Q&A with Dr. Imtiaz Ali, Chief, Section of Cardiac Surgery

Dr. Imtiaz Ali

Chief, Section of Cardiac Surgery
Provenance: Halifax, Nova Scotia

“Surgery is conclusive with results. You see your results right away as opposed to waiting and waiting as you sometimes do in other specialties.”

Why did you choose cardiac surgery as a career path?
During medical school, I always had an interest in surgery and the heart. Originally, I thought I would go into cardiology. But I was fascinated by the actual ambiance of the operating room. The pace of work appealed to me. And the handiwork—you have to have technical expertise to affect a good outcome. I thought I maybe should consider combining internal medicine stuff with surgery so heart surgery became a potential goal.

What attracted you to join the Libin Institute?
An opportunity like this doesn’t come around every day. Knowing the reputation of the Libin Institute as a world class cardiovascular institute was certainly appealing to me. One of the main appeals was the administrative structure here. Being a surgeon, all my previous appointments were in the Department of Surgery at Dalhousie University. Here, it’s in the Department of Cardiac Sciences. This allows for a better working relationship because the two specialties of cardiology and cardiac surgery are so interrelated. Having the opportunity to work in the department of cardiac sciences fosters cross collaboration with cardiology much more so than in previous institutions that I’ve worked at.

Given the Institute’s focus on outcomes research and reputation for databases like APPROACH, what parallel opportunities do you see for cardiac surgery?
One of the major tasks for us here is to establish a surgical clinical database. We have a surgical module in the APPROACH dataset and it looks at over 400 data elements specific to the cardiac surgery component. It’s my duty now to develop the infrastructure (hire the appropriate people) to run and manage it. My hope is that once we have this, as a Division head, I will be able to generate annual risk adjusted outcomes for the group as a whole and also for each individual surgeon. This will also allow us to initiate continuous quality improvement (CQI) projects that should lead to better patient care and outcomes.

As a new Chief of Cardiac Surgery, what are your first orders of business?
Restructuring and finding a better way to triage our patients so they can get their surgeries in a timely fashion. It’s always about clinical betterment. The provincial government has mandated that the wait times for coronary bypass grafting surgeries be benchmarked at six weeks, so that’s a standard. Procedures will be increased by 120 cases over the next 18 months, so my first effort is to reduce the wait list. To really get to the root of the problem of the long wait list will require a long-term solution that requires the cooperation of the referring cardiologists. I’m working very closely with Dr. Ed O’Brien to bring in some fresh ideas on how to triage patients and change the entire referral system so it’s more efficient.

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