Embed Size (px)
Citation preview
2015 Surgery ReportI n o v a F a i r f a x M e d i c a l C a m p u s
Table of Contents
1 Welcome 3 Education
5 Quality and Patient Safety 6 ASTEC 8 Research 9 Midlevel Clinical Practice Providers 10 Surgery Department Administration 11 Surgical Department Organizational Chart
13 Surgical Specialty Areas
24 Surgery by the Numbers
26 Selected Honors, Presentations,
Publications and Research
2015 Surgery ReportI n o v a F a i r f a x M e d i c a l C a m p u s
In 2015, the Inova Fairfax Medical Campus Department of Surgery had another exciting and successful year.
The dedication and determination of our surgeons resulted in significant progress in the department’s mission to deliver world-class patient care, conduct cutting edge research in a multidisciplinary fashion and provide state-of-the-art undergraduate and graduate medical education.
In addition to advancing surgical care through adoption of new technologies, the members of the department continue to be strong advocates for improvements in the quality of care and the experience of patients who receive their care at our institution.
Recognition of the accomplishments of our department’s surgeons at regional, national and international levels further promotes the widespread value of the work our surgeons are doing. Not only do our surgeons participate in many national specialty specific governing bodies, they often have leadership roles and therefore are instrumental in changing the way surgical care is provided well beyond the walls of this campus.
We welcome you to learn more about the Department of Surgery and hope you enjoy the 2015 Annual Report!
1
John J. Moynihan, MD, FACSChairman, Department of SurgeryAssociate Professor, VCU School of Medicine - Inova Campus
Mission Statement
To work collaboratively with the entire healthcare team to provide the highest quality, most innovative and effective patient-centered surgical care to the diverse population we serve
Inova “Vision 2020” is to Build the Future of Health:
1 We will reinvent hospital-based care to increase value for our patients
2 We will look outside our hospitals to build an integrated network of facilities, providers and programs to support our community
3 We will gain national and international recognition and funding – as well as an expanded patient base – through world- renowned specialty care and leading-edge corporate and consumer health programs
Education
2
Education
The Division of Education enjoyed another very successful year in 2015. Once again, growth in training programs, academic productivity, and personnel advancement, defined the extraordinary efforts of the outstanding residents and faculty of this department. As part of the expansion of the residency to 25 positions, five new first year residents started this summer for the first time. We also welcomed new leadership of both the Bariatric/MIS Fellowship and the VCU Surgery Clerkship.
New Residents and Fellows:
In July we welcomed the following new residents and fellows:
Our 2015 residency graduates will proudly represent us in their fellowship programs and beyond:
• Enrico Danzer (PGY 5), Pediatric Surgical Oncology, Memorial Sloan-Kettering
• Allison Key (PGY 5), Trauma/Critical Care, Washington Hospital Center
• Matthew LaPorta (PGY 6), Trauma/Critical Care, Inova Fairfax Medical Campus
• George Younan (PGY 5), Hepatobiliary Surgery, Medical College of Wisconsin
• Anjali Gresens (PGY 6 – Bariatric/MIS Fellow), VAMC, New Orleans, LA
Our residents and fellows continued their high level of academic productivity and scholarly representation in nearly all areas of surgical care. Highlights of the academic presence of our residents include:
• Dr. Ashley McCusker (PGY 5) presented her work “Implementation of a Volume Based Enteral Feeding Protocol in a Single Center Trauma ICU” at the American Association for the Surgery of Trauma annual meeting.
• Dr. Libby Copeland-Halperin (PGY 3) presented her work “Re-evaluating the Role of Blood Cultures in the Evaluation of Postoperative Fever,” at the annual Clinical Congress of the American College of Surgeons.
• Dr. Allison Key (PGY 5) presented her work on a colorectal ERAS protocol at the Chesapeake Colorectal Society annual meeting, where she was awarded first place for best paper presentation
The Department of Surgery was well represented at the annual Graduate Medical Education Quality Research Forum:
• Dr. McCusker won second prize for her presentation of her work on ICU nutritional delivery.
• Dr. Matthew LaPorta, who presented posters on “A Formal General Surgery Residency Didactic Curriculum Derived From Quality In-Training Initiative Guidelines” and “Establishing the Role of Chief Resident in Quality Improvement and Patient Safety.” Both projects further secured the education and participation of all of the residents in the hospital mission of enhancing patient care, improving patient experiences, and maximizing patient outcomes.
3
Laura Adams PGY 1 Michigan State University, School of Human Medicine
Catherine Denkler PGY 1 University of Miami Miller School of Medicine
Therese Federowicz PGY 1 State University of New York School of Medicine
Pamela Henry PGY 1Eastern Virginia Medical School
Joshua Stodghill PGY 1 Edward Via School of Osteopathic Medicine
Meredith Meyer PGY 2 University of South Dakota School of Medicine
Carly Allred PGY 3 University of Oklahoma School of Medicine
Matthew LaPorta PGY 6 Critical Care Fellow IFMC Residency Program
Aram Jawed PGY 6 Bariatric Fellow Morristown Residency Program
Jonathan Dort, MD, FACSVice Chair, Education; Director, Surgery Residency Program; Associate Professor, VCU School of Medicine - Inova Campus
• Dr. Alex Kaminsky presented his work “General Surgery Quality Improvement Project for Communication between Nursing Staff and Residents.” Dr. Libby Copeland-Halperin presented her work on re-evaluating the use of blood cultures in the work up of postoperative fever.
• Dr. Natalie Banks presented “Implementation of a Standardized Protocol for the Treatment of Refractory Clostridium Difficile Infection,” and
• Dr. Edward Wills presented “Early Mobilization in the PACU as a Strategy to Reduce Deep Vein Thrombosis and Pulmonary Embolism.”
The Division of Education was pleased to name Dr. Amir Moazzez as the new Program Director of the Bariatric/MIS Fellowship. Dr. Moazzez is the Medical Director of the Inova Bariatric Center, a Bariatric Center of Excellence, and a bariatric surgeon with the Inova Medical Group. The operative experience, personalized mentorship, and academic and didactic resources create one of the best bariatric fellowship training experiences.
Also this year, Dr. Sharon Bachman was named the new Surgery Clerkship Director for the Inova Campus of the Virginia Commonwealth University School of Medicine. Dr. Bachman has an extensive background in surgical education and simulation, scholarly activity, and minimally invasive surgery. Weekly protected time for students in ASTEC, in the structure of a simulation curriculum designed just for them, has been one of many positive additions to make an already robust clerkship experience even stronger. Jenise Perez continues to support the students as the clerkship coordinator and was voted the outstanding clerkship coordinator in the institution by the VCU/Inova Class of 2015.
We were also pleased to welcome two new team members to our education staff. Ms. Mariam Hashimi joins us as our new residency coordinator. Mariam received her Bachelor of Science in Health Science from George Mason University with a concentration in health systems management. We also welcomed Erica Emery as our new project research coordinator. Erica comes to us from McGill University in Montreal, where she obtained her Bachelor of Science in Biology and her Master of Science in Biostatistics. They join our longstanding Surgery Residency Program Manager, Diann Carreker, who continues to provide unparalleled leadership in this period of unprecedented growth.
In summary, the great successes of our educational programs continue to be a product of our outstanding people. With a group of highly talented residents and fellows, world class faculty, and hospital leadership committed to creating an elite training environment, the future of Surgical Education at Inova Fairfax Medical Campus has never looked brighter.
4
Pictured left to right: Jenise Perez, Sharon Bachman, MD, FACS, Jonathan Dort, MD, FACS, Mariam Hashimi, Diann Carreker
4
Quality And Patient Safety
The Department of Surgery continues to lead the way in many areas of quality and patient safety with the result that our patients and surgeons are benefiting from the efforts. We have a strong team consisting of Jean Donovan, RN, MSN, Paula Graling, DNP, RN, CNOR, FAAN, Kirsten Edmiston, MD, FACS, Amber Trickey, PhD, MS, CPH, and our newest member, Mark Shawky, MHA, our quality consultant. Our Chief resident for quality, Carolina Solis, MD and the resident staff have also embraced our approach to improving patient care and physician work through research and practical application of their quality projects.
We have taken on several projects which are demonstrating the effectiveness of safety focused patient care. Our concentration on handwashing has led to an admirable increase in compliance. This is accompanied by a simultaneous decrease in CAUTI/CLABSI - see Figure 1.
Our peer review process continues to foster a culture of advancing quality through review, education and support. Data from these sessions are utilized to help design guidelines and to help us improve the performance of surgeons through Focused Professional Practice Evaluations. The Department participates in the National Surgical Quality Improvement Project (NSQIP) to help identify
opportunities for improvement. Individual NSQIP and Peer review data was shared with all surgeons so that providers may work towards self-improvement where needed.
Patient Safety Indicators (PSIs) and Hospital Acquired Conditions (HACs) are tracked and through collaboration with the operating room (OR) and Anesthesia staff action plans are developed to
drive continued improvement. In many areas, significant progress has been made with notable reductions in venous thromboembolism (VTE), Surgical Site Infection (SSI) and C. difficile. The Safety Always quality reporting system has become a useful tool to help us identify problems, especially in the pre-op, OR and PACU, with over 1200 Safety Always reports filed, sorted and reviewed. A multidisciplinary group identified and rectified problems in a number of areas including: environmental conditions in the OR, blood wastage, availability of OR pharmacy, and issues with sterile processing services and transport. A new committee, the Surgical Services Quality Operations Committee, (SSQOC), a subcommittee of the Surgical Services Operations Council (SSOC), is now co-chaired by H. David Reines, MD and Steve Lussos, MD from Anesthesia to address major safety problems, Safety Always multi-disciplinary concerns, and large quality improvement opportunities.
Finally, we can all be proud of our improvement in HCAHP scores which have improved in areas of physician communication, staff responsiveness, pain management, environment, and care transition. Combined nursing/surgeon rounding, more attention to teamwork and prompt discharges have all contributed to increases in patient experience survey scores.
Pictured left to right: H David Reines, MD, FACS, FCCM, Jean Donovan, RN, MSN, Kirsten Edmiston, MD, FACS
5
0
5
10
15
20
4 4 43
4 4555555
3 3 3
67
8
1011
10
17
21
Janu
ary
Febr
uary
Mar
ch
April
May
June July
Augus
tSe
ptem
ber
Octob
erNov
embe
rDec
embe
r
Disruptive Repetition
CLABSI
CAUTI
HAND HYGIENECOMPLIANCE
�
��
��
�
��
�
�
� �
�
IFMC CLABSI CAUTI DefectsJanuary - December 31, 2015
CLA
BSI
/CA
UTI
Def
ects
Month 2015
H. David Reines, MD, FACS, FCCMVice Chair, Quality and Safety; Professor, VCU School of Medicine - Inova Campus; Medical Director, CME
Figure 1
Advanced Surgical Technology and Education Center (ASTEC)
The Advanced Surgical Technology and Education Center (ASTEC) continues to be a strong resource for the surgical community. In April of 2015, the center was awarded the Greater Washington Innovation Award for Healthcare by the Fairfax County Chamber of Commerce. The utilization rates for the center have been excellent, and we will soon be adding a second simulation technician to help us run our events. We logged 600 unique learners during 2015, and 2878 learner episodes overall. This includes nearly 100 school-age children who were interested in the perioperative career fields and the new cadre of anesthesia technicians. The center’s average utilization for the year was 70%; when compared to the 5-20% utilization rate of many similar simulation centers, it is clear that we are busy and making a difference!
The residents from the three surgical specialties (General Surgery, OB-GYN and Podiatry), medical students, and nursing staff from the Inova perioperative fellowship program remain our most consistent learners, but we have also continued our focus on multi-disciplinary intraoperative teams training. One
such scenario was beamed live to Inova Fair Oaks Medical Campus as the kick-off event for their surgical stand-down, and served as the starting point for discussion on appropriate time-outs and use of TeamSTEPPS tools by OR staff.
We have also hosted teams from different operating units as they refresh their knowledge of complex operating room technologies, such as the da Vinci® robot. We continue to hold events for practicing surgeons and anesthesiologists in the greater metropolitan area to learn new techniques and refine their skills.
Our clinical mission’s focus on patient safety and quality remained a priority this year. Our high fidelity facility accommodated the neurosurgical team as they performed a dry run for a difficult procedure that was scheduled for the first time at Inova Fairfax Medical Campus. By testing the equipment in ASTEC first, they discovered an incompatibility between two pieces of equipment that would have led to the adverse outcome of cancellation of the case in the OR under anesthesia. Instead, they had time to find a solution prior to the scheduled date and the case proceeded successfully and safely.
We are pleased to report success in our educational research mission. ASTEC faculty have podium and poster presentations at the American College of Surgeons Accredited Education Institutes Meeting this March, as well as an invitation to be faculty for a workshop. We are also giving two workshops and two presentations at the Surgical Education Week meeting in April. We continue to innovate with curriculum development; the first year of a novel communications curriculum for the surgical residents is proceeding with great feedback from the learners. Other novel projects include the use of an SMS texting system to immediately assess resident autonomy in the operating room, the development of a curriculum for bronchoscopy simulation, and the testing of our novel low-cost, high-fidelity models for teaching appendectomies which are created by utilizing 3D printing technology.
Our goals for the next year include developing simulation courses that provide advanced education for OR staff that specialize in specific service lines, to help improve the quality and efficiency of these high-volume or technically difficult procedures. We also are actively looking for ways to facilitate the participation of staff from other Inova operating units in procedural simulation and team training.
6
Sharon Bachman, MD, FACSSurgical Director, ASTEC; Director, Minimally Invasive Surgery; Surgical Clerkship Director; Associate Professor, VCU School of Medicine - Inova Campus
Pictured left to right:
Front Row: Sharon Bachman, MD, FACS, Paula Graling, DNP, RN, CNOR, FAAN, Amber Trickey, PhD, MS, CPHBack Row: John Moynihan, MD ,FACS, Larry Walker, Frank Piscitani, Jonathan Dort, MD, FACS 7
ASTEC Research Mission:
Conduct unique research in the arena of procedural education to enhance the technical and affective skills of practitioners, ultimately benefitting patients.
2016 ASTEC Research Goals:
• Mature ongoing projects on the development of high-fidelity, low-cost simulation models
• Mature ongoing projects on communication skills in graduate medical learners
• Follow the outcomes of teams training projects in Inova System safety and quality outcomes
• Continue research collaborations on the novel use of technology in simulation with GMU, Fairfax Fire and Rescue, and other collaborators
• Continue to support GME projects on assessment and skills acquisition
• Submit at least one training or seed grant
0 20 40 60 80 100
June
July
August
September
October
November
December
January
February
March
April
May
2015 2014
20
20
20
24
39
19
12
85
92
69
87
82
58
60
29
81
89
85
87
ASTEC Utilization Percentage per Month 2014 - 2015
Learners by Group - 2015Figure 2
Figure 3
Research Division
The Research Division of the Department of Surgery is the key resource supporting the academic growth of the department. The team welcomed a new Director of Research, a Project and Research Coordinator, and two new Clinical Research Associates in 2015 and will grow further in the upcoming year by the addition of a Research Nurse.
The Research Division‘s role is to support and foster all research activities within the Department of Surgery spanning from investigator initiated retrospective studies, clinical trials, translational research projects, and industry- as well as NIH sponsored multi-institutional studies. In order to strengthen the support provided by the research team and improve effectiveness, several important initiatives were started in 2015:
• A bi-weekly meeting with the research team to review the progress of all ongoing studies.
• Regular monthly meetings by Specialty with Investigators and their clinical staff to review the status of research projects and to optimize the integration of research and clinical practice.
• The creation and maintenance of a list of regional, national, and international meetings with abstract submission deadlines to facilitate the process of presenting research results for studies conducted by Department of Surgery faculty and residents.
• The restructuring of policies for the Department of Surgery Research Committee to enhance and facilitate the process of initiating new studies and developing research ideas.
The Research Division of the Department of Surgery managed or started 71 studies in 2015 and enrolled or followed-up with 263 patients in prospective studies in addition to completing a number of retrospective analyses. All of these activities contributed significantly to the overall academic achievements of the Department of Surgery and its clinical divisions. A few examples of 2015 achievements are highlighted here:
• Division of Trauma faculty, Dr. Teicher and resident Dr. McCusker, successfully completed a prospective study on nutrition in critically ill patients and presented the results at the American Association for the Surgery of Trauma in September. The Trauma Division initiated seven new studies, oversaw 21 total studies, enrolled 73 patients in prospective clinical trials, and submitted nine papers for publication review based on original research.
• Division of Abdominal Transplant faculty, Dr. Wali as well as Division of Plastic Surgery faculty Dr. Mirali and residents Dr. Copeland-Halperin and Dr. Kaminsky, won Inova seed grants to study microRNAs in transplant grafts and wound culture standardization, respectively.
• Division of Abdominal Transplant faculty, Dr. Wali, with large efforts from the Research and Post-Transplant clinical team, completed enrollment in a seed grant-supported study of high-dose flu vaccine in Post-Kidney transplant patients. This included enrolling 30 patients in approximately three months.
Lana Bijelic, MD, FACSMedical Director, Surgical Oncology Director, Surgery Research Programs
8
Pictured left to right: Elena Lita ,CCRP, Anna Bradford Newcomb, PhD, LCSW, Sarah Wright, MHA, Jeff Wright, MPH, Carrie Pelletier, RN, BSN, Mallory Frazier, MS ,CCRC, Erica Emery, MS
• Division of Thoracic Surgery faculty, Dr. Khandhar, is leading a prospective clinical trial on the use of electromagnetic navigation bronchoscopy procedures using the superDimension navigation system in patients having VATS procedures as national PI. He is also leading a project looking at the impact of local anesthesia on pain scores in patients undergoing VATS.
• Division of Vascular Surgery faculty, Dr. Hashemi, is the PI of a multicenter, aortic stent device study who, with partner Dr. Mukherjee, has enrolled 12 patients. This enrollment has made Inova one of the top enrolling sites for continuing access in the country.
• Division of Thoracic Surgery faculty, Dr. Khandhar, is leading a prospective clinical trial on the use of electromagnetic navigation bronchoscopy procedures using the superDimension navigation system in patients having VATS procedures as national PI. He is also leading a project looking at the impact of local anesthesia on pain scores in patients undergoing VATS.
• Division of Vascular Surgery faculty, Dr. Hashemi, is the PI of a multicenter, aortic stent device study who, with partner Dr. Mukherjee, has enrolled 12 patients. This enrollment has made Inova one of the top enrolling sites for continuing access in the country.
• Division of Breast Surgery faculty, Dr. Edmiston, is continuing to enroll patients in a prospective clinical trial evaluating Chloroquine in DCIS patients and is also developing a trial evaluating the role of vitamin D in DCIS patients in collaboration with the Inova Department of Oncology and George Mason University.
• Division of Surgical Oncology faculty, Dr. Bijelic, successfully applied for access to the National Cancer Data Base (NCDB) to study treatment trends in patients with malignant mesothelioma.
Midlevel Clinical Practice Providers
The Department of Surgery hired its first physician assistant in 2002, and has continued to steadily expand its midlevel staff since that time. The Department now employs eight providers, who are integral to the high quality care delivery to surgical patients to include both physician assistants (PA) and nurse practitioners (NP). One midlevel is permanently assigned to each of the various surgical teams and works alongside the surgical residents. The midlevel providers participate in daily rounds, write progress notes, see consults, provide patient education, help to coordinate discharge needs and services, communicate with families and consultants, and assist in the operating room as needed.
This model has numerous benefits. Most importantly, the continuity of the same midlevel on a service ensures that we consistently provide an optimum level of care for our patients. It also gives the nurses and other staff a reliable, reachable contact when issues arise, and residents or attendings are unavailable. Our model also affords the surgical residents sufficient free time to meet their educational requirements and capitalize on learning activities. Additionally, the PAs and NPs ensure that the surgical attendings have a stable point of contact, someone with whom they have worked intimately and who knows their preferences. This knowledge is then passed down to each group of rotating residents. This allows the residents the ability to rotate on and off each service easily and efficiently. The midlevel providers have proven themselves to be an invaluable adjunct to our surgical residency program and to the care of our patients.
Additionally, there are two NPs assigned to the Urology service. These midlevel providers function quite efficiently and autonomously, and are primarily responsible for triaging all urologic consultations for the entire Inova Fairfax Medical Campus.
As the Department of Surgery continues to evolve and grow, we are confident that our PA and NP staff will do the same.
Pictured left to right: Amanda Lalicato, NP, Tammi Nelson, PA-C, Kristen Rupell, PA-C, Roslynn Mason, PA-C, Marisa Moe, MSN, ACNP-BC, Stephanie Cardace, PA-C
Surgery Department Administration
The Department of Surgery continues to grow in both human resource and clinical capacity to deliver optimal surgical care at IFMC. Our divisions of Education, Quality and Safety, Advanced Technology, Research and Clinical Practice are maturing and now have identified leadership pairs with an identified surgeon leader and content expert at the helm of each division. We have begun to develop our teams along these service divisions and are formulating strategic plans to assure success.
As with any endeavor, one of the most precious commodities is human capital, and we have assessed the needs moving forward and are attracting talent to fill gaps in department positions in clinical, education, research and administrative support. In addition to the new team members within the service lines, the department welcomed Brianna Miller and Lauri Garrett to the administrative support team. Brianna supports the team in ASTEC, and Lauri provides support to the Surgical Education and Research suite on the basement level of the critical care wing IFMC.
At the end of the year, the Department moved into its new home in the north patient tower second floor administrative suite. The suite currently houses the Chairman and Vice Chair offices as well as medical directors of Surgical Oncology and Abdominal Transplant with areas for physician dictation, computer access and collaboration.
Department leaders are engaged in activities surrounding the perioperative continuum of care both on campus and across Inova. The Department in collaboration with system Chief Nursing Officer, Maureen Swick, led the Systems Surgical Quality and Outcomes Council (SSQOC) which brings the chief of surgery, chief of anesthesia and director of perioperative nursing from each hospital together to solve issues related to perioperative care.
Promoting collaboration and cooperation among the surgical divisions and the customers we service, both internal and external, will be a focus of the coming year. Our optimal care of the surgical patient depends on the success of each of us to work at our maximum potential and our administrative team is here to make sure that happens for every member of our team.
Pictured left to right: Sheila Jackson, Brianna Miller, Lauri Garrett, CTR, Anabella Chiquillo
Paula Graling, DNP, RN, CNOR, FAANDirector, Department of Surgery; Clinical and Education Director, ASTEC
John J. Moynihan, MD, FACSChairman
Department of Surgery
H. David Reines, MD, FACS, FCCM Vice Chair
Quality
Costanza Cocilovo, MD, FACSMedical Director Breast Surgery
Donald Colvin, MD, FACS, FASCRS Section Chief
Colorectal Surgery
Gordon Hafner, MD, FACS Section Chief
General Surgery
Mark D. Falls, MD Section Chief
Ophthalmology
Stephen S. Kim, MD, FACS, FAAPSection Chief
Pediatric Surgery
Michael T. Gocke, DDS Section Chief Oral Surgery
Khalique Zahir, MD, FACSSection Chief
Plastic Surgery
Patty Lee, MD, FACSSection Chief
Otolaryngology
Sandeep Khandhar, MDMedical Director/Section Chief
Thoracic SurgeryD
Margaret Griffen, MD, FACSSection Chief
Trauma Acute Care Surgery
Lana Bijelic, MD, FACS Medical Director
Surgical Oncology
Sharon Bachman, MD, FACSMedical Director
Minimally Invasive Surgery
Alan Speir, MD Medical Director/Section Chief
Cardiac Surgery
Jonathan M. Dort, MD, FACSVice ChairEducation
Johann Jonsson, MD, FACSMedical Director, Kidney/Pancreas
Transplant Program Section Chief, Transplant Surgery
11
Surgical Specialty Areas
Surgical Specialty Areas
Breast Surgery
The advancement in the delivery of care for patients with breast disease continued at Inova throughout 2015. Several important milestones were reached including recognition of breast surgery as a distinct section within the Department of Surgery. The growth of the program remains steady as the skill and expertise of our surgeons has become a hallmark for the care we deliver.
Additionally, this expertise has allowed for successful accreditation across the health system by the National Accreditation Program for Breast Centers (NAPBC) at Inova Alexandria Hospital, Inova Fair Oaks Medical Campus and Inova Fairfax Medical Campus. We have continued to create a patient focused approach to care including increasing the number of intraoperative localization procedures for patients as well as the number of oncoplastic procedures, resulting in greater patient comfort and satisfaction.
Delivering and monitoring the quality of our care is a high priority and in addition to participating in internal quality outcome reviews, we engage in a multidisciplinary fashion with our cross specialty colleagues to create evidenced-based pathways for the patients we treat. This interdisciplinary approach to cancer care is integral to Inova Schar Cancer Institute and our surgeons are directly engaged in its planning and vision.
Education remains important to our surgeons, and we are intimately involved in the clinical training of general surgery and obstetric-gynecology residents through educational lectures, conferences and interview selection meetings. The breast surgery section continues to be directly involved in the advancement of care through scientific investigation.
Studies centered on high risk patients and genetic factors, the role of Vitamin D in breast cancer management in select cohorts of patients, and the quality of life
for patients with breast cancer are just a few examples of the depth and breadth of our research interests. Delivering excellent clinical care for breast cancer patients includes providing them with a defined plan for survivorship transition on their care journey. One of our goals looking forward into 2016, is to make this part of the fabric of the care we provide.
Cardiac Surgery
Inova Heart and Vascular Institute is home to one of the most experienced, collaborative cardiovascular surgery programs in the nation. Surgical volume for 2015 exceeded 1000 cases. We offer tertiary level care in all aspects of cardiac surgery - from myocardial revascularization, percutaneous valvular intervention and large vessel surgery to heart and lung transplant and pediatric surgery. We are one of the few programs in the country to administer adult, pediatric, thoracic and vascular surgery from within the same group. A robust cardiac surgical research agenda differentiates our program and defines us as an institute.
Our patient-centered care delivery model focuses on the patient and family from the moment they enter our hospital to discharge and beyond. HCAHPS scores for our cardiac and thoracic surgery unit continue to reflect reports of patient satisfaction with reports at the 85th percentile for patients likely to recommend the hospital for care
13
Costanza Cocilovo, MD, FACSBreast Surgical Oncologist, Medical Director
Alan Speir, MD Medical Director, Cardiac Surgery Section Chief
Colon and Rectal Surgery
The volume of Colon and Rectal surgery continues to grow at IFMC and 2015 was no exception. The colorectal robotic program is flourishing and has added to the overall volume achievements of over 600 cases for the year. In addition to the volume, we also see patients of higher acuity and are caring for patients with increasingly complex clinical problems.
The members of the Colon and Rectal section have been involved in a number of clinical effectiveness efforts over the past year to enhance the value, quality, and efficiency of the care provided to patients having colon and rectal surgery. The influence of section decisions and implementations has expanded with section members now providing care across Inova including: Inova Alexandria and Inova Loudoun Hospitals, Inova Fair Oaks and Inova Fairfax Medical Campuses. The following is a summary of some of the accomplishments of the section and its surgeons this past year.
The ERAS (Enhanced Recovery After Surgery) project provided significant improvements in patient care and is an ongoing major effort of collaboration between the section and the departments of anesthesia, nursing, surgery, resident staff, and pharmacy. The basic concept of opioid-sparing anesthesia after evaluation has resulted in shorter hospital stays for elective colon surgery patients without complications and has additionally resulted in significant pharmacy savings. The Department of Anesthesia has transitioned to Tranversus Abdominus Plane (TAP) blocks with long-acting local anesthetics as part of the ERAS program. Drs. Iaconetti, Graling and Colvin presented at the National ERAS conference in May, and Dr. Colvin participated in a national webcast program on ERAS to present the IFMC protocol. With the documented success achieved by this program at IFMC, the team hopes to implement this program at other Inova Health System hospitals in 2016.
A major effort to reduce readmissions for dehydration after ileostomy creation was spearheaded by Dr. Lynda Dougherty. With implementation of the protocol and enhancement of the Wound Ostomy Continence Nursing (WOCN) team, we have seen a significant decrease in this category of readmissions. A new technology, which allows for the remote, wireless monitoring of ileostomy output, holds promise for additional help with reduction of readmissions for ileostomy patients due to dehydration.
The section through a collaborative effort with Gastroenterology, Infectious Disease, Medicine and Surgery developed a protocol for managing patients with C. difficile infection. The protocol focused on early collaboration among practitioners once a patient is admitted and mobilization of all possible treatments, pharmaceutical and procedural, to reduce ultimate need for emergent surgery. The success of this multidisciplinary effort was presented at medical grand rounds and at the Inova GME Quality Symposium.
Surgical site infections (SSI) in colon surgery continue to be an opportunity for improvement across the United States. Members of the section and clinical effectiveness team are working to review cases and creating new templates for care that promote safety and quality.
The section continues to be active in surgical resident teaching, peer review, surgical leadership council and the colorectal oncology development taskforce for the cancer center. The longstanding (20+ years) monthly colorectal multidisciplinary conference continues to be a well-attended conference.
The section has worked with the pathology department to adhere to the National Comprehensive Cancer network (NCCN) guidelines for colon and rectal cancer reporting and reflex testing for genetic defects where appropriate. The section has also developed a Urogynecology/Colorectal monthly multidisciplinary meeting aimed at coordinating care of patients who seek surgery for specific conditions requiring the expertise of practitioners from both specialty areas.
Patient experience standings, also known as HCAHP Scores, on the surgical floor South Patient Tower Eleven (SPT 11) have been consistently high this past year in large part due to improved provider communication. An education curriculum for staff and providers is being developed and training sessions will be initiated in the ASTEC simulation center.
14
Donald Colvin, MD, FACS, FASCRSSection Chief
General Surgery
The section of General Surgery had another active year, performing nearly 4,500 cases in 2015. A wide range of conditions including head and neck, gastrointestinal, hepatobiliary, and abdominal wall hernia diseases are all managed by our surgeons. This depth and breadth of the clinical caseload has been a hallmark of General Surgery, helping to support the residency program and allowing us to enlarge the program now to five residents per year. Expanding the minimally invasive approach to surgery and introducing new technological advances to the general surgeon’s armamentarium occurred in a profound way in 2015.
Modern medicine might be defined by the movement towards multidisciplinary integration of patient care, moving away from the silos of specialty care in an effort to coordinate the expertise and strengths of all caregivers. Towards this end, a number of initiatives have been underway. Following on the advances of the ERAS protocol in colorectal surgery, a pilot study by general surgery and anesthesia has indicated that perioperative use of Neurontin and acetaminophen decreases use of narcotics in the PACU for outpatient hernia and cholecystectomy patients. This is being expanded to a prospective evaluation of the regimen compared to a standard program of acetaminophen, ibuprofen, and narcotics in which patient pain scores as well as medication use will be tracked in PACU and through their first postoperative office visit.
Management of gastrointestinal hemorrhage involves physicians from multiple departments caring for patients who range from highly stable to critically ill; the potential for errors and delays in diagnosis and treatment are numerous. In an effort to overcome these obstacles, a task force was formed to construct a Clinical Pathway for Non-Variceal GI Bleeding with representatives from surgery, gastroenterology, interventional radiology, nuclear medicine, emergency room, medical hospitalists, surgical and medical critical care, and nursing. This is in the process of being integrated across the Inova system and is expected to be rolled out in Epic later this spring.
Surgical Oncology
Lana Bijelic, MD, FACSMedical Director, Surgical Oncology; Director, Surgery Research Programs
Surgical Oncology at Inova Fairfax Medical Campus has experienced an important year of growth, with the addition of new faculty members, introduction of novel procedures and establishment of new destination programs. Surgical oncology is a critical component of multidisciplinary cancer care and the development of disease-specific multidisciplinary programs within Inova has grown in 2015 and is expected to continue to expand even further in 2016. An example of such a program is the Inova Melanoma and Skin Cancer Center, which led to a tremendous growth in overall surgical procedures for patients with melanoma. In 2014, IFMC saw a total of 83 melanoma cases and during the first six months of 2015, our volume had reached 132 melanoma cases. We also introduced a novel procedure in the surgical treatment approach of melanoma: the endoscopic inguinal lymphadenectomy. This minimally invasive approach is associated with reduced morbidity compared to standard lymphadenectomy and is most commonly used for patients with melanoma and those with genital tract cancers. Drs. Hafner and Bijelic have performed four of these procedures since first introducing the technique in August 2015.
15
Gordon Hafner, MD, FACSSection Chief
Lana Bijelic, MD, FACS
Building destination programs to treat complex conditions is another important new area of growth for the Department of Surgery, such as the establishment of a HIPEC (Heated Intraperitoneal Chemotherapy combined with cytoreductive surgery) program in June 2015 directed by Dr. Bijelic.
Cytoreductive surgery and HIPEC procedures consist of extensive surgical resection for patients whose tumors have spread throughout the peritoneum followed by the application of heated chemotherapy into the abdominal cavity to achieve maximal local-regional effectiveness while minimizing systemic absorption and toxicity. It is established as a treatment option for patients with appendiceal and colon cancer, mesothelioma, gynecologic cancers and occasionally other malignancies. Inova’s program is the only HIPEC program in Northern Virginia and one of only a handful of programs in the broader southeastern region.
Ophthalmic Surgery
In Ophthalmic Surgery, 2015 continued to be a year that saw our section members performing a full spectrum of ophthalmic care across all of our subspecialty disciplines. Overall surgical volume exceeded 2,000 cases. Cataract, corneal, pediatric and retinal surgery continued to dominate our case load at the Woodburn surgery center. The new Zeiss microscope has been enthusiastically embraced by the staff, and the new video monitor allows the nursing staff to follow the cases more easily. A video marker for TORIC/ Astigmatism IOLS has been made available to our practitioners and will help to increase the accuracy of our premium lens offerings. Volunteer attending surgeons continue to provide surgical guidance to our Ophthalmology residents and provide care through the indigent clinic at the Lions Eye Clinic at Inova Fairfax Medical Campus. We continue to provide inpatient consultations and emergency room evaluations. The pediatric specialists work in the neonatal
16
Mark Falls, MDSection Chief
17
intensive care unit (NICU) to screen for Retinopathy of Prematurity and answer any questions related to ophthalmic care of the neonatal or pediatric patient. We are working in conjunction with other areas of medicine to ensure timely dissemination of appropriate information for eye-related issues in the context of ER consults or questions for inpatients. In order to drive safe and efficient care for all patients, we are working on a Telemedicine initiative to more fully utilize our off campus, community- based staff of ophthalmologists. Many members of our section serve on the executive committees of local ophthalmology societies like the Northern Virginia Academy of Ophthalmology which continue to provide local instructional opportunities for Ophthalmology. Dr. William Rich, a local Ophthalmologist who was on staff here for many years, has just become the new President of the American Academy of Ophthalmology. We look forward to bringing state of the art ophthalmic care to our hospital campus and our community.
Oral/Maxillofacial Surgery
The surgeons in the section of Oral and Maxillofacial Surgery (OMS) at Inova Fairfax Medical Campus are integral to Inova’s healthcare delivery system. Surgeons care for both adult and pediatric patients throughout the campus who have had major and minor oral and facial trauma, and major dental infections of the head and neck. Surgeons who are members of this section are greatly relied upon for their general dental knowledge. Over 150 surgical cases were performed by the section this year.
Highlights from the OMS section this year include:
• Continuing education grand rounds and hands on treatment of dental emergencies scenario provided to the Pediatrics Emergency Department
• Curriculum development meetings with the Advanced Surgical Technology and Education Center (ASTEC) staff to explore education on management of difficult airway and airway rescue.
The airway management curriculum as well as less invasive techniques to access the maxillofacial region will be explored for the continued training of Inova Oral and Maxillofacial Surgeons.
Otorhinolaryngology
ENT section members provide general ear, nose and throat care as well as highly specialized surgeries. Overall volume in 2015 exceeded 1,300 cases. In 2015, our section welcomed 4 new active members: Sarah Blank, MD, Belinda Mantle, MD, Esther Yoo, MD and Mark Domanski, MD.
The cochlear implant program continues to grow, especially in pediatrics, under the direction of Jerry Lin, MD, PhD. Skull base surgeries (anterior, middle, posterior, and infratemporal) are performed in active collaboration with neurosurgery, plastics and reconstructive surgery and have been the focus of courses developed by Ameet Singh, MD in the
ASTEC simulation lab. Transoral robotic surgery has been an asset in the armamentarium treating oropharyngeal cancers, which continue to increase in incidence in the United States. A specialized retractor (FK-WO retractor) was purchased and has helped improve the exposure of the surgical site in transoral surgery. IFMC surgical services acquired sialoendoscopy instruments designed for procedures in patients with chronic sialoadenitis and sialolithiasis, and we look forward to offering new procedures to patients who will benefit from this less invasive therapy in 2016.
Patty Lee, MD, FACS Section Chief
Michael Gocke, DDSSection Chief
Cochlear Implant
Timothy Egan, MD, Inova site director of the Walter Reed Resident Training Program, has led development of an Upper Airway Stimulation program for the treatment of sleep apnea in patients who are not able to tolerate CPAP. Untreated sleep apnea is a common problem with significant morbidity. A central component of the program is a CPAP Intolerant Clinic that tries to find alternatives to CPAP therapy for patients who are unable or unwilling to use CPAP. The CPAP Intolerant Clinic is a multidisciplinary team involving ENT, sleep medicine, dentistry and weight loss specialists. The team has been formed and will begin seeing patients in the coming months. Patients who qualify will be offered the Inspire Upper Airway Stimulation device which is a novel device that has been clinically proven to improve sleep apnea in patients who cannot use CPAP. The Inspire device is a great alternative to patients who have been refractory to traditional treatments.
Section members participate in hospital committees and hold faculty positions leading clinical rotations and education teams across Inova Fairfax Medical Campus. Members are actively engaged in local community outreach, staffing the Inova craniofacial clinic as well as holding association leadership positions on the local, regional and national level. The section is highly regarded in national rankings. In 2015 US News and World Report, Inova Fairfax Medical Campus Ear, Nose, and Throat service ranked higher than many other regional academic and community, Ear, Nose and Throat programs.
Pediatric Surgery
The Pediatric Surgery section has had another tremendous year in 2015. Always striving to provide an unparalleled level of care to the patients at the Inova Children’s Hospital, the division welcomed the addition of Dr. Joseph Hartwich. Dr. Hartwich completed his Pediatric Surgery fellowship at the Hasbro Children’s Hospital and Brown University School of Medicine, and expanded the section’s expertise in the innovative care of newborns with congenital anomalies, fetal care and intervention, and pediatric tumors.
The Section has continued to be extremely busy, performing approximately 1,700 cases over the past year. These have included the surgical management of the most complex diseases, such as congenital diaphragmatic hernia, necrotizing enterocolitis, complex anorectal malformation, giant omphalocele, VACTERL anomalies, and thoracic and abdominal tumors, as well as the more common conditions such as appendicitis, inguinal hernia, hypertrophic pyloric stenosis, and intussusception. State-of-the-art technology such as the da Vinci robotic surgical system, and state-of-the-art techniques such as scarless umbilical surgery have been utilized to provide the highest level of care, lowest morbidity, reduced length of hospitalization, and the best possible outcomes.
The pediatric surgeons have been active in clinical education, training medical students, surgical residents, and pediatric residents. They have also been committed to regional and national conferences, serving as invited speakers and faculty.
In 2016, with the opening of the new Inova Children’s Hospital, the Pediatric Surgery section remains committed to providing world-class multidisciplinary care for the pediatric patients of Northern Virginia.
18
Stephen Kim, MD, FACS, FAAPSection Chief
Plastic Surgery
The Plastic Surgery Section provides comprehensive plastic surgery services at IFMC treating complex abdominal wall defects, traumatic injuries, and reconstruction after oncologic surgery, as well as traditional cosmetic surgery. The section has been very productive this year, with over 1,800 surgical cases performed.
The section members were also busy conducting, presenting, and publishing clinical research activities, as well as grant writing to obtain funds for research activities. Inova Fairfax surgical residents have been actively engaged in these efforts with our plastic surgeons.
Khalique Zahir, MD, FACSSection Chief
Craniofacial 3D Model
19
Trauma/Acute Care Surgery
In 2015 the Division of Trauma Acute Care Surgery (TACS) continued to provide trauma care for Northern Virginia as a Level I trauma center designated by the Commonwealth of Virginia and verified by the American College of Surgeons. The division continues to provide 24/7 surgical critical care and acute general surgery care to the IFMC patient community. We collaborate with pre-hospital personnel and planning through the regional EMS council and provide outreach and injury prevention throughout the region. Recognizing that our patients’ and families’ recovery continues well beyond discharge, our Trauma Survivors Network (TSN) provides support and assistance for months, and sometimes years after injury.
The division treated almost 2,500 trauma patients. Nearly 1,200 required activation of the trauma team for immediate evaluation and treatment, and we managed over 800 patients in the intensive care unit. In July 2015 we initiated a more formal acute care surgery component of the team involving multiple general surgeons. In just 4 months we provided emergency general surgery care to over 175 patients.
Initiatives for our division in 2015 included trauma-related topics such as fall prevention, chemical prophylaxis for venous thromboembolism in the brain injured patient, and appropriate chemical prophylaxis for venous thromboembolism in the obese patient. Critical care initiatives for 2015, in collaboration with our Trauma Intensive Care Unit staff, have focused on interventions preventing infections and on nutrition delivery. We maintained improvements made through 2014 for urinary tract infection and continue our robust quality improvement program to evaluate program performance and institute change as needed.
Research endeavors for the TACS division include a wide range of topics and both retrospective and prospective data collection and analysis. We presented our intensive care unit nutrition initiative at the American Association for the Surgery of Trauma in September and anticipate publication in 2016. Our team has been working on several national multi-institutional research studies and is collaborating with George Mason University, the National Institutes of Health, and the Department of Defense on other projects.
Outreach is a mainstay of every Trauma program and in 2015 our Injury Prevention initiatives included car seat safety, workshops for drowning prevention and bicycle safety as well as elderly fall prevention. Distracted driving programs designed to reach the new teenage driver are conducted regularly, both in-house and at area high schools. Our Injury Prevention Coordinator completed the Marine Corp Marathon as part of our sponsorship through the Safe Kids coalition. Our community outreach continues to include education such as EMS provider night, multiple Advanced Trauma Life Support courses, and a half-day conference focusing on the emotional care of the trauma patient.
20
Margaret Griffen, MD, FACSSection Chief
Finally, beyond the extensive clinical care we provide, we recognize that the disease of trauma is different than many others and that recovery extends well beyond discharge. The TSN continues to grow, and now includes 6 monthly groups. Through the TSN we help our patients and families work through the pain, anger, sadness and frustration that accompany “getting your life back” after a trauma. Over twenty patient and family TSN volunteers give back by meeting with our current patients, helping them to see that recovery is possible. The care of our patients would not be complete without this component of our team’s care.
Overall, 2015 has been a very productive year for the Division of Trauma Acute Care Surgery. We have added personnel and in November made a move to the newly renovated third floor unit to better serve our patients. We continue to develop and grow the components of our program to provide excellent care to our patients.
Thoracic Surgery
The Thoracic service in 2015 continued to grow in depth and breadth as treatment of lung cancer has remained our steadfast focus.
The addition of Amit “Bobby” Mahajan, MD, interventional pulmonologist, has truly revolutionized the delivery of care to our patients in Northern Virginia and the surrounding regions. Our procedural volume has grown by 60%, but more importantly, the available resources, personalized treatment and expeditious care has carved the path for our program’s growth and development.
Paul Kiernan, MD, FACS continues to take on complex cases, guiding with his wisdom and experience.
Our three thoracic nurse practitioners, Christy Schatz, NP, RNFA, Christiana Powers, NP and Carolyn Rosner, NP perform steadfastly with their empathetic
and conscientious perioperative care. They have furthered the mission with several national presentations, abstract submissions, and published manuscripts on perioperative care. These efforts, together with database management services, student mentorship, perioperative pathway development and participation in clinical trials all help us give back to our community in a meaningful, educational and reproducible way.
Our medical director and chief, Sandeep J. Khandhar, MD, has also been selected as the principal surgical investigator in one of the largest worldwide trials being performed. The study includes 2,500 patients internationally to evaluate the feasibility of electromagnetic navigation bronchoscopy for the diagnosis of lung cancer. Our close industry collaborations have kept us at the forefront of technology and care delivery in the thoracic space. We expect significant incremental growth over the next year, raising the bar, challenging norms, while preserving the essence of what it means to take excellent care of patients.
Sandeep Khandhar, MDMedical Director, Thoracic Surgery Section Chief
Amit “Bobby” Mahajan, MD
Sandeep J Khandhar, MD
21
Transplant Surgery
In 2015, the abdominal transplant program continued its more than 24 years of providing comprehensive compassionate care to the patients it serves in an outstanding integrated clinical environment on the top floor of our new south patient tower building. The clinical growth of the program was evidenced not only by the large number of patients transplanted, but also by the ever increasing number of patients referred to the program from other institutions. The abdominal transplant clinic accounted for more than 2000 post-transplant patient visits and an increasing number of pretransplant and potential living donor evaluations.
As a member of United Network for Organ Sharing (UNOS), we are working to continue to drive excellence and quality of care for transplant patients. One initiative in which we are participating is centered on decreasing the waiting times for blood group B patient candidates through the A2 to B blood group sharing program. By allowing this sharing of organs from A2 patients to B patients, the wait times for transplant has been brought more in line with other blood group candidates. Another example of work being done to improve long term outcomes, is the expansion of the surveillance biopsy program which allows for detection of early subclinical renal pathology which may then be treated to impact long term survival.
Advances in minimally invasive surgical techniques combined with technological advances in monitoring and data tracking and trending have allowed our providers to continue to blend new approaches to care into the fabric of what we do.
The ability to deliver state-of-the-art care would not be possible for the Inova Abdominal Transplant Program without the dedicated team of surgeons, nephrologists, nurses, pharmacists, dieticians and social workers who each and every day collaborate to provide well recognized care… every time, every touch.
Urologic and Robotic Surgery
Urology: Urology continues to provide contemporary medical and surgical management of structural abnormalities of the genitourinary (GU) system, with nearly 2,000 surgical cases performed. Through continuous review and analysis of protocols, medications, and instruments, urology services remain at the forefront in the treatment of urological malignancies, stone disease, prostate disease, GU reconstruction and urinary tract infections.
GU Oncology services not only include the more common GU malignancies of prostate, kidney, bladder, ureter and testes, but also coordinated participation in multidisciplinary and multispecialty management of many other cancers such as colorectal, retroperitoneal, gynecological, and metastatic cancers. This ongoing commitment to multidisciplinary care coordination for cancer patients involving urological care will be integrated into the new Inova Schar Cancer Institute. Minimally Invasive GU Surgery (MIS) procedures are comprehensively incorporated in patient decision-making when surgical treatment is contemplated. Most of the MIS procedures are performed with da Vinci Si robot-assisted laparoscopic techniques that have supplanted most open abdominal and pelvic GU surgeries. Urology MIS continues to remain cutting-edge while enhancing patient safety and recovery.
Urinary Stone Disease Surgery comprises the largest proportion of urological surgical volume. The utilization of contemporary equipment for ureteroscopy (flexible and rigid), percutaneous nephrostolithotomy, extracorporeal shockwave lithotripsy and laser technology is continuously evaluated and updated to maximize efficacy and patient safety.
Robotic Surgery: The variety of robotic surgery procedures at IFMC continues to expand to meet patient expectations and is driven by the proven benefits of robotic surgery such as reduced surgical site infections, improved surgical visualization, shorter lengths of stay, and quicker recovery. This growth is managed through Comprehensive Teams Training that encompasses
Johann Jonsson, MD, FACSDirector,Kidney and Pancreas Transplant Program Section Chief
Simon Chung, MDDirector, Robotics Surgery Section Chief, Urology
22
extensive training and ongoing review of patient care considerations of the robotic surgery team members comprised of nurses, surgical assistants, anesthesiologists, nurse anesthetists and surgeons. The robotic surgery program is integrated into the education of residents of almost all of the surgical disciplines of the department.
Vascular Surgery
The Vascular Surgery division of the Department of Surgery has had a busy and productive 2015, performing approximately 600 cases. Our program offers the entire range of services for vascular disease including endovascular and open repair for diseases of the thoracic and abdominal aorta, complex repair of the visceral aorta including the first fenestrated endovascular repair that we performed percutaneously in 2015. This repair was done using a custom made graft with covered stents placed in both the renal arteries and a scallop for the superior mesenteric artery. The entire infrarenal abdominal aortic aneurysm and bilateral common iliac artery aneurysms were excluded. The patient was discharged in excellent condition with a length of stay of two days in the hospital.
We are part of the NELLIX trial, bringing the latest innovation in the endovascular management of abdominal aortic aneurysm with the goal of
eliminating Type II endoleaks which are a consequence of standard endovascular repair of an abdominal aortic aneurysm.
We offer a full range of services for carotid disease including endarterectomy and carotid stenting. We are part of the CREST 2 trial, which is an NIH sponsored trial of high importance evaluating the results of carotid endarterectomy versus best medical therapy and carotid stenting versus best medical therapy for asymptomatic high-grade carotid stenosis.
All patients with peripheral vascular disease are treated with the latest in endovascular and open surgical repair including access to drug eluting balloons and stents to complex open surgical repair for limb salvage in patients with critical limb ischemia. We are participating in the BEST CLI trial, another NIH sponsored trial of high importance evaluating the results of endovascular versus open surgical repair in patients presenting with critical limb ischemia.
Treatment of venous disease is an important component of patient care delivery. Outpatient treatment for venous insufficiency and varicose veins to medical and endovascular treatment of deep venous thrombosis and venous thromboembolic disease are part of the skill set of members of the vascular surgery section. Our practitioners continue to work across the specialty barriers to ensure optimal patient care outcomes by close collaboration with cardiology and interventional radiology. Many of our research initiatives are a result of collaboration between the three specialties. We have presented our clinical research and cutting edge results at most of the major national meetings as well as in the international arena. We look forward to enhancing the vascular program to the next level in 2016.
Dipankar Mukherjee, MDSection Chief
23
Fenestrated Endovascular Repair of a Juxta-Renal Abdominal Aortic Aneurysm
Instruments Ready Intraoperative Ultrasound
Dipankar Mukherjee, MD
Figure 4 Main OR - Surgical Volumes by Specialties - 2015Figure 5
0
5000
10000
15000
20000
25000
30000
35000
40000
2013 2014 2015
32,97336,05135,687
32%
Inp
atient
68% O
utpatient
Ambulatory Surgery Center - Surgical Volumes by Specialties - 2015
Surgical Volume - 2015Figure 6 Total Surgical Volume 2013 - 2015Figure 7
Plastics
4% 20% 4%
14% 15%
14%
6%
3%
4
% 6% 5%
Orthopedics
General
GeneralTrauma
Neurosurgery
Ortho-trauma
1%Transplant
Uro/GYN
1%Podiatry
Vascular/Thoracic
GYN-Room 21Other
0%
Robotics1%ENT
1%Dental/Oral
1%Gastroenterology
Podiatry
0%GYN
1%Oral Surgery
1%Opthalmology
Pediatrics
Orthopedics
0%
1%Others
0%Colorectal
Urology - Cysto Room
Urology - Open Room
Plastics
General
ENT 11% 36%
10%
13
%
9%
5
%
13%
24
Surgery by the Numbers
24
Selected Honors, Presentations, Publications and Research
25
Selected Honors, Presentations, Publications and Research
Association Representation
Bachman, S.
• Society of American Gastrointestinal and Endoscopic Surgeons, Hernia Task force
• Society of American Gastrointestinal and Endoscopic Surgeons, FUSE Committee, member
• Society of American Gastrointestinal and Endoscopic Surgeons, Research and Career Development Committee
Cocilovo, C.
• American Society of Breast Surgeons, Chair, Legislative Committee
• American College of Surgeons Surgical Coalition, American Society of Breast Surgeons, Representation
Colvin, D.
• American College of Colon and Rectal Surgeons, Website Committee
Dort, J.
• Society of American Gastrointestinal and Endoscopic Surgeons, Resident Education Committee,
• Society of American Gastrointestinal and Endoscopic Surgeons, Continuing Education Committee, Member
• Society of American Gastrointestinal and Endoscopic Surgeons, Quality, Outcomes, and Safety Committee, Member
• Society of American Gastrointestinal and Endoscopic Surgeons representation to National Quality Forum, Task Force, Member
• Society of American Gastrointestinal and Endoscopic Surgeons, ADOPT program, Chair
• Association of Program Directors in Surgery, Board of Directors, Member
• Association of Program Directors in Surgery, Program Committee, Member
• Association of Program Directors in Surgery, Nominations Committee, Member
• Association of Program Directors in Surgery, Independent Academic Medical Center Committee, Member
• American College of Surgeons, DC Chapter, Treasurer
• American College of Surgeons, DC Chapter, Councilor
• American College of Surgeons, Resident Paper Competition, DC Chapter, Chair
• American College of Surgeons, Virginia Chapter, Councilor
• Association of Operating Room Nurses, Simulation Accreditation Task Force, Member
Doud, G.
• DC Board of Medicine- Medispa Task Force
• Academy of Otolaryngology Head and Neck Surgery- Facial Plastic Surgery Education committee
• American Academy of Otolaryngology Head and Neck Surgery, Women in Otolaryngology committee, Member at large
Graling, P.
• AORN Foundation, Board of Trustees, Member
• Association of periOperative Registered Nurses, Simulation Taskforce, Chair
Kaminsky, A.
• American Society of Plastic Surgeons, Curriculum Development Committee
Kim, S.
• American Pediatric Surgical Association, Membership and Credentials Committee
Mukherjee, D.
• South Asian American Vascular Society, President 2014-2015
• Society of Vascular Surgery, Advisory Assembly of Vascular Societies, Member November 2010-present
Reines, H. D.
• Council on Graduate Medical Education, Chair
• American College of Surgeons, Board of Governor
• Foundation of University of Vermont, Board
• Foundation of Christian Medical College, Board, Vellore India
• Agency for Healthcare, Research and Quality, Advisory Board
• Association of Program Directors in Surgery, Committee on Non-Affiliated Programs
• American College of Surgeons, Metropolitan Chapter, Counselor 2007-present
Roese, M.
• Washington Metropolitan Area Otolaryngology Society, President
26
Books/Book ChaptersMukherjee D, Kfoury E. Carotid Endarterectomy - Vascular Surgical Perspective. In: Laligam N. Sekhar, ed. Textbook of Neurosurgery Place of publication: Thieme Publishers; in press.
Spencer P, Singh A, Woodworth B. Surgical Techniques in Otolaryngology – Head & Neck Surgery: Sinonasal Surgery Jaypee Brothers Medical Pub; 1 Ed ISBN-13: 978-9351524625
Teicher EJ, Michetti CP. Antiepileptic drugs, Antibiotics, Nutrition. In: JM Ecklund, Moores LE, ed. Neurotrauma Management for the Severely Injured Polytrauma Patient Place of publication: 1st ed. Springer; in press.
PublicationsBaldwin KM, Ehrenberg PK, Geretz A, Prentice HA, et al. HLA class II diversity in HIV-1 uninfected individuals from the placebo arm of the RV144 Thai vaccine efficacy trial. Tissue Antigens 2015; 85(2): 117-126.
Copeland-Halperin LR, Cohen RA. Recurrent Breast Cancer in a Patient with a Ventriculoperitoneal Shunt. Case Reports in Surgery 2015; vol. 2015, Article ID 659395. doi:10.1155/2015/659395
Copeland-Halperin LR, Copeland M. Facial augmentation by intra-oral delivery of autologous fat. Archives of Aesthetic Plastic Surgery 2015; accepted for publication.
Copeland-Halperin LR, Kaminsky AJ, Bluefeld N, Miraliakbari R. Sample procurement for cultures of infected wounds: A systematic review. Journal of Wound Care 2015; accepted for publication.
Copeland-Halperin LR, Pimpinella V, Copeland M. Combined liposuction and excision of lipomas: long-term evaluation of a large sample of patients. Plastic Surgery International 2015; Vol. 2015, Article ID 625396. doi:10.1155/2015/625396
DeMichele A, Yee D, Berry DA, Albain KS, Benz CC, Boughey J, Buxton M, Chia SK, Chien AJ, Chui SY, Clark A, Edmiston K, et al. The Neoadjuvant Model Is Still the Future for Drug Development in Breast Cancer. Clinical Cancer Research 2015; 21(13): 2911-2915.
Dort JM, Trickey AW, Kallies KJ, Joshi ART, Sidwell RA, Jarman BT. Applicant Characteristics Associated With Selection For Ranking At Independent Surgery Residency Programs. Journal of Surgical Education 2015; 72(6):e123-e129.
Fitzgerald DC, Holmes SD, St Onge JR, Ioanou C, Martin LM, Ad N. Systemic inflammatory response during cardiac surgery: a pilot study. Innovations (Philadelphia, PA) 2015; 10(2):125-32.
Folch EE, Bowling MR, Gildea T, Hood KL, Murgu SD, Toloza EM, Wahidi MM, Williams T, Khandhar SJ. Design of a Prospective, Multicenter, Global Cohort Study of Electromagnetic Navigation Bronchoscopy in up to 2500 Subjects. Journal of Thoracic Oncology. 2015
Gillinov M, McCarthy PM, Benussi S, Damiano RJ, Ad N. Surgical Ablation for Atrial Fibrillation. Seminars in Thoracic and Cardiovascular Surgery. 2015; 27(1):65-79.
Holmes SD, Martin LM, Miller CE, Shuman DJ, Ad N. How do minimally invasive cardiac surgery patients compare to median sternotomy patients on expectations and psychosocial outcomes? Innovations. 2015; 10 (suppl 2): S47.
Jarman BT, Joshi ART, Trickey AW, Dort JM, Kallies KJ, Sidwell RA. Factors and Influences That Determine the Choices of Surgery Residency Applicants. Journal of Surgical Education 2015; 72(6):e163-e171.
Je HG, Shuman DJ, Ad N. A systematic review of minimally invasive surgical treatment for atrial fibrillation: a comparison of the Cox-Maze procedure, beating-heart epicardial ablation, and the hybrid procedure on safety and efficacy. European Journal of Cardio-Thoracic Surgery. 2015; 48(4): 531-41.
Kaminsky AJ, Patel KM, Cocilovo C, Nahabedian MY, Miraliakbari R. The biplanar oncoplastic technique case series: a 2-year review. Gland Surgery. 2015; 4(3): 257-262.
Kfoury E, Dort J, Trickey A, Crosby M, Donovan J, Hashemi H, Mukherjee D et al. Carotid endarterectomy under local and/or regional anesthesia has less risk of myocardial infarction compared to general anesthesia: An analysis of national surgical quality improvement program database. Vascular. 2015; 23(2): 113-119.
Lamb SV, Massengill J, Sheridan MJ, Stern LE, von Pechmann W. Safety of Combined Sacral Colpopexy and Sigmoid Resection with Suture Rectopexy: A Retrospective Cohort Study. Female Pelvic Medicine and Reconstructive Surgery. 2015; 21(1):18-24.
Li SS, Kaminsky AJ, Copeland-Halperin LR, Miraliakbari R. The vastus lateralis free flap for lower extremity Gustilo grade III reconstruction. Microsurgery. 2015; doi: 10.1002/micr.22526. [Epub ahead of print]
Li X, Zhang K, Pajewski NM, Brill I, Prentice HA, et al. Immunogenetic influences on acquisition of HIV-1 infection: consensus findings from two African cohorts point to an enhancer element in IL19 (1q32.2). Genes and Immunity. 2015; 16(3): 213-220.
Mavroudis C, Stulak JM, Ad N, Siegel A, Giamberti A, Harris L, Backer CL, Tsao S, Dearani JA, Weerasena N, Deal BJ. Prophylactic atrial arrhythmia surgical procedures with congenital heart operations: review and recommendations. The Annals of Thoracic Surgery. 2015; 99(1): 352-9.
Michetti CP, Franco E, Coleman J, Bradford A, Trickey AW. Deep Vein Thrombosis Screening and Risk Factors in a High Risk Trauma Population. Journal of Surgical Research. 2015; 199(2):545-51.
Michetti CP, Griffen M, Tran HT, Crosby ME, Trickey AW. Laparoscopic cholecystectomy performed by acute care surgeons and general surgeons. The American Surgeon. 2015; 81(5): E220-221.
Michetti CP, Newcomb A, Prentice H, Rodriguez J. Ventilator-associated pneumonia in trauma patients: the role of non-modifiable risk factors. Critical Care Medicine. 2015; 43(12)suppl 1:111.
27
Miller J, Lieberman L, Nahab B, Hurst G, Gardner-Gray J, Lewandowski A, Natsui S, Watras J. Delayed intracranial hemorrhage in the anticoagulated patient: A systematic review. Journal of Trauma and Acute Care Surgery. 2015; 79(2):310-3.
Prentice HA, Tomaras GD, Geraghty DE, et al. HLA class II genes modulate vaccine-induced antibody responses to impact HIV-1 acquisition. Science Translational Medicine. 2015; 7(296): pp. 296ra112.
Ramanathan R, Parrish DW, Hartwich JE, Haynes JH. Utility of admission serum lactate in pediatric trauma. Journal of Pediatric Surgery. 2015; 50(4):598-603.
Rogers S, Richards KC, Davidson M, Weinstein AA, Trickey AW. Description of the Moderate Brain Injured Patient and Predictors of Discharge to Rehabilitation. Archives of Physical Medicine and Rehabilitation 2015; 96(2):276-282.
Schatz C. Enhanced Recovery in a Minimally Invasive Thoracic Surgery Program. AORN Journal. 2015; 102(5): 482-492.
Spiegelstein D, Holmes SD, Pritchard G, Halpin L, Ad N. Preoperative hematocrit as a predictor of perioperative morbidities following nonemergent coronary artery bypass surgery. Journal of Cardiac Surgery. 2015; 30(1): 20-6.
Trickey AW, Wright J, Donovan, J, Reines HD, Dort JM, Prentice HA, Graling P, Moynihan J. Inter-rater reliability of Hospital Readmission Evaluations for Surgical Patients. American Journal of Medical Quality. 2015; in press.
Wali RK, Lee AH, Kam JC, Jonsson J, Thatcher A, Poretz D, Ambardar S, Piper J, Lynch C, Kulkarni S, Cochran J, Djurkovic S. Acute Neurological Illness in a Kidney Transplant Recipient Following Infection With Enterovirus-D68: An Emerging Infection? American Journal of Transplant. 2015; 15(12): 3224-8.
PresentationsAllred C. Predicting the future: our struggles with communicating a poor prognosis. General Surgery Grand Rounds, Inova Fairfax Medical Campus. December 2015; Falls Church, VA.
Bijelic L. Cytoreductive Surgery and HIPEC for Peritoneal Metastases: Past, Present and Future. General Surgery Grand Rounds, Inova Fairfax Medical Campus. October 2015; Falls Church, VA.
Bijelic L. Invited Presentation. 4th Annual Mid-Atlantic Peritoneal Malignancy Workshop, Eastern Virginia Medical School and Sentara Cancer Network. June 2015; Virginia Beach, FL.
Bui S, Chhina MK, Khandhar S, Mani H, Nathan SD, Grant GM. Effect of the In-Vitro Combination Treatment with Curcumin, Aspirin and Sulforaphane on Idiopathic Pulmonary Fibrosis Fibroblasts. American Thoracic Society May 2015; Denver, CO.
Cohen RA. Recent Advances in Breast Cancer Care. General Surgery Grand Rounds, Inova Fairfax Medical Campus. March 2015; Falls Church, VA.
Cohen RA. Recent Advances in Breast Cancer Care. Medicine Grand Rounds, Inova Fairfax Medical Campus. May 2015; Falls Church, VA.
Colvin D, Iaconetti DJ, Graling PR. Implementation of an ERAS Program for Colon and Rectal Surgery: The Inova Fairfax Hospital Experience. Enhanced Recovery After Surgery and Perioperative Medicine, World ERAS Society, May 2015; Washington, D. C.
Colvin D. Opioid Sparing ERAS Protocol. Simulcast National Presentation. May 2015.
Copeland-Halperin, L. Postoperative Blood Cultures: When Are They Worth the Effort? General Surgery Grand Rounds, Inova Fairfax Medical Campus. October 2015; Falls Church, VA.
Copeland-Halperin LR, Kaminsky AJ, Bluefeld N, Miraliakbari R. Culture swabs in the evaluation of wound infection: A critical assessment of unresolved issues. DC Chapter of the American College of Surgeons All Surgeons Day. March 2015; Washington, D.C.
Copeland-Halperin LR, Kaminsky AJ, Miraliakbari R. Bacteriological Sampling of Infected Wounds: Data Gaps and Future Research Directions. Virginia Society of Plastic Surgeons Biennial Educational Meeting. November 2015; Richmond, VA.
Copeland-Halperin LR, Li SS, Kaminsky AJ, Lodhi FK, Li J, Miraliakbari R. Computer-aided surgical simulation in head and neck reconstruction: A cost comparison among traditional, in-house, and commercial options. Virginia Society of Plastic Surgeons Biennial Educational Meeting. November 2015; Richmond, VA.
Danzer E. Surgery Case Review. General Surgery Grand Rounds, Inova Fairfax Medical Campus May 2015; Falls Church, VA.
Dort JM, Graling PR. Spaced Education for Safety Excellence. AORN Conference and EXPO. March 2015; Denver, CO.
Doud Galli S. Medicine and Philanthropy in the Korean American Community. Korean American Medical Society’s Medical Student Conference, George Washington University Medical School Nov 2015; Washington, DC.
Doud Galli S. Taking the Right Risks. Smith College’s Women’s Leadership Conference. March 2015; Northampton, MA.
Dougherty L. Advanced Management of Colon and Rectal Cancer. Inova Fair Oaks Hospital. October 2015; Fairfax, VA.
Dougherty L. Surgical Management of Inflammatory Bowel Disease. Medical Grand Rounds, Inova Fairfax Medical Campus. October 2015; Falls Church, VA.
Edmiston K. Breast Cancer Care in Low Resource Environment. General Surgery Grand Rounds, Inova Fairfax Medical Campus. January 2015; Falls Church, VA.
Franco E. Small bowel obstruction: the sun has risen, now what? General Surgery Grand Rounds, Inova Fairfax Medical Campus. May 2015; Falls Church, VA.
Ghee C. Surgical Case Review: Chronic Thromboembolic Pulmonary Hypertension. General Surgery Grand Rounds, Inova Fairfax Medical Campus. November 2015; Falls Church, VA.
28
Graling PR. Introduction to Simulation in the Perioperative Environments. AORN of Northern Virginia, Chapter Meeting. February 2015; Washington, DC.
Graling PR. Levels of Evidence, Quality Rating Scales, Evidence Summary Table. Inova Evidence-Based Practice Fellowship Program. April 2015; Falls Church, VA.
Graling PR. Making Continuing Medical Education Convenient, Fast and Fun- Inova Fairfax Medical Center’s Formula for Success. Qstream® Webinar Series. March 2015.
Graling PR. Optimizing the use of 2%CHG cloth baths to reduce SSI. AORN Executive Leadership Series at EXPO. March 2015; Denver, CO.
Graling PR. Using simulation to develop safe surgical teams. Virginia Association of Nurse Anesthetists, District 2 Spring Meeting. March 2015; Ashburn, VA.
Gresens A, Alshkaki G, Ferdjallah M. Weight Loss Patterns After VBG-Sleeve Gastrectomy. ACS Resident Research Competition. March 2015
Gresens A. Bariatic Surgery in 2015: Beyond “My 600-lb Life”. General Surgery Grand Rounds, Inova Fairfax Medical Campus. April 2015; Falls Church, VA.
Griffen M. Vascular Trauma. General Surgery Grand Rounds, Inova Fairfax Medical Campus. June 2015; Falls Church, VA.
Grimsley J, Kaminsky AJ, Patel S, Mehan V. Abstract Submission - The Periosteocutaneous Flap for Fingertip Injuries. American Society of Plastic Surgeons. 2015.
Hartwich J. Nonoperative treatment of early acute appendicitis in children. General Surgery Grand Rounds, Inova Fairfax Medical Campus. November 2015; Falls Church, VA.
Hartwich J. Long Term Care of Children with Surgically Corrected Congenital Anomalies. Mohsen Ziai Pediatric Conference. November 2015; McLean, VA.
Holmes SD, Martin LM, Miller CE, Shuman DJ, Ad N. How do minimally invasive cardiac surgery patients compare to median sternotomy patients on expectations and psychosocial outcomes? Annual Meeting of the International Society for Minimally Invasive Cardiothoracic Surgery. June 2015; Berlin, Germany.
Key A. Surgery Case Review. General Surgery Grand Rounds, Inova Fairfax Medical Campus. March 2015; Falls Church, VA.
Key A. Surgery Case Review. General Surgery Grand Rounds, Inova Fairfax Medical Campus. April 2015; Falls Church, VA.
Khandhar SJ. Discussions with a Thoracic Surgeon. Medical Grand Rounds, Inova Fairfax Medical Campus April 2015; Falls Church, VA.
Khandhar SJ, Folch EE. NAVIGATE Best Practices. NAVIGATE Investigator Meeting. August 2015; Nashville, TN.
Khandhar SJ. Mobility is a Mindset…the Bed is Barbaric. Get Movin’: An Interdisciplinary Approach to Early Progressive Mobility, Inova Fairfax Hospital. March 2015; Falls Church, VA.
Khandhar SJ. Mobility is a Mindset . . . the Bed is Barbaric: Lifting the Anonymity of the Respiratory Care Practitioner in the Post-Operative Setting. Virginia Society of Respiratory Care, Inova Fairfax Medical Campus June 2015; Falls Church, VA.
Khandhar SJ. No Leak, No Stay – A Quicker Path Home. Bard Progel Course, George Washington University Hospital September 2015; Washington, DC.
Khandhar SJ. Patient Wins…Cancer Loses. Medtronic Thoracic Sprint Team, STS Meeting January 2015; San Diego, CA.
Khandhar SJ. Patient Story Involving Medtronic Technology. Medtronic 2015 Employee Holiday Program December 2015; Minneapolis, MN.
Khandhar SJ. Patient Wins… Cancer Loses. Shine a Light on Lung Cancer Event, Life With Cancer November 2015; Falls Church, VA.
Khandhar SJ. Thoracic Surgery: New Developments…New Hope. Thoracic 101: NeuWave Medical National Sales Meeting. January 2015; Miami Beach, FL.
Khoshbin S. Surgery Case Review. General Surgery Grand Rounds, Inova Fairfax Medical Campus June 2015; Falls Church, VA.
Kim S. Acute Surgical Problems: Diagnosis Not to Miss. American Academy of Pediatrics National Conference & Exhibition October 2015; Washington, DC.
LaPorta MW. My Most Memorable Case. General Surgery Grand Rounds, Inova Fairfax Medical Campus May 2015; Falls Church, VA.
LaPorta MW. Surgery Case Review. General Surgery Grand Rounds, Inova Fairfax Medical Campus March 2015; Falls Church, VA.
Li SS, Kaminsky AJ, Copeland-Halperin LR, Lodhi FK, Li J, Miraliakbari R. Computer-aided surgical simulation in head and neck reconstruction: A cost comparison among traditional, in-house, and commercial options. Northeastern Society of Plastic Surgeons September 2015; Philadelphia, PA.
Li SS, Kaminsky AJ, Copeland-Halperin LR, Miraliakbari R. The vastus lateralis free flap for lower extremity Gustilo grade III reconstruction. Virginia Society of Plastic Surgeons Biennial Educational Meeting. November 2015; Richmond, VA.
Mantle B. Pediatric Head and Neck Infections. Inova Pediatric Lecture Series. September 2015; Falls Church, VA.
Mathis R. Fascial Closure Technique and Incisional Hernia. Surgical Fellow Rounds, Anne Arundel Medical Center. November 2015; Annapolis, MD.
McCusker A, Betts M, Msall B, Wright JM, Prentice HA, Bradford AN, Lita E, Teicher E. Prospective Evaluation of Nutritional Adequacy of Volume Based Enteral Feeding in a Single Center Trauma/Surgical ICU. American Association for the Surgery of Trauma Annual Meeting. September 2015; Las Vegas, NV.
29
McCusker A, Betts M, Msall B, Wright JM, Prentice HA, Bradford AN, Lita E, Teicher E. Prospective Evaluation of Nutritional Adequacy of Volume Based Enteral Feeding in a Single Center Trauma/Surgical ICU. 2nd Annual Inova GME Quality Symposium. May 2015; Falls Church, VA.
Mirali R. Leadership. General Surgery Grand Rounds, Inova Fairfax Medical Campus. January 2015; Falls Church, VA.
Mirali R, Kaminsky AJ. Advances in Facial Reconstruction. General Surgery Grand Rounds, Inova Fairfax Medical Campus. April 2015; Falls Church, VA.
Moynihan J. Surgical Care of the Elderly Patient. General Surgery Grand Rounds, Inova Fairfax Medical Campus November 2015; Falls Church, VA.
Moynihan J, Clougherty P. Safety Stand Down. General Surgery Grand Rounds, Inova Fairfax Medical Campus. July 2015; Falls Church, VA.
Mukherjee D. A Cost-Effective Comparison of CEA under Local vs General Anesthesia. General Surgery Grand Rounds, Inova Fairfax Medical Campus. June 2015; Falls Church, VA.
Mukherjee D. A Cost-Effective Comparison of CEA under Local vs General Anesthesia. Neurological Society of the Virginias. January 2015; Greenbriar, WV.
Mukherjee D. A Cost-Effective Comparison of CEA under Local vs General Anesthesia. Society of Vascular Surgeons Annual Meeting. June 2015; Chicago, IL.
Mukherjee D. Carotid endarterectomy under local anesthesia. Annual Meeting of the Vascular Society of India. October 2015; Pune, India.
Mukherjee D. Contribution of surgeons of South East Asian origin and the world of vascular surgery. Annual Meeting of the Vascular Society of India. October 2015; Pune, India.
Mukherjee D. Lessons learned from 30 years of trying to perfect Carotid Endarterectomy. General Surgery Grand Rounds, Inova Fairfax Medical Campus. January 2015; Falls Church, VA.
Mukherjee D. Management of complications of carotid endarterectomy. Annual Meeting of the Vascular Society of India. October 2015; Pune, India.
Mukherjee D. Percutaneous EVAR vs Surgical EVAR - Real World Results. VEITH Symposium. November 2015; New York City, NY.
Mukherjee D. Role of lower extremity bypass in the management of CLI - is it headed for extinction? Annual Meeting of the Vascular Society of India. October 2015; Pune, India.
Mukherjee D. Role of lower extremity bypass in the management of Critical Limb Ischemia. American College of Surgeons Annual Meeting. October 2015; Chicago, IL.
30
Newcomb A. The Trauma Survivor Family: Needs, Experience and Interventions. Medical College of South Carolina Surgery Grand Rounds. May 2015; Charleston, SC.
Piscitani F, Trickey AW, Dort J, Bachman S, Graling P, Esteban C. The Advanced Surgical Technology and Education Center – A Cut Above. Thomas Jefferson High School for Science and Technology Symposium to Advance Research, June 2015; Alexandria, VA.
Prentice HA. Deconstructing the Statistical Analysis Section in Published Literature. General Surgery Grand Rounds, Inova Fairfax Medical Campus. November 2015; Falls Church, VA.
Prentice HA, Wright JM, Graling P, Dort JM, Moynihan JJ. The Addition of Spaced Learning to a General Surgery Residency Program. Academic Surgical Congress. February 2015; Las Vegas, NV.
Purkert W. Medical-Surgical Missions, Experience in Rwanda and Haiti. Medicine Grand Rounds, Inova Fairfax Medical Campus. January 2015; Falls Church, VA.
Reines HD. Bridging the Knowing-Doing Gap: Quality Improvement as a Patch to Change. CME Palooza Fall Virtual Conference. April 2015.
Reines HD. Engaging Residents in the Quality In-Training Initiative. American College of Surgeons National Surgical Quality Improvement Program Conference. July 2015; Chicago, IL.
Reines HD. Introduction to Quality, Safety, and Peer Review: The Alphabet Soup You Need to Know to Survive and Things You Can Do With It Grand Rounds, Inova Fairfax Hospital Department of Medicine June 2015; Falls Church, VA.
Schatz C. Enhanced Recovery After Thoracic Surgery- Raising the Bar, It All Starts With You! Virginia Society of Perianesthesia Nurses. September 2015; Fairfax, VA.
Schatz C, Khandhar SJ. Raising the Bar in Comprehensive Care of the Thoracic Surgery Patient: It’s All About the Team! OR Executive Summit – AORN National Meeting. March 2015; Denver, CO.
Schatz C. The Nurse Practitioner in the Perioperative Setting: Making it Work, Making it Excellent, Making it Innovative. OR Manager National Conference. October 2015; Nashville, TN.
Singh A. Advances in Endoscopic Skull Base Surgery and Drug Eluting Therapy for Chronic Sinusitis. 6th Annual Cherry Blossom Otolaryngology Update George Washington University Medical Center. April 2015. Washington, DC.
Singh A. Challenges in Endoscopic Skull Base Reconstruction. 2015 Inova Endoscopic Pituitary & Anterior Skull Base Surgery Course. October 2015. Fairfax, VA.
Singh A. Challenges in Endoscopic Skull Base Reconstruction. Pituitary Adenoma Research Foundation. April 2015. Fairfax, VA.
Singh A. Rhinologic Management of Middle Ear and Eustachian Tube Disease. 2015 American Rhinologic Society Summer Sinus Symposium. July 2015. Chicago, IL.
Sobel R. Updates in Treatment of Head & Neck Cancer. General Surgery Grand Rounds, Inova Fairfax Medical Campus. February 2015; Falls Church, VA.
Trickey AW, Wright J, Donovan J, Reines HD, Dort J, Prentice HA, Graling P, Moynihan J. ACS NSQIP More Accurately Reflects Clinical Reasons for Hospital Readmission than Administrative Claims Data. American College of Surgeons National Surgical Quality Improvement Program Conference July 2015; Chicago, IL
Trickey AW, Wright J, Donovan J, Reines HD, Dort J, Prentice HA, Graling P, Moynihan J. Causes of surgical readmissions are more clinically accurate in ACS NSQIP than administrative claims data. Virginia Chapter of the American College of Surgeons. May 2015; Richmond, VA.
Wright J, Prentice HA, Trickey AW. The Nuts and Bolts of Meeting Your Academic Productivity Requirements. General Surgery Grand Rounds, Inova Fairfax Medical Campus. October 2015; Falls Church, VA.
Younan G. Surgery Case Review. General Surgery Grand Rounds, Inova Fairfax Medical Campus. April 2015; Falls Church, VA.
PostersBanks N, Ambardar S, Primeggia J, Shah A, Graling P, Prentice HA, Wright JM, Peninger M, Dougherty L. Implementation of a Standardized Protocol for the Treatment of Refractory and Recurrent Clostridium difficile Infection. 2nd Annual Inova GME Quality Symposium May 2015; Falls Church, VA.
Copeland-Halperin LR, Prentice HA, Wright JM, Dort J. Re-evaluating the Role of Blood Cultures in the Evaluation of Postoperative Fever. 2nd Annual Inova GME Quality Symposium. May 2015; Falls Church, VA.
Copeland-Halperin L, Prentice HA, Wright JM, Dort JM. Predictors of Positive Blood Cultures in the Evaluation of Postoperative Fever. American College of Surgeons Annual Meeting. October 2015; Chicago, IL.
Dort JM, Trickey AW, Kallies KJ, Joshi ART, Sidwell RA, Jarman BT. Applicant Characteristics Associated with Selection for Ranking at Independent Surgery Residency Programs. Association of Program Directors in Surgery Meeting April 2015; Seattle, WA.
Gorney Brown P, Sotelo T. Management of Distal Female Urethral Stricture. Mid-Atlantic American Urologic Association Annual Conference. October 2015; Nassau, Bahamas.
Graling P, Trickey AW, Wright J, Gallimore H, Vasaly F, Crosby M, Dort J. Refining utilization of the WHO checklist to improve safety and efficiency in surgery and optimize communication in the operating room. Virginia Patient Safety Summit. January 2015; Richmond, VA.
Graling PR, Wright JM, Prentice HA, Jones E, Seifert P, Graham K, Dort J. Using an Interprofessional Simulation Activity to Improve Knowledge Retention and Decrease Incidence of Catheter Associated Urinary Tract Infections (CAUTI). Virginia Patient Safety Summit. January 2015; Richmond, VA. 31
Harrison G, Wood EB, McReynolds S, Nassr L, Presgrave K, Rovelli E, Stinson S, Trickey AW, Charles E, McCabe J. Effectiveness of Video Discharge Instructions in the Pediatric Emergency Department: A Nurse-Led Evidence Based Practice Project. Inova Evidence-Based Practice Nursing Symposium, October 2015; Falls Church, VA.
Kaminsky AJ, Grimsley J, Patel S, Mehan V. The periosteocutaneous flap for fingertip injuries. American College of Surgeons All Surgeons Day. March 2015; Washington, DC.
Kaminsky AJ, Li S, Lodhi F, Bradford AN, Wright JM, Dort J. General Surgery Quality Improvement Project for Communication between Nursing Staff and Residents. 2nd Annual Inova GME Quality Symposium. May 2015; Falls Church, VA.
Khandhar S, Krimsky W, Mattingly J, Peltola JC, Howk K, Schell J, Costello DM, Magnuson T, Kern M. Performance of a Novel Coring Tool Biopsy Device using Endobronchial Lung Navigation in a Porcine Lung Model. Poster Presentation at the American Thoracic Society Meeting. May 2015; Denver, CO.
LaPorta MW, Bachman SL, Graling P, Donovan J, Prentice HA, Reines HD, Moynihan JJ, Dort J. Establishing the Role of Chief Resident of Quality Improvement and Patient Safety. 2nd Annual Inova GME Quality Symposium. May 2015; Falls Church, VA.
LaPorta MW, Bachman SL, Graling P, Donovan J, Prentice HA, Reines HD, Moynihan JJ, Dort J. A Formal General Surgery Residency Didactic Curriculum Derived From Quality In-Training Initiative Guidelines. 2nd Annual Inova GME Quality Symposium. May 2015; Falls Church, VA.
McCusker A, Betts M, Msall B, Wright JM, Prentice HA, Bradford AN, Lita E, Teicher E. Implementation of a Volume Based Enteral Feeding Protocol in a Single Center Trauma ICU. Virginia Patient Safety Summit. January 2015; Richmond, VA.
Michetti CP, Prentice HA, Lita E, Wright J, Ng E, Bradford A. Forced-Choice Blood Transfusion Orders Reduce Transfusions in Critically Injured Patients. American Association for the Surgery of Trauma Annual Meeting. September 2015; Las Vegas, NV.
Trickey AW, Wright J, Donovan J, Reines HD, Dort J, Prentice HA, Graling P, Moynihan J. ACS NSQIP More Accurately Reflects Clinical Reasons for Hospital Readmission than Administrative Claims Data. National Surgical Quality Improvement Program Annual Conference, July 2015; Chicago, IL.
Wills E, LaPorta M, Trickey AW, Graling P, Prentice H, Colvin D. Early Mobilization in the Colorectal Surgery Population as a Strategy to Reduce Deep Vein Thrombosis and Pulmonary Embolism. 2nd Annual Inova GME Quality Symposium. May 2015; Falls Church, VA.
Research StudiesBijelic L – Principal Investigator, Bernaiche T. – Initiating Resident. A survey assessing physician knowledge, attitudes, and practice patterns regarding cytoreductive surgery and hyperthermic intraperitoneal chemotherapy for peritoneal metastases
Cohen R – Principal Investigator, Copeland-Halperin L. – Initiating Resident. Quality of Life in Patients Undergoing Intraoperative Breast Irradiation
Colvin D – Principal Investigator, Key A. – Initiating Resident. Reducing Length of Stay in Colectomy Patients Utilizing an Opioid Sparing Pain Management Protocol
Dort J. – Principal Investigator, What is the Value of the MIS/AORN Checklist? A Multi-institutional Practical Assessment
Dort J. – Principal Investigator, Copeland-Halperin L. – Initiating Resident. Optimizing the Value of Blood Cultures in the Evaluation of Fever in Postoperative Patients
Dort J. – Principal Investigator, Khoshbin S. – Initiating Resident. Evaluating the relationship between the lunar cycle and emergency surgical volume
Dort J. – Principal Investigator, Mathis R. – Initiating Resident. Assessment of Resident Laparoscopic Skills and Effect of Structured Simulations
Dort J. – Principal Investigator. Singh S. – Initiating Resident. Venous Thromboembolic Event (VTE) Rate in Renal Transplant Patients Without Prophylactic Heparin
Dougherty L. – Principal Investigator Optimizing a Training Pathway for Clinical Success in Robotic Assisted Colon and Rectal Surgery
Dougherty L. – Principal Investigator, Banks N. – Initiating Resident. Development of a Standardized Protocol for the Treatment of Recurring and Refractory Clostridium difficile Infection
Edmiston K - Principal Investigator, Cancer Molecular Profiling Project (CMPP)
Edmiston K - Principal Investigator I-SPY 2 TRIAL: Investigation of Serial Studies to Predict Your Therapeutic Response with Imaging and Molecular Analysis 2
Edmiston K - Principal Investigator Preventing Invasive Breast Neoplasia with Chloroquine (PINC) Trial
Edmiston K - Principal Investigator The Expression Project for Oncology (expO)
Graling P. – Principal Investigator, Using an interprofessional simulation activity to improve knowledge retention and decrease incidence of catheter associated urinary tract infections (CAUTI)
Griffen M. – Principal Investigator. A Policy Relevant U.S. Trauma Care System Pragmatic Trial for PTSD & Comorbidity
Griffen M. – Principal Investigator. Development and Use of Clinical Proteomic and Nanotechnologies to Identify and Validate Markers for Acute Trauma in Biofluids: Detection, Monitoring and Convalescence
32
Hafner G. – Principal Investigator, LaPorta M. – Initiating Fellow, Bernaiche T. – Initiating Resident. Multimodality pain management in outpatient inguinal hernia and laparoscopic cholecystectomy patients
Hashemi H. – Principal Investigator, Grant C. – Initiating Resident. The Role of Patch Angioplasty for Maturation of Arteriovenous Fistulas
Hashemi H. – Principal Investigator, Prospective, Multicenter, Single Arm Safety and Effectiveness Study of Endovascular Abdominal Aortic Aneurysm Repair using the Nellix System with Continued Access.
Jonsson J. - Principal Investigator, Evaluation of Acute Rejection Rates in de novo Renal Transplant Recipients Following Thymoglobulin Induction, CNI-free, Nulojix® (belatacept)-based Immunosuppression
Jonsson J. - Principal Investigator, Grant C. – Initiating resident. Pure Laparoscopic Donor Nephrectomy: A Single Center Experience
Khandhar S. – Principal Investigator, A randomized controlled trial of the effectiveness of liposomal bupivacaine (Exparel) when compared to local injection of bupivacaine after thoracoscopy
Khandhar S. – Principal Investigator, Ghee C. – Initiating Resident. A randomized controlled trial of continuous subpleural infusion of bupivacaine after thoracoscopy
Khandhar S. – Principal Investigator, Ghee C. – Initiating Resident. A retrospective analysis of the natural history and efficacy of current treatment paradigms for primary spontaneous pneumothorax
Lee P. Credentialed Surgeon ECOG-3311 Phase II Randomized Trial of Transoral Surgical Resection followed by Low-dose or Standard-dose IMRT in Resectable p16+ Locally Advanced Oropharynx Cancer.
Lee P. Subinvestigator - RTOG-1216 Randomized Phase II/III Trial of Surgery and Postoperative Radiation Delivered with Concurrent Cisplatin versus Docetaxel versus Docetaxel and Cetuximab for high-risk Squamous Cell Cancers of the Head and Neck.
Mahajan A. – Principal Investigator, Cheah MA. – Initiating Resident. Surgical Bronchoscopic Training: Expanding the Surgical Resident Curriculum
Mehan V. – Principal Investigator, Kaminsky A. – Initiating Resident. Novel technique for fingertip amputation
Michetti C – Principal Investigator. FRIEND or FOE: Defining Risk Factors for Reintubation Using a Pre-Extubation Evaluation Form
Mirali R. – Principal Investigator, Copeland-Halperin L. – Initiating Resident. Culture Swabs in the Evaluation of Wound Infection: A Critical Assessment of Unresolved Issues
Mirali R - Principal Investigator, Kaminsky A. – Initiating Resident. Free-flap evaluation for lower extremity, upper extremity, breast, trunk and craniofacial and neck reconstruction at a non-academic institution
Mirali R- Principal Investigator Li S. – Initiating Medical Student. A Comparison of Recurrence Rates and Complications between in-Office and in-Hospital Surgical Excision of Skin Cancers
Mukherjee D. – Principal Investigator , A Pivotal Clinical Study to Evaluate the Safety and Effectiveness of the Ovation™ Abdominal Stent Graft System
Mukherjee D. – Principal Investigator , Changes in Resident Operative Experience and Outcomes in Peripheral Vascular Surgery
Mukherjee D. – Principal Investigator , Clinical Investigation Plan for the Zenith® Low Profile AAA Endovascular Graft
Mukherjee D. – Principal Investigator , Kfoury E. – Initiating Resident. The Carotid Stenosis Arsenal: Carotid Endarterectomy under General or Local Anesthesia vis-à-vis Carotid Stenting
Mukherjee D. – Principal Investigator , Post Approval Study Evaluating the Long Term Safety and Effectiveness of the Endurant Stent Graft System (ENGAGE PAS)
Mukherjee D. – Principal Investigator , Real World Experience with Percutaneous vs. Open Femoral Cut-down for EVAR
Mukherjee D. – Principal Investigator , VALOR II: The Valiant Thoracic Stent Graft System Clinical Study
Otchy D. – Principal Investigator, Yim E. – Initiating Resident. The Consequences of Colorectal Anastomotic Leaks
Paquette E. – Principal Investigator, Wills E. – Initiating Resident. Hernia Urinary Retention
Teicher E – Principal Investigator. The Incidence of Pedestrian and Bicyclist Injured During Daylight Savings Transition (DST) at a Single Level I Trauma Center
Wali R. – Principal Investigator, A phase IV, randomized, investigator-blinded, single center clinical study to evaluate the safety, immunogenicity and efficacy of commercially available influenza trivalent inactive vaccine (TIV), single intramuscular dose of either Fluzone or Fluzone High-Dose after thirty days following solid organ transplantation (kidney, heart, and lung transplant)
33
23
G34731/5-16/750
