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IMVH: Looking Backwards ... Forward

Despite a year of tumultuous confrontation, fired by speculation that Inova Mount Vernon Hospital might be closing or moving, significant strides were made in both medical care and upgrading of existing services at the Parkers Lane facility.

One of the specialties for which IMVH is noted is joint replacement. In 2003, there were 1,300 of these procedures performed as compared to 750 in 1997, the year Susan Mullee Herbert began her tenure as the hospital's administrator and vice president of Inova Health System.

"This all began here in 1995. People have come to us from 31 countries and 49 states for joint replacement," Herbert said. Closely allied with this is the hospital's expertise in rehabilitation.

"The hospital has 67 beds dedicated to acute rehabilitation," she said. "We have added eight beds to private status in this area because of the increase in brain injuries. Patients with this injury can not recover as well with distractions."

There is also a comprehensive rehabilitation center and program. In an area known as "Easy Street," rehabilitation patients learn to master the skills of everyday life after suffering brain injuries or medical problems.

IN ADDTION to joint replacement and rehabilitation, another area of expertise at IMVH is the Wound Healing Center, according to Herbert. It is home to the only hyperbaric chambers in Northern Virginia.

"Our Wound Healing Center continued to grow exceeding its 2003 volume goal and financial targets. It has produced excellent clinical outcomes, with a healing rate of 90 plus percent for all wounds," Herbert said. "The national clinical benchmark is only 80 percent."

Another area of improvement during last year was restoration of the Emergency Department, according to Herbert. "We now have chest pain rooms where all testing can be done and a new pediatric room with new state-of-the-art cribs," she explained.

"We have made clinical changes for children. Their space is now more user friendly. All the beds in this department are monitored. This was developed by listening to the community," Herbert acknowledged. "We also have a separate room for ear, nose and throat cases."

She pointed out, "Twenty percent of the patients who come to ER are admitted. All these improvements were dedicated last February."

Herbert said, however, "Patient satisfaction was less than I wanted last year. But our scores have grown from less than optimal to near the top. They are up nine percent points."

WHAT HAS DRIVEN this achievement is a program called "Straight From The Heart," according to Herbert. "It puts patients at the center of our decision-making process," she said.

"We conducted a cycle of service analysis. This reduced the number of administrative steps which patients face from admission to discharge from 23 to 11. This moved our scores from the low to high 80 percent," Herbert explained.

"Our outpatient satisfaction went from 97 percent to 99 percent. My mandate is to insure the community's needs are met and go forward to grow our services," she said. "But I need volume more than anything else."

That drop in volume has been one of the elements behind the fear that IHS is planning to move the hospital's primary services to a new location — either in the Springfield or Lorton areas. But this has been adamantly denied by Herbert and other IHS officials since the rumors first surfaced last January.

A citizen group known as the Southeast Health Planning Task Force, has been studying the hospital's operations and financial structure for the past 12 months. A final report is expected within the next 30 days.

SOME OF THE new equipment added to IMVH's inventory throughout 2003 included a PET Scan on a mobile pad, a new CAT Scan, nuclear medicine camera, and a venous ablation laser which provides a non-invasive way to deal with problems associated with veins.

The new Multi-Slice CT Scanner is faster, more accurate and more comfortable for patients undergoing diagnostic procedures. It can be used for a variety of testing from trauma situations to bone scanning and oncology, according to hospital personnel.

"We can now scan geriatric and trauma patients in a single breath hold," said John DeGrazia, MD, director, Radiology, IMVH. "This results in a more accurate diagnosis while reducing examination time and increasing patient comfort."

It provides an accurate picture of blood flow through the vessels of the head, neck, thorax, abdomen, pelvis, and other extremities, according to DeGrazia. Doctors can also use the CT Scanner to evaluate osteopathic and traumatic alterations of bone surfaces using three dimensional imaging.

The new mobile PET Scan Unit became operational in August. These are "most often used on cancer patients to determine the stage of the disease and plan treatment," according to the hospital. "With both the Multi-Slice CT Scanner and PET Scan Unit at the hospital, residents no longer have to travel out of the area to receive this high technology diagnostic testing."

DURING 2004, Herbert plans to expand the Wound Healing Center. "After we opened it, we discovered it was an unmet community need. It has just exploded," she said.

Another primary goal in the year ahead is to open an expanded Low Vision Center to develop a "rehabilitation service for patients suffering from macular degeneration and other vision problems," she said.

"However, it will be located in the area of Prosperity Avenue and Route 50, not at the hospital. That is the area where the most retina specialists have their practices," Herbert explained. "But, it will be operated under Inova Mount Vernon Hospital."

Along with Alexandria, "The Mount Vernon zip code is one of the highest stroke areas in Northern Virginia," Herbert claimed. To meet that challenge Operation Stroke was initiated at IMVH in January 2003.

A stroke response team was developed to ensure rapid identification and treatment of acute stroke patients. The emergency department staff make sure each stroke patient is triaged appropriately and that clinical tests are performed quickly.

The hospital developed a Clinical Effectiveness Team to monitor the care and treatment of acute stroke patients. Multidisciplinary, the team is composed of doctors, nurses, laboratory personnel, as well as staff from pharmacy, radiology, and rehabilitation.

IN EARLY 2004, IMVH will begin a comprehensive Stroke Registry called "Get With The Guidelines." It will provide data on acute stroke outcomes for continuous quality improvements, Herbert clarified. "Physicians will use this information for the continued management and risk modification of these patients," she said.

Some of the other highlights of 2003 noted by Herbert in her annual Report to the Medical Staff included:

*Renovation of four rooms on the 4B surgical unit will create more flexibility and increase effective capacity of the Rehabilitation Center program.

*Planning was completed for the consolidation of the Inova Alexandria Hospital inpatient psychiatric service into IMVH. Renovation to add four to six psych beds should be completed by early 2004.

*The medical laboratory was accredited based on the results of an on-site inspection by the Commission on Laboratory Accreditation of the College of American Pathologists.

*Hospital volunteers donated more than 55,000 hours of work throughout the hospital and contributions from the Auxiliary during 2003 exceeded $189,232. This brought the group's total contributions to more than $3 million since their inception.

Although there remains controversy about the future of IMVH, its location and services, Herbert was adamant that her goal is to grow the institution's capabilities. She expressed this in her letter to the medical staff at the beginning of her annual report.

"As a new year approaches, I know that we will build on our work together to deliver the highest quality care to our patients and the community we are privileged to serve," she wrote.