.youtube.com/watch?v=klfxQuXT66s
sheepscreek wrote 1 day ago:
Formula One teams are known to throw money (and lots of it) at
problems. It works for them because:
- 2 drivers/cars per team.
- ~2 hour race on a weekend every ~2 weeks per season.
They donât need to solve every problem and the solutions just need
to work well during the race (at least for the pit crew).
The hospital needs to do this for hundreds of patients every day.
They need solutions that can scale (cost less per person). This was
about one specific problem (handover) but different patients could
bring with them different complications and add new constraints.
Still very cool though. Glad they got some actionable insights.
traceroute66 wrote 1 day ago:
> It works for them because:
You missed item number 3 from your list ....
Because F1 has a shit load of sponsors willing to throw a shit load
of money at the team as long as they get their logo on the side of
the car.
Hospitals don't have that. Even the US has not (yet ?) stooped so
low as to have corporate sponsorship for hospitals !
"Mr Patient, your heart operation is being sponsored by $megaCorp
... pay extra to remove the ads from your implanted pacemaker".
jdietrich wrote 1 day ago:
It's more to do with the bureaucratic costs of getting a product
licensed as a medical device. By the standards of the medical
industry, an F1 wheel nut gun or a WEC refuelling rig isn't
particularly expensive; the prohibitive part is getting a
specialist item approved for medical use. Motorsport can do things
that don't scale, because no-one is stopping them from using a
one-off prototype made to precisely fit their needs. They (and
their suppliers) iterate incredibly rapidly Bringing a new medical
device to the market is an immensely expensive multi-year project.
Obviously there are benefits to the precautionary principle, but
I'm not sure that anyone has quantified the costs.
dralley wrote 1 day ago:
As it turns out, the pit crew is just about the only functional part of
the modern Ferrari team.
rurban wrote 22 hours 16 min ago:
It's not that Ferrari is not functional. It is, but it severely
hampered by management.
When they were successful, they tried every new idea out, directly at
the track. Because they they had their own track at the door. When
they weren't allowed to do that anymore (all others complained about
their unfair advantage), they had a gap from the idea to get the
result from trying it out. So they build simulators (which all the
others already had). But they were still used to try anything out, so
that their simulators couldn't reproduce anything anymore. Because
they constantly changed all the settings.
So the managers went radical and restore backups of the simulators
every single night. They became stable, but the engineers lost all of
their work every single day. So they stopped improving the system.
That's when the car stopped improving also.
Management problem.
storus wrote 1 day ago:
Next yearâ¢
hs586 wrote 1 day ago:
The drivers are doing alright :)
dralley wrote 1 day ago:
Well, one of them anyway
linhns wrote 1 day ago:
I still wonder how Alonso managed to compete for WDC in 2010.
flopsamjetsam wrote 23 hours 28 min ago:
We are checking.
jack_tripper wrote 1 day ago:
By being one of the greatest drivers ever.
vjvjvjvjghv wrote 1 day ago:
Vettel scored 2nd two times. It seems possible. I would love to see
LeClerc in a different car.
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