‘None of this work was perfect, but it was rapid and it was impactful’

“The task of vaccination has been laser focused,” writes Shiran Isaacksz in the latest Pandemic Perspectives essay. “The shared purpose to save lives by vaccinating as many people as quickly as possible united many teams across different sectors, organizations and geography.” (Photo: Courtesy Shiran Isaacksz)

By Mr. Shiran Isaacksz

It started, as it always does, with a phone call. It was a Sunday in March 2003, the eve of my first big leadership opportunity in healthcare – four weeks as acting Director. On the line was UHN’s Chief Financial Officer. The news was grave. The provincial government was closing all hospitals to visitors, and non-patient facing staff were being asked to work from home in response to Severe Acute Respiratory Syndrome (SARS). Suddenly, I was supporting my team through the initial phase of an epidemic that would be a major influence in how I approached the next two decades of my career. 

As a self-proclaimed planner, the unknown of SARS had me feeling completely unprepared with both a sense of urgency and dread. My team, and so many others, had to figure out how to work remotely, before smart phones, high speed internet or MS Teams. It was challenging and unprecedented. But the experience helped me learn early in my career how having a shared purpose can bring individuals and teams together to create something lasting and meaningful with collective impact.  

A few years after SARS, I was on the team tasked with developing and implementing a real-time monitoring and reporting information system for all critical care beds in Ontario. The outbreak exposed a critical gap in our health system and it needed to be addressed. That project and the team which led it, became the foundation for what is now Connected Care at UHN. Over the past 15 years, we have driven large-scale innovation across the province and helped to build the organization’s skillset, capacity and relationships throughout the health system.  

‘Responding to the pandemic, as it has for many of us, has been a constant in my life.’

– Shiran Isaacksz

That work also prepared me for the phone call I received on March 13, 2020. I awoke that Friday the 13th acutely aware of the escalating COVID-19 situation. Two days earlier, the World Health Organization (WHO) declared a pandemic. The images from Italy and New York were dramatic. I knew the threat was coming closer to home. I was huddled with the leadership team in my office discussing the potential impact on our staff and programs, when Grace Ivo, Executive Assistant UHN’s President & CEO, called to say Dr. Kevin Smith wanted to see me in his office as soon as possible. As I grabbed my jacket and started the walk to Toronto General Hospital, I had that same feeling of urgency and dread I experienced 17 years earlier. 

When I arrived at Kevin’s office, he waved me in as he was wrapping up a call. Hanging up, he jumped right in, asking me if I was willing to be redeployed to provide program support for the Ministry of Health’s COVID-19 response. It was part of a call going out across Ontario in an effort to mobilize the largest modern day health system response to a threat we were only just beginning to understand. I blurted out an emphatic “yes!” before he finished asking. We both appreciated the urgency and I said I could be ready to help within the hour.  As I got up to leave, he said: “Shiran you need to run, not walk. We don’t have much time.” 

At home later that evening, I watched WHO’s daily COVID-19 briefing. Dr. Mike Ryan, Executive Director of its Health Emergencies Program, offered insight on his two decades managing Ebola outbreaks: “Perfection is the enemy of the good when it comes to emergency management. Speed trumps perfection…The greatest error is not to move. The greatest error is to be paralyzed by the fear of failure. If you need to be right before you move, you will never win.” Those words, and Kevin’s earlier that day, have served as my North Star over the past year. 

Responding to the pandemic, as it has for many of us, has been a constant in my life. In Wave One, my focus was on three critical areas: program support for the Ministry of Health COVID response, rapid implementation of a virtual care platform for primary care in the downtown core (and eventually long-term care across the province), and driving new integrated care pathways to support some of the most vulnerable patient populations. Through this accelerated effort, I witnessed clinical disciplines from across TeamUHN and community partners come together in shared purpose. The result again was astounding – in four weeks an integrated care pathway for COVID positive patients was established to ensure individuals were well cared for at home with remote monitoring, education and timely access to specialist care as needed.  

None of this work was perfect. But it was rapid and it was impactful. By leveraging existing relationships and bringing together an informal network of super connectors, programs that were built in weeks have endured through Wave Two and Wave Three, supporting patients and providers alike. Connected COVID Care alone has now supported more than 16,000 patients. 

These experiences made me ready for the next phone call. It came on Dec. 29. Rebecca Repa, UHN’s EVP of Clinical Support & Performance, confirmed UHN was receiving its first shipment of the Moderna vaccine the next day. I was asked to mobilize a team to begin vaccinating long-term care residents within 48 hours. Again, playing in my head, I heard the words of urgency: “run don’t walk,” “speed over perfection,” “the greatest error is to be paralyzed by fear.” This time, though, it was different. Gone was the dread. In its place, was an understanding of what was possible.  

‘Just as I know the call will come, I expect there to be urgency attached. But no dread. Just opportunity to move collectively toward building a better healthcare system for all.’

– Shiran Isaacksz

The task of vaccination has been laser focused. The shared purpose to save lives by vaccinating as many people as quickly as possible united many teams across different sectors, organizations and geography. Our collective impact resulted in the inoculation of more than 20,000 long-term care residents and staff – providing a ring of protection around some of our most vulnerable in less than two months.  

Like so many others, our teams are exhausted. But what pushes us now is the goal of extending our mobile vaccination efforts and learning into other high-risk populations with a particular focus on equity. Teams have rallied around #TeamVaccine to expand to congregate settings and shelters. And the most recent phone call, which was received two weeks ago, has us leading the City of Toronto mobile vaccination campaign that includes community clinics, door-to-door support as well as in-home vaccinations. This is not easy work but we keep going because we know we are making a difference.  

Looking forward, I know there will be another phone call. There always is. Whether it is in this pandemic or after, I am both nervous and excited to answer it. I hope it will be another catalyst to challenge the status quo, drive new models of care and work together with a shared purpose of improving outcomes and the experience for patients. Just as I know the call will come, I expect there to be urgency attached. But no dread. Just opportunity to move collectively toward building a better healthcare system for all. 

Mr. Shiran Isaacksz is Vice President, Altum Health and UHN Connected Care

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