Healthcare teams have adopted organizational and process techniques from the world of motor racing—specifically the pit stops of Formula One—to improve the safety and efficiency of transferring patients from the operating theatre into the intensive care unit (ICU).
At the heart of this initiative is the recognition that the transfer phase—immediately after surgery—is a high-risk period in which multiple tasks, vital monitoring changes and team handovers occur under time pressure.
At Great Ormond Street Hospital (GOSH) in London, a high number of infants undergoing heart surgery were not surviving the handover from the operating theatre to the paediatric ICU. In the 1990s and early 2000s, clinicians identified handover problems such as role confusion, inconsistent communication, interruptions and time loss.
Two doctors, Martin Elliott (cardiac surgeon) and Allan Goldman (intensive-care specialist), observed an F1 pit stop on television.
In 1999, Dr. Martin Elliott and Dr. Allan Goldman from Great Ormond Street Hospital visited the Ferrari Formula One team in Maranello, Italy, to observe their pit-stop operations firsthand. They studied how each crew member’s movement, position, and timing were choreographed and how communication was managed under intense time constraints.
Later, members of the Ferrari and Williams F1 teams visited Great Ormond Street Hospital to watch an actual patient transfer from the operating theatre to the intensive care unit. The F1 engineers analyzed the handover process and provided feedback on workflow design, positioning, and communication flow, helping the medical team redesign their procedure to reduce confusion and delays.
The following adaptations were made from the pit-stop model into the hospital setting:
Clear leadership/command structure: In an F1 pit stop, one person (the “lollipop” operator) signals when the car must leave. The hospital team assigned the anaesthetist as “team lead” during the transfer phase, who then hands over to the ICU doctor when the patient arrives.
Defined team roles and choreography: Just as each mechanic in the pit crew has a fixed task (wheel-gun operator, jack man, tyre carrier etc), the hospital transfer team defined specific roles (nurse for drains/lines, physiologist for monitoring, whichever specialist) and fixed positions so staff do not “get in each other’s way”.
Structured communications and limited simultaneous chatter: Pit‐stop teams often proceed with minimal verbal communication, relying on rehearsal and non-verbal cues. Hospitals introduced checklists and briefing/debriefing sessions and limited unstructured conversation during the handover.
Active monitoring of performance and error reduction: In the study at GOSH, implementation of the new protocol reduced the mean number of technical errors from 5.42 to 3.15 and omissions of information from 2.09 to 1.07; handover time fell from a mean of 10.8 minutes to 9.4 minutes. 1
A prospective intervention study (50 handovers before and after) at GOSH measured technical errors, information omissions and team-work scores. After applying the F1-inspired protocol, all three metrics improved significantly.
Other analyses indicate that the model of transferring knowledge from motor racing to healthcare (and other high-risk industries) is feasible and beneficial.
While the exact impact on mortality remains difficult to isolate, the reduction in handover errors and omissions is taken as a useful proxy for improved patient safety.
Applying these methods means that healthcare teams should:
Map the handover process and identify bottlenecks or “handover gaps” where time is lost or errors occur.
Assign one team lead for the process and define a clear transfer of responsibility when the patient arrives in ICU.
Define fixed roles for each team member, including physical positioning, task list and back-up coverage.
Use a structured checklist for the handover, covering patient status, lines/ventilation, monitoring, complications, expected plan.
Simulate handovers including possible complications or delays, debrief after each case and capture errors/omissions for continuous improvement.
Monitor metrics such as handover duration, number of information omissions, number of technical errors, and team-work scores.
By introducing clear leadership, fixed roles, concise structured communication, checklists, rehearsal and performance monitoring, medical teams have reduced errors, improved consistency and shortened handover time. This model offers a practical example of cross-industry learning in patient-safety practices.
References
Catchpole, Ken R., Marc R. de Leval, Angus McEwan, Nick Pigott, Martin J. Elliott, Annette McQuillan, Carol MacDonald, and Allan J. Goldman. “Patient Handover from Surgery to Intensive Care: Using Formula 1 Pit-Stop and Aviation Models to Improve Safety and Quality.” Paediatric Anaesthesia 17, no. 5 (May 2007): 470-478. https://doi.org/10.1111/j.1460-9592.2006.02239.x.
YouTube. 2022. “Formula 1 Pit Stops Have Saved the Lives of Countless Babies.” Posted by [channel name if available]. Video, [runtime]. https://www.youtube.com/watch?v=ZeMGrHcfRjY.