Inova Heart and Vascular Institute

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Inova Heart and Vascular Institute
INOVA health system
Geography
LocationWoodburn in Fairfax County, Virginia, Virginia, America
Organisation
Hospital typePrivate
Services
Beds156
Links
Websiteinovaheart.org/home

Inova Heart and Vascular Institute (IHVI) is a 156 patient room hospital, dedicated to the prevention, diagnosis and treatment of heart disease [1]. The Institute is part of the larger Inova Fairfax Medical Campus (IFMC), the flagship of the INOVA health system. IHVI is located in Woodburn in Fairfax County, Virginia, physically attached to IFMC[2]. Created to be an institute that specializes in cardiac care, IHVI specializes in cardiac endoscopic and surgical procedures. It encompasses multiple Operating rooms (ORs) Interventional radiology (IR) suites, recovery units, specialized cardiac telemetry monitoring floors/step-down units, two Intensive Care Units (ICUs) and a cardiac rehab facility [3].

Capability

Inova Heart and Vascular Institute is a five story structure, with 156 patient beds [4][5]

  • 48 cardiac ICU/CCU beds
  • 108 cardiac telemetry beds
  • 6 Cardiovascular Operating Rooms (CVOR’s)
  • 4 Electrophysiology labs
  • 7 cardiac catheterization labs

The inpatient rooms can be subdivided between seven units.

  • The cardiology (1st) floor, includes a 24-bed critical care unit, and a step down unit. [6]
  • The second floor of the Institute is dedicated to cardiac surgery patients and includes a 24-bed cardiovascular intensive care unit, 28-bed surgical telemetry unit. [6]
  • The third floor includes two cardiac telemetry units (24 and 28 beds each)[7]
  • The fourth floor holds the Acute Pulmonary Unit, a stepdown unit dedicated to pulmonary issues.[7]
  • Two ICU units; a Coronary Care Unit (now "Cardiac Intensive Care Unit") and a Surgical ICU (Cardiovascular Intensive Care Unit/CVICU).[7]

The Institute continues to be involved in research; such as exploring methods to improve cardiogenic shock outcome and addressing aspirin hypersensitization in patients with coronary artery disease (This is problematic because aspirin is an important therapy in this patient population) [8][9][10].

History

IHVI shares its history with the larger Inova Fairfax campus which created its open-heart surgery program in 1977 when surgeons performed an atrial septal defect repair. Construction began in 2002 and IHVI first opened opened in 2004 on the campus of Inova Fairfax Hospital[11][1]. At the time, the 156-bed facility was built and constructed to increase growth in all areas of cardiac care[12]. Prior to this, Edward Lefrak, US surgeon, conducted DC area's first successful heart transplant In Fairfax hospital [13].

2019 Patient suicide

In the evening of January 22, Thomas Wimmer, of Ashburn, a 64 year old patient was discovered by staff, “brandishing a pistol” on the IHVI fourth floor, Acute Pulmonary Unit (APU) having shot himself. A "code silver" was called over the hospital prompting a temporary hospital lockdown [14]. Officers were dispatched. Wimmer, apparently wounded, refused to relinquish his weapon for an hour, according to police. eventually police were able to enter the room and render medical aid. Wimmer was taken to the hospital’s trauma center, where he died shortly before 11 p.m. [15][16][17][14]. Currently, it has not been publicly reported how Wimmer acquired the pistol, with which he killed himself.

COVID-19 response

In early 2020, hospitals across the country, including Inova Fairfax medical campus (and by extension IHVI) began preparations for anticipated mass influx critically ill patients affected by the COVID-19 pandemic.

Some of the most notable responses campus wide included attempts to stock up and ration medical equipment, notably personal protective equipment (PPE) and mechanical ventilators, the termination of all elective surgical procedures, cross training clinical staff to operate in the Intensive Care Unit (ICU) and the reallocation of certain clinical services to bolster those under more stress. For example, Physical Therapy services were drawn back initially (due to low patient census) and (PT) Technicians were cross-trained and staffed to bolster Respiratory Therapist teams. The Team nursing model was introduced to the coronary care unit (among other ICU's) in anticipation of higher acuity needs and some Clinical staff from the Progressive Coronary Care Unit (PCCU) and Cardiac Rehabilitation units were cross-trained in the ICU to take care of acutely ill patients.[7]

Physical changes made to individual units included the conversion of almost rooms in the Cardiac Intensive Care Unit (CICU) to negative pressure rooms. Certain circumstances causing aerosolized viral droplets (mechanical ventilatory equipment or ventilatory assist devices such as Heated humidified high-flow therapy|High Flow Nasal Canula) need to be treated as airborne. The standard isolation of which is a negative pressure isolated room with appropriate PPE for enclosed staff.[7]

Other procedural changes instituted by the campus were the creation of designated staff entrances by restricting building access to specific places and the near termination of all non-patient visitors to the hospital[7].

Since the Virginia executive lockdown in early March, 2020, the number of patients in IHVI appeared to plummet. This could conjecturally be attributed to the pause on elective surgeries and decrease in number of people seeking help. However, over the next few weeks, the number of critically ill patients could be observed in individual ICU units to rise steadily. Because historically, IHVI is commonly responsible for a high number of immunocompromised patients (heart transplants e.g.) attempts were made by leadership to keep the IHVI units from bearing the brunt of taking COVID-19 cases. During the early days of the pandemic, the Medical Surgical ICU of Fairfax Hospital, which was located in a separate building was unofficially designated "COVID Unit" and bore the brunt of the critically ill COVID Pneumonia patients. However, as the number of critically ill patients increased, and because of the limitations in testing (accuracy and availability) IHVI was soon taking care of many COVID-19 positive patients, many of whom in the ICUs were suffering from COVID-19 induced Acute respiratory distress syndrome (ARDS).

In the media

        

References

  1. 1.0 1.1 Virginia: SENATE JOINT RESOLUTION NO. 239, 2006 Session https://lis.virginia.gov/cgi-bin/legp604.exe?061+ful+SJ239+pdf
  2. "Healthcare". Fairfax County EDA. Retrieved 2020-05-01.
  3. "100 hospitals and health systems with great heart programs | 2018". www.beckershospitalreview.com. Retrieved 2020-05-01.
  4. "Inova Fairfax Hospital Heart & Vascular Institute". RMF Engineering. Retrieved 2020-05-01.
  5. "Inova Heart and Vascular Institute". Shen Milsom & Wilke. 2016-04-12. Retrieved 2020-05-01.
  6. 6.0 6.1 "Inova Heart Institute | Turner Construction Company". www.turnerconstruction.com. Retrieved 2020-05-01.
  7. 7.0 7.1 7.2 7.3 7.4 7.5 Primary Source Testimony: primary account of witnessed facts by working healthcare provider at the time of event. (Advise: primary account is that of a specific bedside health worker, maybe limited in scope and may not necessarily reflect official organization view)
  8. Tehrani, Behnam; Alex; Truesdell, er; Singth, Ramesh; Saulino, Patricia; Barnett, Scott; Gurbel, Paul; Murphy, Charles; O'Connor, Christopher (2020-05-01). "Figure1". Journal of the American College of Cardiology. ISSN 0735-1097.
  9. Tantry Udaya S.; Gurbel Paul A. (2017-02-01). "Rapid Desensitization of the Patients With Aspirin Hypersensitivity and Coronary Artery Disease". Circulation: Cardiovascular Interventions. 10 (2): e004881. doi:10.1161/CIRCINTERVENTIONS.117.004881.
  10. "There's No 'I' in Shock Team: Multidisciplinary Approach Seems to Pay Dividends". TCTMD.com. Retrieved 2020-05-01.
  11. "New Heart Center Opens". www.connectionnewspapers.com. Retrieved 2020-05-01.
  12. "Vascular Access and Vascular Closure Programs for Nurses and Technologists at INOVA Heart and Vascular Institute, Fairfax Hospit". Cath Lab Digest. Retrieved 2020-05-01.
  13. ItkowitzCongress, Colby Itkowitz closeColby; campaigns; Policy, Health; reporter, Pennsylvania politics EmailEmailBioBioFollowFollowPolitics. "'She's pretty special:' Defying odds, the D.C. area's first heart transplant patient is still alive 30 years later". Washington Post. Retrieved 2020-05-01. {{cite web}}: |last3= has generic name (help)
  14. 14.0 14.1 "Police Say No Public Threat After Shooting at Inova Fairfax Hospital". NBC4 Washington. Retrieved 2020-05-01.
  15. reporterEmailEmailBioBioFollowFollow, Martin Weil closeMartin WeilLocal. "Man fatally shoots himself at Inova Fairfax Hospital, police say". Washington Post. Retrieved 2020-05-01.
  16. ABC7, John Gonzalez (2019-01-23). "Patient armed with gun shoots, kills himself inside Inova Fairfax Hospital, police say". WJLA. Retrieved 2020-05-01.
  17. "Patient dies after shooting himself at Inova Fairfax Hospital". INSIDENOVA.COM. Retrieved 2020-05-01.

External links

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