It's pretty rare that I'm sit on all 18 tables when the ICM decisions get complicated, so that helps. Most decisions can be made in <1 second anyway. Half the time I'm waiting for my PC to catch to me!

Otherwise it's just practice. I think Boku87 was playing up to 50 at once during his PokerStars challenges. He is playing MTTs, so he is more likely to be at a full table and therefore have more time before he needs to act again. But I would guess 60 hands/hour is probably normal for a MTT. He needs to be making and performing decisions in around 1-1.5 seconds.