NEWSLETTER - DAY 03 WEDNESDAY 20th FEBRUARY
Hospitals learn about efficiency from F1 I
n a world of severe hospital budget cuts and ever-increasing calls for higher levels of efficiency and safety, hospitals must start working differently – and they can learn a lot from the corporate world. So said Allan Goldman, Clinical Unit Chair for Critical Care at London’s Great Ormond Street Hospital at the 6th World Congress of Paediatric Cardiology and Cardiac Surgery, currently on in Cape Town. “In terms of how we process patients, we need to learn how industries process things and get rid of waste in systems. We need to look at how they efficiently manage flow,” he said. “In terms of safety we have to learn from high reliability organisations,” Goldman told a plenary entitled Heart Surgery is a Risky Business: Doing it Better, Safer for Less. Hospitals must shift their focus towards “from physician-, surgeon- and nurse-centred care to patient-centred care, said Goldman, who trained in South Africa. “We have the opportunity, with fantastic data, to improve outcomes,” he
By SUE SEGAR said, adding that such data was often to be found in the examples and experiences of industry. In an inspired move, following a “small cluster of failures” around an operation in the late 1990s, Goldman’s hospital consulted a Formula 1 Team in a bid to learn about systems of efficiency. “We wanted to learn how they did a pit stop – and how we could relate that to how we handed over patients from a theatre team to an intensive care unit,” he said. “At a pit stop, the racing cars come in and their tyres are changed and they are filled with fuel in a matter of seconds. We wanted to learn from this efficiency.” In a further bid to learn from industry, the hospital’s head of the Cardiac Unit, contacted a human factors expert who had transformed the airline industry. “From that time on we have had this ethos of having human factors experts in our department to look at factors affecting the performance of operations using human factors.
Surgeons learn a thing or two about efficiency from Formula 1 teams
Allan Goldman
“The Formula 1 Team helped us to look at team interfaces. “We realized we have a huge amount to learn from other industries.” Goldman said another great challenge for hospitals, moving forward, was how teams work together. “We need to move away from a focus on individuals. “Of course we need fantastic surgeons. There’s no question of that. But it is really the big teams and how functional they are that will determine outcomes.” Goldman said decreasing availability of money, coupled with higher expectations and a new shift on patient safety, placed a heavy responsibility on hospitals to learn to “do the same with less money”. “We have been through the first phase of getting children with high mortality rates in the 1960s, 70s and 80s to mortality rates of one to two percent. “The next challenge is about quality of life and long term outcomes.” Goldman said the knowledge he gained from working with - and learning from - industry had led to his joining up with a retired pilot and a retired surgeon to start a series of conferences called Risky Business: Learning from other industries. They have run 10 conferences since 2006,” he said. “It is possible, if we change the way we think and work, to learn from other industries and from each other.”