[HN Gopher] Formula One Handovers and Handovers From Surgery to ...
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Formula One Handovers and Handovers From Surgery to Intensive Care
(2008) [pdf]
Author : bookofjoe
Score : 102 points
Date : 2025-12-06 19:21 UTC (7 days ago)
(HTM) web link (gwern.net)
(TXT) w3m dump (gwern.net)
| dralley wrote:
| As it turns out, the pit crew is just about the only functional
| part of the modern Ferrari team.
| linhns wrote:
| I still wonder how Alonso managed to compete for WDC in 2010.
| vjvjvjvjghv wrote:
| Vettel scored 2nd two times. It seems possible. I would love
| to see LeClerc in a different car.
| jack_tripper wrote:
| By being one of the greatest drivers ever.
| flopsamjetsam wrote:
| We are checking.
| hs586 wrote:
| The drivers are doing alright :)
| dralley wrote:
| Well, one of them anyway
| storus wrote:
| Next year(tm)
| rurban wrote:
| 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.
| squigz wrote:
| "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, "Why don't you
| just have one thing that does both and has its own power supply
| and its own ventilator?" 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."
| sheepscreek wrote:
| 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 don't 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.
| jdietrich wrote:
| 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.
| traceroute66 wrote:
| > 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".
| dataviz1000 wrote:
| > 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"
| https://www.youtube.com/watch?v=klfxQuXT66s
| asplake wrote:
| 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 didn't need Ferrari to surface that
| one!
| jll29 wrote:
| 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:
| 45 minutes of CPR sounds like it would be really rough on
| both you and the patient. Better than dying though :)
| psidium wrote:
| 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.
| xeonmc wrote:
| 2008 -> 2021 bookends
| PhoenixFlame101 wrote:
| 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:
| They made sure it wouldn't happen again though
| secfirstmd wrote:
| 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:
| 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:
| 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:
| 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.
| lifeisstillgood wrote:
| It's 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.
| scrollop wrote:
| Interesting.
|
| Another take-
|
| "Two F1 fan surgeons found a way to visit Ferrari headquarters as
| a business trip."
| PaulRobinson wrote:
| 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.
| dbgrman wrote:
| I'm curious how the OP got to this PDF document... like what were
| they researching? searching? how?
| sturza wrote:
| It was an anecdote or a story shared on HN eariler this year.
| zimpenfish wrote:
| 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.
| celticninja wrote:
| 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.
| alexpotato wrote:
| 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.
| raphman wrote:
| Some more sources I saved recently after learning about Elliott's
| work:
|
| The original paper by Catchpole et al. (2006):
| https://onlinelibrary.wiley.com/doi/10.1111/j.1460-9592.2006...
|
| A quite interesting lecture on the whole project, given by
| Elliott in a racecar driver's suit:
| https://www.youtube.com/watch?v=ZeMGrHcfRjY
|
| Annotated transcript of the talk available here:
| https://www.gresham.ac.uk/watch-now/formula-1-and-its-contri...
|
| A WSJ article from 2006: A Hospital Races To Learn Lessons Of
| Ferrari Pit Stop:
| http://www.wsj.com/articles/SB116346916169622261 (archived copy:
| https://archive.is/xEbio)
|
| Times article from 2024: The surgeon who used F1 pitstop
| techniques to save lives of babies:
| https://www.thetimes.com/sport/formula-one/article/professor...
| (archived copy: https://archive.is/1iGXK)
| raphman wrote:
| 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:
| 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.
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