Surgeon-in-Chief Shaf Keshavjee:
PLANNING FOR THE RESEARCH HOSPITAL OF THE FUTURE
Shaf Keshavjee
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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.
M.M.
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Annette Remmes
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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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