McGill Cardiology Towards (closer) collaboration Lawrence Rudski MD FRCPC FACC FASE Professor of Medicine Director, Division of Cardiology Director, Azrieli Heart Center Jewish General Hospital McGill University

Collaboration is: Not natural – id/ego/superego Evolutionarily advanced Evolutionarily necessary Evolutionarily satisfying, if successful But SOMETIMES HARD

Why Collaborate? 1 + 1 = 3 1 vs. 1 = < 2

Ingredients for Successful Collaboration Understand your own situation Have a willing partner for collaboration – need to understand that the process is based on mutual respect and that the end-game is a win- win Strategic Planning Exercise: Establish Goals for Collaboration – for you and for the collective Develop strategies of Attaining Goals Develop Benchmarks Get buy-in from players – make it fun and make them believe that the collaboration is a natural evolution of their goals

Top Down or Bottom Up Yes (Un)fortunately highly motivated physicians who all know what is right and won’t be told otherwise So…they need to pool/pull together and have their epiphany that collaboration will improve their personal state and the state of their missions Overall General Guidance and Benchmarks from above Centralized Authority and Decentralized Decision-Making

Blockers – What is Needed? Time…we don’t have enough time to go into this Trust… Are we there yet? Communication – lack thereof Leadership $$$ - sadly, probably the least important first step

Not So Depressing Clinical Teaching Research Missions - To our members – ALL 3 are just and important and fully intertwined. Cannot focus on one without the others Clinical Teaching Research

Internationally Renowned Structural Program (MUHC) Frailty (JGH) Transplant (MUHC) Lipids (MUHC) Vascular Biology (JGH) Pulmonary Hypertension (JGH) Cardiac Imaging – Echo (JGH) and MRI (MUHC) Electrophysiology (MUHC) Epidemiology and Epigenetics (Both) ACHD ( Both)

Clinical CROSS APPOINTMENTS Essential Services at Both, Complementarity to some extent, but lack of recognition that two (or three) stronger sites better than one – like for U de M Offre de Services for ministry – Not a fun exercise Congenital * Heart Failure/Transplant/Mechanical Support – issues to work out Interventional/Structural – including imaging * Pulmonary Hypertension Electrophysiology CVICU * CROSS APPOINTMENTS

Teaching Combined Training Program offering complementary learning opportunities Strong interest from both sites to contribute Harmonization of roles and responsibilities for Attending MD for rotations in CVICU, consults, clinic Combined/Collaborative Fellowships – High Risk PCI, Echo, Beth Raby ACHD, Core trainees (Incl. funded positions) Retreat to get everyone together to discuss challenges Significant Improvements since, under leadership of Annabel Chen- Tournoux and Natalie Bottega

Beth Raby Fellowship in ACHD

Ongoing Research Collaboration Frailty – Cardiac Surgery and TAVR - Funding ACHD – Fully Integrated Interventional cardiology – minor CTO MRI – Nascent

Empowerment - Life’s Hard Enough Mission Vision Goals & Objectives Action Plan

Familiarity Breeds… SUCCESS

Research – Opportunities – Working Groups Directive to be INCLUSIVE – Other partners and sites welcome – St. Mary’s LGH etc

The Glass is Fillable Looking for a Sommelier…

Let’s Make Cardiology Great(er) Again