Dr. Marc Afilalo steps down after 38 years as Chief of Emergency Medicine

Research and innovation are the focus of his new responsibilities

Although Dr. Marc Afilalo has stepped away from the day-to-day operations of the JGH Emergency Department (ED), which he led for 38 years, he is continuing to play an active role in areas that he says have always been crucial to the department’s successful development: research and innovation.

Even in his earliest days as Chief in the mid-1980s, Dr. Afilalo says he emphasized the importance of gathering a broad range of data about patient care (essential for research), while developing a strategy—known as a practice plan—to enable emergency staff in all fields to raise their expertise to a superior level (a springboard for innovation).

“Since the beginning, my greatest push in our department has been to achieve excellence in the quality of care,” Dr. Afilalo says. “This means always keeping in mind the fact that the healthcare system belongs to the patients; we’re only the providers.

“My second priority was to aim for excellence in the quality of practice—in other words, creating the conditions that allow our professionals to do their best, no matter where in the ED they work. You can’t have high-quality care, unless the members of our team are satisfied with what they’re doing.”

Dr. Afilalo is easing back after a total of 43 years at the JGH, having passed the baton to the new Chief, Dr. Joel Turner. He is also staying on as Chair of the Department of Emergency Medicine at McGill University.

However, he adds that the ED at the JGH has particular challenges of its own—notably, the fact that approximately 56 per cent of its patients live in Laval, the south shore and other areas not officially served by the JGH or CIUSSS West-Central Montreal.

Yet, the hospital’s ED has continued to garner accolades from the Ministry of Health and Social Services and from organizations in the field of emergency medicine for being able to handle a hefty average of 260 patients per day—a number that often surges much higher.

Dr. Afilalo attributes this capability to various factors, including:

• The design of the Emergency Department, which opened in Pavilion K in 2014. Since the guiding principle in developing the ED was “form follows function,” the comments of staff had a major impact in determining what would work best in practice. This led to outstanding features, such as the Rapid Assessment Zone and the practice of having patients wait only a short time to be triaged.
• The ED’s quest for innovation has been bolstered by a hospital and a CIUSSS where many new types of evidence-based techniques and technology are highly prized—e.g., the Hospital@Home program, virtual care and the Connected Health Record.
• Dr. Afilalo has consistently encouraged a multidisciplinary team approach that encompasses physicians, nurses, allied health professionals, orderlies, clerical staff and other personnel.
• In a similar vein, Dr. Afilalo has nurtured an atmosphere in which teammates in the ED are united not just by professionalism, but by close, family-like connections. “We all watch each other’s backs,” he says proudly.

“My absolute pride is that I’ve been the leader of a team that’s so strongly committed to our patients,” Dr. Afilalo says. “These core values will continue under Dr. Turner. We’re not going to be starting from scratch; there will be continuity.

“I’m proud of all of them and everything we’ve achieved together. This is a feeling I will always cherish.”