TOP- U.S. News & World Report ranks Inova Fairfax Hospital No. 1 in the region

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1 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

2 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, 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

3 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

4 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 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-My-Inova) or visit inova.org/ AskTheExpert. Jeff Welgoss, MD Urogynecologist

5 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

6 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 n H t 6 FALL 2012 Inova Fairfax Hospital

7 U.S. News & World Report ranks Inova Fairfax Hospital No. 1 in the region 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

8 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 Gatehouse Road Falls Church, VA 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 My-Inova ( ) 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 Monday Friday from 9 a.m. 4 p.m. or 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 My-Inova ( ). subscribe now! To ensure future arrival of InHealth, request your FREE subscription by calling My-Inova ( ) 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!