From pit crews to project crews: What healthcare and construction teach us about delivering strategy

There is a powerful pattern emerging across industries.

From Formula 1, to healthcare, to construction, high-performing organisations are not succeeding because they have better strategies.

They are succeeding because they have better execution systems.

business team meeting

Case study 1: Great Ormond Street Hospital × McLaren F1

When execution saves lives

At Great Ormond Street Hospital (GOSH), leaders identified a critical risk:

• Transfers of critically ill children between units were inconsistent

• Communication breakdowns were occurring

• Role clarity was weak at the most critical moments

Sound familiar?

This is the same failure pattern seen in projects during stage transitions.

healthcare team portrait

What they did

GOSH partnered with the McLaren Formula 1 team to study pit stop operations.

What they observed:

• Every role precisely defined

• Every movement choreographed

• One clear leader at each moment

• Zero tolerance for ambiguity

What changed

They implemented:

• Structured transfer protocols

• Clear accountability for decision-making

• Checklist-driven readiness controls

• Simulation-based team training

The result

• Reduced clinical risk

• Faster, more predictable transfers

• Improved team coordination

medical team meeting

The insight for project delivery

Most failures do not occur because of lack of skill.

They occur because of poor coordination at critical moments.

In project terms, these are:

• Stage gates

• Governance approvals

• Handover between teams

• Transition to operations

These are your “pit stop moments.”

performance meeting

Case study 2: Heathrow Terminal 5

When construction rewrote the rules of delivery

Now consider one of the most complex infrastructure projects ever delivered in the UK: Heathrow Terminal 5 (T5).

Historically, large construction projects suffered from:

• Fragmented supply chains

• Adversarial contracts

• Misaligned incentives

• Cost overruns and delays

The problem

Traditional delivery models created:

• Siloed teams

• Blame shifting instead of collaboration

• Poor integration across contractors

This is the construction version of the strategy implementation gap.

Collaboration between teams reviewing project plans

The intervention: the T5 agreement

BAA fundamentally redesigned how the project would be delivered:

1. Integrated Team Model

   • Client, contractors, and suppliers operated as one team

     
     

2. Aligned Incentives

   • Shared risk and reward model

   • Focus on project success, not individual contracts

     
     

3. Clear Governance and Decision Rights

   • Rapid decision-making

   • Escalation paths clearly defined

     
     

4. Focus on Coordination Over Contracts

   • Less emphasis on legal protection

   • More emphasis on delivery outcomes

The result

• Delivered close to schedule and budget

• Significantly reduced disputes

• High levels of collaboration across the supply chain

The insight for project delivery

T5 proved:

You cannot contract your way to success.

You must design your delivery system for success.

construction worker smiling

Connecting the dots: the real lesson

Across both case studies, the pattern is clear:

Dimension	Healthcare (GOSH × F1)	Construction (T5)	Project Delivery Insight
Roles	Precisely defined	Integrated teams	Clarity removes friction
Handover	Structured transfers	Coordinated interfaces	Transitions are critical
Governance	Clear leadership	Defined decision rights	Speed + control matters
System Design	Choreographed	Designed operating model	Delivery is engineered

The hero framework: DELIVER

To operationalise these lessons, organisations need a system.

This is where the DELIVER model becomes critical.

The 5Ps applied

• Purpose

  Clear alignment to strategic outcomes

  
  

• People

  Defined roles, accountability, capability, culture

  
  

• Practice

  Governance, lifecycle controls, standardisation of ways of working

  
  

• Platform

  Tools, data, and AI-enabled insights

  
  

• Performance

  Measurement of value, not just activity

  
  

Why this matters more than ever

Modern project environments are:

• More complex

• More interconnected

• More time-constrained

Traditional approaches struggle under:

• Uncertainty

• Ambiguity

• Interdependencies

These are well-recognised characteristics of complex projects, where interactions and system behaviour can drive unexpected outcomes.

writing on yellow post-its

The shift required

Organisations must move from:

Delivery as activity → Delivery as a system

This aligns with the evolution of project management itself:

• From process-driven to principle-driven

• From outputs to outcomes

• From control to value delivery systems

Practical actions for leaders

To apply these insights:

Redesign your “pit stops”

• Strengthen stage gates and transitions

• Standardise handovers

Clarify roles and decision rights

• Eliminate ambiguity

• Enable faster decisions

Integrate teams

• Break down silos

• Align incentives

Embed real-time performance insight

• Move beyond static reporting

• Introduce data-driven governance

A woman aplaused by people in a room

Final thought

The surgeons at Great Ormond Street didn’t become better clinicians overnight.

The Heathrow T5 team didn’t suddenly become more capable contractors.

They became better coordinated systems.

And that made all the difference.

businesswoman

Start bridging the gap

If you want to move from strategy to successful delivery:

👉 Download the first 3 chapters of The Strategy Implementation Gap: https://www.pmlogic.com.au/sig-book

Closing reflection

How aligned are incentives, accountability, and governance across your delivery ecosystem and is this misalignment contributing to the reality that over 90% of complex or AI initiatives fail to scale or deliver sustained value?

You don’t need a better strategy.

You need a better way to deliver it.

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Please contact one of the PMLogic team to find out how we can help you uplift your delivery capability.

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