From the Director: Year in Review

James

In April 2020, James Ficke directed the conversion of the Baltimore Convention Center into an alternative care site for COVID-19 response.

Even during an unprecedented year like 2020, our department has remained committed to the mission of Johns Hopkins Medicine — to improve the health of the community and the world by setting the standard of excellence in medical education, research and clinical care. Though the challenges continue to be many during the coronavirus pandemic, we remain focused on training the next generation of leaders in our field, on making discoveries and developing clinical innovations, and taking excellent care of our patients and their families.

In March, our team responded to the COVID-19 pandemic by reconsidering our highest priorities. These include protecting our workforce while providing essential clinical care, maintaining continuity of education and research, and promoting physical distancing while minimizing the impact on team psychosocial well-being. In light of these priorities, our department split into two teams to reduce the risk of disabling our group if a quarantine was necessary. While one team worked on-site, performing essential clinical activities such as handling urgent and emergency cases and consultations, as well as continuing care of hospitalized patients, the other team worked remotely. Every two weeks, we rotated from on-site to remote work.

To help preserve the resources of hospitals across Maryland, together with the University of Maryland, we converted the Baltimore Convention Center into a field hospital to manage patients with lower acuity COVID-19—a project that has allowed me to call on my previous experience commanding a 298-bed Army hospital in Mosul, Iraq.

Also in March, we introduced and rapidly employed telemedicine. Through telehealth and necessary in-person appointments, we achieved approximately 50% of our typical clinic volume within two weeks. When appropriate, we continue to replace in-person visits with video visits. We’ve also embraced distance learning with a structured schedule that includes faculty-led teleconferences in case-presentation form, prerecorded webinars, assigned reading and chief resident-led teleconferences with a question-review format.

Leaders across the department came together and decided to pause all elective procedures from mid-March until we began to safely resume these surgeries in late-May. To make this happen, we prioritized complex cases, increased use of telemedicine, and continued to move any ambulatory surgeries that we could into the outpatient setting. By the end of July, we reached more than 100% of our normal utilization of operating rooms.

Our department had more than 67 articles accepted for publication in 2020, with topics including COVID-19’s impact on elective orthopaedic surgery and racial disparities in the timing of radiographic assessment and surgical treatment of hip fractures. I am extremely proud of this work as well as the fact that our department secured $22 million in new research grants this year.  

I am thrilled about the leadership roles taken on by our faculty members in various organizations, including the Scoliosis Research Society, the Musculoskeletal Tumor Society and the Ruth Jackson Orthopaedics Society.

While 2020 has been difficult, it has also been rewarding to grow in the face of new challenges to keep our patients safe while continuing to provide the medical care they need. We look forward to creating better outcomes and to improving the lives of the patients and families we commonly serve.

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