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Surgeon-in-Chief Shaf Keshavjee:


Shaf Keshavjee
Shaf Keshavjee

Shaf Keshavjee describes his position as Surgeon - in - Chief at the University Health Network as one of "broadened responsibility in an institution with remarkable talent and vision". His goal is to "take surgical services up to the next level, as an integral part of the research hospital of the future, providing world class care in the Canadian setting."

The SIC has a broad portfolio including Anaesthesia, Critical Care, Ophthalmology, Gynecology, Otolaryngology and all of the surgical specialties. He will support the leadership in these areas, but "you have to be in the trenches of the operating room, the clinic and the laboratory to understand and anticipate the challenges." The leadership team includes Stephanie Brister as Operating Room Medical Director at Toronto General Hospital, Rod Davey as Medical Director of Operating Room at the Toronto Western Hospital and Dave McCready at Princess Margaret. Scott McIntaggart and Judy Costello are part of his outstanding senior administrative leadership staff, supported by Lisa Spatafora, Laura Bortolamiol and Annette Remmes.

Bryce Taylor will lead the Patient Safety and Checklist Project as he has done so well in recent years. He will also head the International Patient Program.

A good example of a SIC problem occurred in the week just before our interview. Twenty-eight transplants resulted in multiple cancellations of elective cases that week. Rather than leave these on the board, hoping for a slot, Shaf - with the help of Stephanie Brister, the nursing staff and Andrew Pierre as surgeon of the month opened the operating rooms needed to get them done. "We will improve the life of the academic surgeon. You cannot just cancel cases and then assign operating days on short notice that interrupt their future schedule. We've revamped the operating schedule to run like a business, optimizing utilization, OR day length and staffing of the operating rooms to increase throughput."

An example of "the research hospital of the future" is the Organ Repair Laboratory being built in the operating room at Toronto General. This room will enable leading edge stem cell work and organ repair and regeneration within the surgical unit. "Terry Yau can process a patient's bone marrow stem cells and inject them into the heart, following the research work that he and Richard Wiesel have developed. Markus Selzner can resuscitate livers, and the lung transplant team can resuscitate lungs, not by trolleying them to a laboratory, but working optimally and immediately within the surgical operating room suite." Readers who have worked with grant funds will recognize how drawn out the process of building a novel laboratory like this could be. Shaf 's approach was "You start the conversion, I'll find the money".

His strategic planning for Critical Care includes a conversion from scrambling to find a few beds on a daily basis as the main occupation of the Critical Care team to rightsizing the Intensive Care Unit to be able to accommodate the complex patients dealt with daily at UHN. Shaf will participate in the strategic planning of Critical Care until this goal is accomplished. Another high priority is bringing the informatics systems of research and clinical care together.

On the weekend that I interviewed Shaf by telephone, he was just in from skating with his daughter Sara. Shaf tries to get home on Friday night in time to blow the snow off the rink they built in their backyard and then flood it for early Saturday skating. His wife Donna McRitchie continues her busy life as General Surgeon, Vice President for Medical Affairs and Head of Critical Care at North York General Hospital.


Annette Remmes
Annette Remmes

Annette Remmes continues in the office of the Surgeon-in- Chief at the University Health Network where she has worked for the past 11 years with Bryce Taylor. She is the Business Management Administrator for the Department of Surgery at UHN, taking on additional responsibilities and bringing the benefit of her extensive knowledge and experience within Surgical Services. She is currently reviewing and assisting in the implementation of a new credentialing policy for observers in clinical areas, with primary focus on the operating rooms across the three sites. She continues to help in searches for new faculty members and in the credentialing of surgeons. "The search and recruiting process is continuously improving toward greater fairness and wider scope."

This September will mark 25 years at the University Health Network for Annette. She enjoys the position: "the people are the best part of the job, they are like family." She works actively with Lisa Spatafora, formerly the divisional secretary of the Thoracic Surgery Division and currently Shaf Keshavjee's executive assistant. Laura Bortolamiol manages Shaf's clinical practice as she has done for the past 17 years. Annette likes to solve new problems, which she does with grace and facility. "Problems are only as big as I make them". She has learned from experience, reading, and passionate engagement with her job. She is grateful to Bryce Taylor for giving her many opportunities to grow in this position. Annette is currently reading "The EQ Edge" by Steven Stein and Howard Book, "an excellent book on developments that have taken place in emotional intelligence research over the past five years." Steven Stein, PhD, is a clinical psychologist and former assistant professor in the Department of Psychiatry at the University of Toronto.

Annette kayaks and works actively on her farm in the Bancroft area. She is a former team member of the fUHNatics Dragon Boat and is active in Yoga. The continuity that she has provided has been invaluable to Shaf in his transition into the position of Surgeon-in-Chief.

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