m fall 2012 - Inova Health System

HEALTH AND WELLNESS Made Personal | FALL 2012
INOVA FAIRFAX HOSPITAL
TOP-
NOTCH
U.S. News & World Report ranks Inova
Fairfax Hospital No. 1 in the region
ALSO IN THIS ISSUE:
3 Breast reconstruction
4 Urinary incontinence help
5 Lung tumor technology

INthenews
{
FOLLOW
}
THE LEADER
Standing Tall
Inova Fairfax Medical Campus is
reaching new heights — literally.
This September, the campus
broke ground on the 12-story
Inova Women’s Hospital and
Inova Children’s Hospital. And in
January, Inova Fairfax Hospital
plans to open a new patient
tower for adult care, a site to
behold at 11 stories and 216,000
square feet.
Both additions will provide
much-needed services for
the Fairfax community. The
660,000-square-foot women’s
and children’s hospital, set to
open in 2016, will have nine
floors dedicated to women’s
healthcare services and three
floors to pediatrics.
The new tower will feature all
private patient rooms, each featuring
evidence-based designs
that promote faster healing and
increased family involvement.
Another innovation in the
tower is its high-tech infrastructure,
which will support EpicCare
EMR. EpicCare represents a
new age in medicine, allowing
patients to retrieve medical
results, schedule doctors’
appointments and view lab
results — all online.
The new patient tower is
a symbol of Inova Fairfax
Hospital’s high standards of
excellence in medicine. Adding
to its stature, U.S. News & World
Report recently ranked the hospital
the best in the Washington,
DC, area. (See pages 6–7.) How
can you top that?
Patrick
Christiansen,
PhD
COO, Inova
Fairfax Hospital
Senior Vice
President, Inova
Health System
The Prevent Defense
Flu shot protects against seasonal flu
Fall and winter are a time for holidays, family
gatherings and good times. Unfortunately, they
also are the seasons for the dreaded flu virus.
More than simply a painful cold, the flu is a
serious illness that each year sends more than
200,000 people to the hospital and kills between
3,000 and 49,000 people in the United States
alone. It is characterized by symptoms that
include fever, sore throat, stuffy nose and
muscle aches.
The best way to prevent the flu is to get a
flu shot each season, according to the Centers
for Disease Control and Prevention. The CDC
recommends vaccinations for everyone 6
months and older. The vaccine releases
antibodies into your body that provide
protection against infection from the flu virus.
Inova’s highly trained nurses can help
protect you and your children with the flu
shot. Unlike some other providers, we can
vaccinate children as young as 6 months.
We also offer a nasal flu vaccine known as
FluMist® if you or your child struggles
with shots.
Fight the Flu
Inova Fairfax Hospital is holding weekly on-site
family flu shot clinics from September through
December. On-site flu shot clinics for worksites
and community groups are also available.
For a complete schedule or more information,
visit inova.org/flu.
New Inova.org — More Than Just a Facelift
The new inova.org website launched on Aug. 1, but it wasn’t just a simple change in appearance.
Here’s why:
We improved the site to help our Web visitors get the health and wellness information they need
faster and easier.
Looking to get or stay healthy? With the new website, Inova launched the “Wellness OnDemand”
page — one-stop access to health and fitness tips, classes, videos, newsletters and other wellness
information.
Need to talk to someone? Now you can find our contact information easier. Call us, email us or
chat with us online.
Checking our site from your smartphone? Whether you have a large or a small screen, you can
now more easily see and interact with our website.
Take us for a test drive. Visit inova.org. The future of health is now online.
2 | FALL 2012 | Inova Fairfax Hospital

GOOD AS NEW
New restorative procedure preserves breast’s appearance
Women undergoing breast
surgery at Inova Fairfax Hospital
now have exciting, new options for
preserving their breasts’ natural
appearance immediately following
surgery. By combining breast
cancer surgery with advanced
reconstructive techniques,
patients are able to undergo
treatment with little or no
aesthetic difference in their
breasts. “While treating the
cancer always comes first, our
goal is to make each patient feel
whole from a cosmetic point of
view,” says Costanza Cocilovo, MD,
Medical Director, Inova Breast
Care Program.
New options
The medical team at Inova Fairfax
Hospital offers a variety of
restorative procedures that can
be performed immediately
following breast cancer surgery.
Women who undergo a lumpectomy,
which involves removing
a tumor while preserving the
breast, may be candidates for
oncoplasty, the reshaping of the
remaining breast tissue to create
a smooth, natural-looking breast.
This leading-edge procedure is
most effective in women with
larger breasts who prefer a
reduction and lift.
For women who undergo a
mastectomy, which involves
removing the entire breast, the
surgeon can perform immediate
augmentation with an implant or
tissue from another area of the
body. Patients with smaller
breasts are often excellent
candidates for an innovative
procedure called nipple-sparing
mastectomy, which preserves
the skin covering the breast.
team approach
To tailor treatment to each
individual patient, the highly skilled
medical team at Inova uses a team
approach. Prior to surgery, a
patient meets with her radiation
oncologist, breast surgeon and
plastic surgeon to develop the best
treatment plan.
“Using a multidisciplinary
approach improves outcomes, but
more importantly, it improves
patient satisfaction,” says Dr.
Cocilovo. “We try very hard to
help patients be in a place where
they’re as happy with their results
as possible.”
Inova Offers
Speakers Bureau
Interested in a guest speaker for your upcoming
club meeting or special event? Contact our
community affairs executive, Bob Lazaro, at
robert.lazarojr@inova.org. He will identify the
appropriate speaker from Inova to help engage
your group or organization.
Link to Pink
Inova Breast Care Institute is hosting many events
throughout October in honor of Breast Cancer
Awareness Month. Among them is the Alexandria
City Annual Walk to Fight Breast Cancer on
Saturday, Oct. 20.
Visit inovalinktopink.org to sign up for our
Link to Pink e-newsletter and to learn about
events happening around Inova.
inova.org/ifh | 3

STOP
the Leak
Urinary incontinence has minimally
invasive treatment options
Common But Not Normal
Pelvic floor disorders are the conditions women experience
when their pelvic muscles and tissues weaken, which can result
in the shifting of pelvic organs and cause uncomfortable symptoms.
Some women are more at risk for developing pelvic floor
disorders. Risk increases for women who:
Have had children
Have gone through menopause
Are overweight
Genetically have weaker, more stretchy tissue
Have undergone certain pelvic surgeries
Experience constipation or other chronic increases in
abdominal pressure
For women in their 20s and 30s, pelvic floor conditions, such
as urinary incontinence, may occur shortly after vaginal delivery.
“During this time, moms are busy with babies and are not necessarily
thinking about themselves. They leak [urine], and they
think, ‘Oh, it’s there, and it’s no big deal,’” Dr. Welgoss says.
“It’s important to be aware that these things exist and realize
that it’s not normal to leak urine because you just had a baby,”
he continues. “It’s common, but it’s never normal.”
Urinary incontinence can be an embarrassing condition that
interferes with a woman’s quality of life. It’s also quite common,
affecting 30 to 50 percent of women at some point during their
lives, according to Jeff Welgoss, MD, Medical Director of
Urogynecology at Inova Fairfax Hospital.
While it occurs across a variety of age groups, urinary
incontinence becomes increasingly common as women get older.
“It’s not uncommon to see people who have been leaking urine
for 10–15 years before they come in and get checked out, so we
end up doing procedures to compensate for their weakened floor
muscles,” says Dr. Welgoss. Women who receive treatment
during the mild and earlier stages of incontinence are possibly
more likely to avoid surgery, he notes.
Two types of incontinence are stress incontinence — leaking
urine with coughing and sneezing — and urge incontinence —
feeling the need to urinate but not being able to make it to the
bathroom fast enough. Urge incontinence can be treated with
nonsurgical methods, such as pelvic floor or Kegel exercises;
avoidance of bladder irritants, such as caffeinated beverages; and
medications. InterStim therapy is also a treatment option, which
involves the implantation of a device that stimulates the sacral
nerves so that the bladder and its related muscles can function
properly. An in-office therapy called tibial nerve stimulation, where
a nerve in the lower leg is stimulated, can also be effective.
For stress incontinence, a minimally invasive surgery is
performed to place a mesh hammock under the urethra. “Basically,
it creates a backstop for the urethra so when the patient coughs or
sneezes, the urethra moves down onto the mesh, and that closes
off the urethra when the muscles don’t,” Dr. Welgoss says. The
recovery from this procedure is minimal. “People go home the same
day — within a couple of hours — and they are driving and back to
working physically non-strenuous jobs in a couple of days,” he says.
Ask the Expert
You’re Not Alone
Learn more about treatment for incontinence and other
pelvic floor disorders at inova.org/women. Click on
“Gynecology” on the left-hand side of the home page.
4 | FALL 2012 | Inova Fairfax Hospital
Don’t Live With Leaky Pipes: Treatment
Options for Pelvic Floor Disorders
Jeff Welgoss, MD, will discuss the causes and treatment
options for female pelvic floor disorders, including stress
and urge incontinence. This FREE lecture will take place
on Tuesday, Oct. 16, at 7 p.m. at Reston Community
Center, Lake Anne Gallery, 1609–A Washington Plaza,
Reston, VA. To register, call 1-855-694-6682
(1-855-My-Inova) or visit inova.org/
AskTheExpert.
Jeff Welgoss, MD
Urogynecologist

GPS for
the Lungs
Special technology locates hard-to-reach tumors
The new superDimension i-Logic
Electromagnetic Navigational
Bronchoscopy system at Inova Fairfax
Hospital helps doctors eliminate the
guesswork associated with traditional
bronchoscopy. It can accurately biopsy
and diagnose tumors located anywhere
within the lungs. “It gives us a very accurate
way to biopsy these nodules, avoiding
other potentially more complicated
interventions and saving patients from
undergoing unnecessary operations,”
says Sandeep Khandhar, MD, Director of
Thoracic Surgery at Inova Fairfax Hospital,
which received the technology this past
summer. He along with Daniel Fortes, MD,
use the system.
A traditional bronchoscopy involves
a physician inserting a lighted scope
through the patient’s airways and guiding
it into the lungs. But a physician’s ability
to see and locate a potentially cancerous
nodule is lost after he or she navigates
two or three generations of airway
branches.
Thanks to electromagnetic navigational
bronchoscopy (ENB), physicians are able
to “see” deep within the lungs using this
technology. The i-Logic software system
creates a three-dimensional map of the
airways for them. They then can navigate
a magnetic probe through the airways,
through the traditional bronchoscope,
to reach a nodule. “This is very similar
to the GPS in your car, where it plots
out a road for you and there’s a satellite
that’s watching your progress in real-time,
knowing where you are along that path,”
Dr. Khandhar says.
“This technology enables physicians to
reach a patient population for whom they
previously really couldn’t do a lot,” notes
Kären Solie, Senior Market Development
Manager at superDimension. “It expands
patient care options and provides another
option for physicians to offer to certain
patients who have compromised lung
function and have indeterminate nodules
in their lung that need either diagnosis,
treatment or both,” she says.
The first time he used this system, which
is available in more than 400 hospitals,
Dr. Khandhar was able to accurately determine
that a nodule within a patient’s lungs
was infectious rather than cancerous and
that her lung problems were the result of
bacterial and mycobacterial infections.
“In this case, an operation [to remove
the nodule] would have absolutely been
the wrong answer,” he says. “What she
needed was intensive drug therapy with
antibiotics. We saved this high-risk patient
a more invasive procedure and all the
potential complications that could have
resulted from that operation.”
How it works
Kick the Habit
Smoking causes serious illnesses,
ranging from lung cancer to heart
disease. Inova TobaccoNET is a workplace
care management, smoking
cessation program. It incorporates
lifestyle and behavior changes to
help employees break the nicotine
habit and achieve tobacco
cessation. To learn more,
visit inova.org/
healthcare-services/
corporate-health/
inova-care-management/
inova-tobacconet/index.jsp.
Breathe Easier
Find out more about Inova’s thoracic
oncology program at inova.org/
thoracic.
SuperDimension i-Logic software creates a three-dimensional map of a patient’s airways
based on a CT scan.
A physician identifies a nodule and maps out a path through the airways to reach
this target.
The patient, under anesthesia in an operating room, lies flat on a board that creates
an electromagnetic field around the patient.
A physician advances a probe with a magnet attached to it through the traditional
bronchoscope, through the patient’s airways, to find the target. All the while, the
system knows exactly where the magnet is located within the lungs because the threedimensional
airway map it created correlates to the electromagnetic field surrounding
the patient.
inova.org/ifh | 5

TOP-NOTCH
Inova Fairfax Hospital has been
ranked No. 1 in the Washington,
DC, metro area in the recent U.S.
News & World Report’s prestigious
listing of the nation’s best
hospitals. Once again, Inova
Fairfax Hospital claimed its
position among the nation’s
top-ranked medical institutions,
placing 23rd in gynecology and
50th in heart and heart surgery.
“These recognitions say a
tremendous amount about the
high quality of care that we
provide,” says Patrick Christiansen,
PhD, Chief Operating
Officer and Interim Chief
Executive Officer for Inova
Fairfax Medical Campus. “It’s
a reflection of how we treat
each of our patients with personalized
care.”
For the past two decades, U.S.
News & World Report’s Best
Hospitals list has become a highly
regarded measure of achievement.
Receiving recognition in the
esteemed listing is a testament to
the superior care and unsurpassed
service provided by the physicians,
nurses, administrators and staff
at Inova Fairfax Hospital.
Women’s Services
The Best Hospitals rankings
evaluate a hospital based on its
ability to provide expert inpatient
care for patients who are especially
at risk because of their age,
physical condition or the challenging
aspect of the care they require.
Inova Women’s Hospital has a
medical team capable of providing
a wide range of care, from the
routine office visit to advanced
treatment for gynecologic cancers.
“Achieving a national ranking
of 23rd really reflects the depth
and breadth of the quality and
competency of our team members
within this program,” says
Patricia Schmehl, Inova Women’s
Hospital Administrator. “Medical
expertise, nursing skill set,
research and a strong background
in promoting women’s
health must all be in place.”
With the addition of a brand
new women’s hospital due in 2016,
the medical team is focused on
building a world-class reputation
as a regional destination for
advanced clinical services.
“We are on a forward trajectory
in terms of taking what we have
to a much higher echelon of
excellence,” says Larry Maxwell,
MD, Chairman of the Department
of Obstetrics and Gynecology.
“We have significant five- and
10-year goals of becoming a major
top OB-GYN department by
national standards.”
Cardiac Competence
There are many reasons Inova’s
Heart and Vascular Institute
received national recognition
for its specialty cardiac services.
Having access to the largest
network of cardiac specialists in
the region, the Institute offers the
highest level of expertise and the
most advanced procedures
available, from 3-D echocardiology
and electrophysiological mapping
to heart transplants.
“This recognition is an
acknowledgement of the highcaliber
care we consistently deliver
“It’s a reflection of how we
treat each of our patients
with personalized care.”
—Patrick Christiansen, PhD,
Chief Operating Officer for
Inova Fairfax Medical Campus
never be more
should
Headlines
than three lines.
6 | FALL 2012 | Inova Fairfax Hospital

Headlines should
U.S. News & World Report
ranks never Inova be Fairfax moreHospital
No. 1 in the region
than three lines.
Above
the Rest
to people in the Washington, DC,
region, as well as to those coming
from other parts of the country,”
says Harvey Sherber, MD, Medical
Director, Inova Heart and
Vascular Institute. “It’s a source
of pride to the physicians, the
administrators and nursing staff at
Inova Heart and Vascular Institute
because it reinforces their sense
of delivering great care in a great
environment and having the
capabilities to treat virtually
anyone with heart problems.”
The Institute offers the highest
level of expertise and a wide array
of cardiac procedures, from the
routine to the most advanced.
“The award reflects our
excellent performance in delivering
a spectrum of care,” says Dr.
Sherber. “The particular aspects
that they look at include heart
failure, myocardial infarction,
bypass surgery and valve surgery,
but in order to deliver good care
in those specific entities you have
to be able to deliver excellent care
across the entire range of medical
conditions.”
How We Rate
For more information about the U.S. News & World
Report hospital rankings, visit health.usnews.com.
In addition to being ranked among the nation’s top 50
hospitals in two specialties — gynecology, and cardiology
and heart surgery — Inova Fairfax Hospital
garnered high-performing marks in these 10 specialties:
Cancer
Diabetes and
endocrinology
Ear, nose and throat
Gastroenterology
Geriatrics
Nephrology
Neurology and
neurosurgery
Orthopedics
Pulmonology
Urology
Exceeding Expectations
The Best Hospitals rankings are designed to help
individuals requiring advanced medical care choose
a facility that excels in a particular specialty. While
other rankings provide a snapshot of how well hospitals
perform routine procedures, the Best Hospitals
rankings single out centers of excellence that provide
unparalleled specialized care. Centers such as these
often receive referrals from other hospitals for the most
challenging cases.
“Our goal is to meet the complex health needs of the
community through high-quality care,” says Dr. Christiansen.
“Having our efforts recognized by an outside
ranking agency makes us feel like we’re on target with
our overall service goals.”
For a facility to achieve recognition in its metro area,
it must score in the top 25 percent among hospitals in
the region in at least one of 16 medical specialties. The
ranking of each specialty is based on reputation, patient
survival and patient safety as well as nursing and
patient services. Inova Fairfax Hospital is among 148
hospitals — fewer than 3 percent of the nearly 4,800
analyzed for the Best Hospital rankings — to garner
such recognition.
inova.org/ifh | 7

Inova Health System is a not-for-profit healthcare system
based in Northern Virginia that consists of hospitals
and other health services, including emergency- and
urgent-care centers, home care, nursing homes, mental
health and blood donor services, and wellness classes.
Governed by a voluntary board of community members,
Inova’s mission is to improve the health of the diverse
community it serves through excellence in patient
care, education and research. Inova provides a healthy
environment for its patients, families, visitors, staff and
physicians by prohibiting tobacco use on its campuses.
8110 Gatehouse Road
Falls Church, VA 22042
NON-PROFIT
US POSTAGE
PAID
INOVA HEALTH
SYSTEM
If you do not wish to receive future mailings from Inova
Health System, please contact us at 1-855-My-Inova
(1-855-694-6682) or inova.org/unsubscribe.
IHS-042-IFH
InovaCares for Seniors PACE Program
A new alternative to traditional senior care
InovaCares for Seniors PACE ® recently
launched its Program of All-inclusive Care
for the Elderly (PACE), the first and only
program of its kind here in Northern
Virginia. PACE is a program for older adults
that helps to preserve the independence of
seniors living in the community and allows
them to receive the care they need and still
remain in their home. Each InovaCares for
Seniors PACE participant receives an individualized
care plan that meets both their medical
and social needs.
This care plan is determined by the
collaborative efforts of an interdisciplinary
team that includes a physician with an
expertise in geriatric medicine, a nurse,
nutritionist, occupational and physical
therapist, social worker, activities coordinator,
home care coordinator and transportation
staff. “Often, the health problems senior
citizens experience are because of non-medical
factors, such as difficulty administering
medications, poor diet, trouble getting to and
from their doctor appointments, lack of
exercise or insufficient social interaction,” says
Good Alternative
Terence McCormally, MD, Medical Director
of the InovaCares for Seniors PACE program
and a board-certified geriatric physician.
“PACE helps with both their medical and
non-medical needs.”
The PACE program provides comprehensive
care for seniors. “A geriatrician in private
practice in our area would typically care for
about 900 patients. At the PACE center, our
team cares for about 100 patients, and this
allows for personalized, coordinated care by
the whole team,” says Dr. McCormally.
InovaCares for Seniors PACE ® is an alternative to a nursing home. For more information
or to request a tour of the InovaCares for Seniors PACE center, please call
703-239-5888 Monday–Friday from 9 a.m.–4 p.m. or email us at pace@inova.org.
You can also visit online at inova.org/pace and pace4you.org.
we’ve gone
electronic
InHealth is now available as
an e-newsletter. To sign up to
receive this free e-newsletter
from Inova Fairfax Hospital, go
to inova.org/subscribe.
InovaCares
for Seniors PACE
services can
include
(but are not limited to):
• On-site access to a physician with
geriatric expertise
• Primary and specialty medical care
(including dental, audiology,
optometry and podiatry)
• Nursing and social work
• Physical, occupational and
speech therapy
• Hospital and emergency care
• Prescription drug coverage and
management
• Lab tests and diagnostic procedures
• Meals and nutrition counseling
• Social activities
• Personal care
• Home care
• Adult day care
• Transportation to/from the center
• Transportation to/from medical
appointments
find a physician
Looking for a doctor?
Our 24/7, bilingual
physician-referral service
can help you find one
close to home or work.
Call 1-855-My-Inova
(1-855-694-6682).
subscribe now!
To ensure future arrival
of InHealth, request your
FREE subscription by
calling 1-855-My-Inova
(1-855-694-6682) or visiting
inova.org/subscribe.
we’re social!
twitter.com/
InovaHealth
facebook.com/
InovaHealth
youtube.com/
InovaHealthSystem
baby and me
Sign up for Inova’s free
weekly pregnancy and
parenting e-newsletter,
Baby and Me. Visit
inova.org/babyandme
to sign up today!