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NASA and NASCAR provide lessons on improving quality, reducing errors
A forum highlighted similarities among surgery, racing and the air and space industries.
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A forum highlighted similarities among surgery, racing and the air and space industries.
In a special topics forum at the Pediatric Orthopedic Society of North America 2012 Annual Meeting, experts from the National Aeronautics and Space Administration and the National Association for Stock Car Auto Racing shared their safety and quality practices with attendees in an effort to improve risk management and care of pediatric orthopedic patients.
The discussion was organized by two physicians at Children’s Hospital in Boston — Peter M. Waters, MD, clinical chief of orthopedics and immediate past president of the Pediatric Orthopedic Society of North America (POSNA), and Peter Laussen, MD, chief of Cardiac Intensive Care and co-organizer of Risky Business educational forums (www.risky-business.com/events) — as part of the Quality and Safety Values and Risky Business Initiatives. Waters and POSNA started the Quality and Safety Values Initiative a year ago to improve the musculoskeletal care for children. The cardiac surgical and intensive care team from Great Ormond Street Children’s Hospital in London, in collaboration with the Royal College of Surgeons in the United Kingdom, pioneered Risky Business in the early 2000s to look at high-risk industries and determine what they could learn from these businesses and how they could adopt similar safety and quality practices. Laussen has been involved in their educational programs and practice changes.
“It is amazing. In the end, whether it is space aeronautics, race car driving or the operating room, it is the same,” Laussen told Orthopedics Today. “You are trying to minimize risk at the interface between human talent and technology.”
Crew chiefs and astronauts
As part of the forum, the president and chief operating officer of Hendrick Motorsports in the National Association for Stock Car Auto Racing (NASCAR) Marshall Carlson spoke to attendees on the topic of building a winning team and Tom Hendricks, a National Aeronautics and Space Administration (NASA) space shuttle commander and pilot presented, “Disaster in a Safety Culture.”
Waters noted that similar risk factors exist in NASCAR, NASA and orthopedic surgery. Waters and Laussen said the most important thing they learned from Carlson and Hendricks was the value of leadership in accomplishing goals.
“If your leaders are not dedicated to high-quality work and not interested in building teams, then you are probably not going to be successful in the end,” Waters told Orthopedics Today. “In addition to champions, you have to be integrated with other like-minded people so you can learn.”
Laussen noted that NASCAR, NASA and orthopedic surgery deal with dynamic problems, in which creating a fix in one area does not always mitigate risk in another area.
In these industries, there must be constant measurement and investigation to prevent problems.
“It is important that [risk] is viewed as a dynamic continuum, and there is continual measurement and evaluation of not only where you have been, but where in the future risk may occur,and that is hard. It takes a multidisciplinary approach,” Laussen said.
Communication, follow up
One safety precaution NASCAR takes is pre-race planning. In the same manner a surgeon conducts preoperative planning, race car drivers must understand their cars, review racing situations, weather conditions, competition and goals, Waters said.
Just like surgical teams, race crews must effectively communicate. Crew chiefs, spotters and race engineers give drivers feedback during races.
“We have an operating room team who, if you have empowered them properly, will communicate clearly to you and directly with you,” Waters said. “One of the goals is clear and direct communication to all members of the team, so you know your risk at that particular moment in time and you can make decisions as to what is best for your patient.”
During his presentation, Hendricks stressed the importance of immediately following up on a disaster. He advised orthopedists to conduct thorough evaluations, without blaming anyone, and to dissect the problem to its core to learn from the experience.
“It is also a systematic approach,” Laussen said. “You start at a global view, and you drill down into specific areas and not ignore concerns or complaints when they come from one area, but also be aware there can be multiple different areas of concern. It is being flexible and scalable in your approach to understanding what the problem was, and then making sure that you follow through and put measures in place to fix the problem.” – by Renee Blisard Buddle
References:
- Laussen P, Carlson M, Hendricks T, Hyman D. Special topics forum: Quality and safety values initiative. Presented at the Pediatric Orthopedic Society of North America 2012 Annual Meeting. May 16-19. Denver.