3 ms·

Formula One Handovers and Handovers From Surgery to Intensive Care (2008) [pdf]

113 points by bookofjoe 11mo ago

dralley 11mo ago
As it turns out, the pit crew is just about the only functional part of the modern Ferrari team.
- linhns 11mo ago
  I still wonder how Alonso managed to compete for WDC in 2010.
  - vjvjvjvjghv 11mo ago
    Vettel scored 2nd two times. It seems possible. I would love to see LeClerc in a different car.
  - jack_tripper 11mo ago
    By being one of the greatest drivers ever.
  - flopsamjetsam 11mo ago
    We are checking.
- hs586 11mo ago
  The drivers are doing alright :)
  - Nervhq 11mo ago
    [dead]
  - dralley 11mo ago
    Well, one of them anyway
- storus 11mo ago
  Next year™
- rurban 11mo 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.
squigz 11mo 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, “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 11mo 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 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 11mo 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.
bamboozled 11mo ago
[flagged]
psidium 11mo 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.
- xeonmc 11mo ago
  2008 -> 2021 bookends
  - hamonrye 11mo ago
    [dead]
- PhoenixFlame101 11mo 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 11mo ago
    They made sure it wouldn’t happen again though
secfirstmd 11mo 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 11mo 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 11mo ago
lifeisstillgood 11mo ago
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 11mo ago
Interesting. Another take- "Two F1 fan surgeons found a way to visit Ferrari headquarters as a business trip."
- PaulRobinson 11mo 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 11mo 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.
dbgrman 11mo ago
I'm curious how the OP got to this PDF document... like what were they researching? searching? how?
- sturza 11mo ago
  It was an anecdote or a story shared on HN eariler this year.
  - zimpenfish 11mo 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.
- celticninja 11mo 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.
alexpotato 11mo 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.
- NedF 11mo ago
  [dead]
raphman 11mo ago
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.1460-9592.2006.02239.x 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 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-contributions-healthcare 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 http://www.wsj.com/articles/SB116346916169622261 (archived copy: https://archive.is/xEbio 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-martin-elliott-interview-surgeon-f1-pitstops-babies-ferrari-j3sbkjssk https://www.thetimes.com/sport/formula-one/article/professor... (archived copy: https://archive.is/1iGXK https://archive.is/1iGXK)
- raphman 11mo 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 11mo 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.

113 points by bookofjoe 11mo ago

dralley 11mo ago

As it turns out, the pit crew is just about the only functional part of the modern Ferrari team.

linhns 11mo ago
I still wonder how Alonso managed to compete for WDC in 2010.
- vjvjvjvjghv 11mo ago
  Vettel scored 2nd two times. It seems possible. I would love to see LeClerc in a different car.
- jack_tripper 11mo ago
  By being one of the greatest drivers ever.
- flopsamjetsam 11mo ago
  We are checking.
hs586 11mo ago
The drivers are doing alright :)
- Nervhq 11mo ago
  [dead]
- dralley 11mo ago
  Well, one of them anyway
storus 11mo ago
Next year™
rurban 11mo 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.

squigz 11mo 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, “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 11mo 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 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 11mo 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.

bamboozled 11mo ago

[flagged]

psidium 11mo 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.

xeonmc 11mo ago
2008 -> 2021 bookends
- hamonrye 11mo ago
  [dead]
PhoenixFlame101 11mo 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 11mo ago
  They made sure it wouldn’t happen again though

secfirstmd 11mo 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 11mo 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 11mo ago

lifeisstillgood 11mo ago

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 11mo ago

Interesting. Another take- "Two F1 fan surgeons found a way to visit Ferrari headquarters as a business trip."

PaulRobinson 11mo 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 11mo 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.

dbgrman 11mo ago

I'm curious how the OP got to this PDF document... like what were they researching? searching? how?

sturza 11mo ago
It was an anecdote or a story shared on HN eariler this year.
- zimpenfish 11mo 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.
celticninja 11mo 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.

alexpotato 11mo 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.

NedF 11mo ago
[dead]

raphman 11mo ago

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.1460-9592.2006.02239.x 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 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-contributions-healthcare 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 http://www.wsj.com/articles/SB116346916169622261 (archived copy: https://archive.is/xEbio 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-martin-elliott-interview-surgeon-f1-pitstops-babies-ferrari-j3sbkjssk https://www.thetimes.com/sport/formula-one/article/professor... (archived copy: https://archive.is/1iGXK https://archive.is/1iGXK)

raphman 11mo 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 11mo 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.