A Q&A with Dr. Jim Calvin

In this Q&A, Dr. Jim Calvin, Chair/Chief, shares updates about the Department’s recent activities, priorities for the new fiscal year and a message of support to clinical teams.

"I look at the future of the Department as being very bright with significant advances in all areas, and it's been it's been a pleasure to be part of the team putting all of these components together. We are poised to optimize our success at all three aspects of our mission – clinical quality, state-of-the-art research and exceptional education." 

What message would you like to share with the clinical teams in their work during this third wave and the care they are delivering in the community?

Well firstly, I want to thank the teams for all the work that they have done during the past 16 months, it's been quite exceptional. The Department of Medicine has been asked to expand beds, contract beds, to get vaccinated, to be tested, to have clerks and medical students working with them or not working with them and so on. They have had to make a number of changes to cope with the uncertainty. The local medical community has been able to respond well to COVID-19 because of the adaptations made by the Department of Medicine.  

My expectation for individuals going forward is that they continue to follow the hospital’s rules regarding cohorting and caring for community patients with COVID-19. We need to stay calm, and we also need to be kind to one another. The hospital is also operating on demands that are being driven by decisions at the provincial level – I have a strong sense of gratitude for how everyone has stepped up to adapt to all of these changes and continue to deliver excellent patient care and medical education. 

What is happening at the Centre for Quality, Innovation and Safety (CQuInS)? What are the research and educational offerings that will be developed in the coming months?

CQuInS has been assisting the LUC3 Clinic in managing COVID-19 outpatients by helping with data collection on their activities, the number of patients being seen, and how they've been managing those patients in the clinic and remotely. We've used digital signaling from pulse oximetry as a way of monitoring oxygen levels in patients who are at home. The Clinic helps the hospital anticipate and potentially avoid admissions to hospital – we’ve seen and assessed more 1,200 patients since last summer in the Clinic

Some of the data CQuInS is collecting is helping with cost savings and identifying where we can improve care. We currently have an ongoing project that utilizes coaches to teach and strategize with patients about how to manage their disease. We've also hired a full-time educator to help us build curriculum in CQuInS and we are providing curriculum at the postgraduate level, particularly in the senior years of the Internal Medicine program. We have some ongoing quality improvement (QI) projects for each of the residents to participate in as part of that process.

We’ve also been running a quality improvement project for the Ivey School of Business for business students who are interested in health care. The goal going forward is to be able to provide a curriculum that will extend beyond the Department and the hospitals in London, as QI is a necessity for all health care institutions. 

We also use CQuInS to teach ourselves. We have faculty that are well-versed in QI, so we come together as a group in something we call a ‘mastermind series’ where we will present subjects around QI. This will certainly help to build our research focus as well as ensure the application of QI principles to our work.

What are some of the other achievements within the Department during the past few months that you’d like to highlight?

During the COVID-19 pandemic, staff and faculty are still involved with patient care, research and education, so those remain our main areas of focus. We have switched from face-to-face meetings with patients in an ambulatory setting to virtual and telephone care. I think that this method of patient care is going to grow, and the hospital will continue developing digital means to check on patients.  

Dr. Anthony Tang received peer-review funding for virtual care, and while this started in electrophysiology and cardiac arrhythmia, it's well suited to be adapted to other chronic care diseases.

In the first wave of COVID-19, we saw the growth of research projects that were specifically focused on the virus, such as understanding the pathophysiology of COVID-19 and identifying inflammatory markers. As we’ve been able to resume research, we’ve resumed many clinical trial studies that do not require patients to make in-person visits.

We've also been involved with competency by design for couple of years now and I think we're now getting to the point where we're evaluating how well we do it, especially as it relates to doing frequent evaluations.

A new fiscal year has just gotten underway, are there any important initiatives the Department is focusing on in 2021-2022?

We have hired two new researchers from the University of California San Francisco who have a background in vascular medicine and critical care medicine. They bring considerable expertise with them, and I’m excited to welcome them to the Department. With these positions, we have made a significant investment in research equipment and space.

As a Department, we have also added several new Endowed Chair positions and are focused on adding more positions moving forward. The goals for research going into the future are very ambitious, extending from population health to undertaking a pragmatic trial – a real-world clinical trial that is not as heavily controlled. Going forward, I think the emphasis will continue to be on collaboration between basic scientists and clinicians.

Recruitment and talent development is another key area of focus. In the past seven years, we’ve hired several clinician-scientists and researchers, which has resulted in a big change to the staff complement in the Department. This has led to clinical trials in gastroenterology, research exploring the stem cell work in colonic cancer, studies related to population health and more. We’ve also contributed to research training, helping early career physicians to become ICES scholars and scientists. This will allow the Department to do more in the way of big data and big data analytics. 

I look at the future of the Department as being very bright with significant advances in all areas, and it's been it's been a pleasure to be part of the team putting all of these components together. We are poised to optimize our success at all three aspects of our mission – clinical quality, state-of-the-art research and exceptional education.