Domhnall MacAuley: Patient safety and sports performance

Domhnall MacauleyEighty thousand spectators hold their breath as they watch the penalty. Hushed anticipation. Fearful will he hold his nerve, handle the pressure, cope with the stress. But, is it that important? Nobody dies. Not like the decisions you make every day. For a surgeon or anaesthetist, fatal outcomes can be immediate. For others their mistakes may take a little longer. Life and death decisions, long term disability, or discomfort. But, let’s be realistic. Patient safety and sport—hardly comparable.

There was a Formula One racing car on the stage in the main auditorium at the International Forum on Quality and Safety in Healthcare. When Peter Van Manen, Managing Director of McLaren Electronic Systems spoke, it wasn’t about the risk of driver death—which is a remarkably rare occurrence when you consider the nature of the sport—but about the science of innovation, the importance of teamwork, and the application of their electronic monitoring systems in healthcare. A new motor racing car is born every year, and they must predict, monitor, and optimise performance to margins of hundreds of a second. Everyone plays a part from design to delivery. And, in the pit, seventeen people work together to change four wheels in less than 3.5 seconds.  Every aspect of the cars performance is transmitted by telemetry directly to the pit team, and relayed to the factory where a second team of experts scrutinise every nuance on a bank of screens.  Finishing first may be the only goal but first they must finish. So, although driver safety may not be the prime objective, it is essential for success.  Back to healthcare and, like the sign we often read on the side of passing lorries—how are we driving? Listening to how McLaren develop, nurture, and monitor a car, our care of human life seems almost diffident.

Peter gave some examples where quality management in the motor racing industry could make a difference to healthcare. Ferrari worked with Great Ormond Street to improve the handover from the paediatric cardiac surgery team to the intensive care team. Aspiring to the efficiency of the pit stop team they drew up a new handover protocol with their help. The McLaren Racing Team work with Birmingham Children’s hospital, not just in developing telemetry to improve monitoring care within the special care baby unit, but also in ambulance transport. And (although he told me afterwards that it was tongue in cheek), he also said, there were so many parallels between the environments, that intensive care  units could easily double as a formula one pit garage—if only they were cleaner.

Domhnall Macaulay is primary care editor, BMJ