Want your farmer’s market fix in the middle of the week? Try the Spotsylvania Regional Medical Center parking lot on Wednesdays from 3 to 7 p.m. The market started this week as an extension of the popular Saturday market that’s been on Gordon Road for 14 years. (Photo by Robert A. Martin)

Two Mary Washington Healthcare divisions received Healthcare Improvement Awards from George Mason University.

Mary Washington Hospice received an Excellence in Clinical Improvement award. Hospice leaders revised the operation of the department to reduce overtime and improve patient and staff satisfaction. Net income for the department went from $264,000 in 2010 to $1.2 million in 2011, according to contest materials.

The Department of Pathology and Laboratory Medicine received an Excellence in Service Improvement award. Lab workers redesigned how they collect, test and report the results of outpatient specimens. They identified 16 steps in the process, then reduced it to 12 steps. This lowered the cost of a test from $4.56 in 2009 to $4.33 in 2011.

The annual contest is open to all healthcare systems in the mid-Atlantic region. This year there were 22 submissions.

Amy Umble wrote here about epinephrine auto-injectors, or EpiPens. She reported: “Late last month, Gov. Bob McDonnell signed into law bills that ensure all schools have extra epinephrine on hand and staff trained to inject the dose. Locally, that law will require few adjustments.”

Hospital food? It might surprise you.

Kurt Rabin offered a review of the food at Mary Washington Hospital’s cafeteria. He wrote: “On a scale of hospital food ranging from ‘critical condition’ to ‘resting comfortably,’ we’d have to rate MWH’s current state as ‘stable.’ ”

Scott Shenk reported here on how Spotsylvania Regional  honored one of its young volunteers.  He wrote: “The hospital near Massaponax is a place Selena Guzman spent a lot of time during the final months of her life. Selena, a 16-year-old who planned to be a doctor, volunteered nearly 200 hours at the hospital in an eight-month span. But that all ended on Dec. 20 when she was killed in a car accident on Salem Church Road in Spotsylvania.”

McConnell

Finally, Mary Washington Healthcare has presented its annual Spirit of Women awards to Andrea McConnell, Gail Perkins and Kristen Roth.

McConnell founded the Fairy Godmother Project, a local non-profit that provides meals, cleaning, lawn care and professional photography for families while their children are receiving cancer treatment.

Perkins is a registered nurse at Mary Washington Healthcare who helped found its Sexual Assault Nurse Examiner’s Program.

Roth is a student at Riverbend High School who has helped many through her work at Crossroads Vineyard Church.

The Spirit of Women awards is an annual program that honors those who contribute to their communities through their work and service activities. More details about the program and award winners are here.

Empty beds such as this one are a common sight at Stafford Hospital.

After visiting the HealthSouth Rehabilitation Hospital of Fredericksburg last week, I couldn’t help but compare what’s happening there with what’s happening at the region’s other new hospitals.

HealthSouth opened in 2007 with 40 beds, a number that may have underestimated the community’s need. Donna Phillips, the CEO, said that HealthSouth has been full for about a year. It’s building a 12-bed addition which should be ready later this year.

Compare that to Stafford Hospital, which opened in 2009 with 100 beds, and Spotsylvania Regional Medical Center, which opened in 2010 with 126 beds. The two hospitals were planned and built in one type of economy and opened in another. As a result, they have more beds than the community needs.

Both Stafford and Spotsylvania Regional feature whole floors of empty rooms. Hospital officials are sensitive about this, so exact patient counts are hard to come by. But it’s safe to say that each of the two hospitals has more unused beds than used ones. Add Mary Washington Hospital, and you have an overall vacancy rate for the region of about 40 percent.

The population of the area continues to grow, so the two hospitals will be busy someday. But when?  Five years? Ten years? In the meantime, $330 million in investments is not fully used.

(A blog post on this topic written two years ago can be seen here.)

The 5th Annual Marine Corps Historic Half will affect traffic at Mary Washington Hospital.

The traffic patterns in use Sunday at Mary Washington Hospital for the 5th Annual Marine Corps Historic Half will be the same as in past years.

And what hospital officials are telling patients, visitors and staff is also the same:

“Plan extra time,” said James Swisher, vice president for project management and continuous improvement.

The “leave early” advice is offered because moving about the hospital campus on race day can be difficult. One of the exits will be closed, left turns will be prohibited at some intersections, and thousands of runners will be strung across the property from one end to the other.

“The biggest times of impact are 6:30 a.m. to 10:30 a.m.,” Swisher said.

Once again, runners will enter the campus from U.S. 1, just after the 10-mile mark, travel behind the hospital, and exit onto Cowan Boulevard. That means they’ll again have to tackle Hospital Hill, the mile-long climb adjacent to the emergency department.

Two entrances will be open at the hospital, but only one exit will be open.

In its recent newsletter to runners, Marine Corps officials warned them about Hospital Hill, saying, “No two words strike more fear or inspire greater determination in the hearts of Historic Half runners everywhere.”

Runners will be separated from vehicles while on campus. The entrances at Cowan Boulevard and U.S. 1 will be open, but traffic will not be able to exit at Cowan Boulevard.  The traffic pattern is the same one in use for several years.

“We feel like it’s a good plan,” Swisher said. “We’ve gotten to be old hat at it.”

One new wrinkle this year is the new connector road between the hospital and Eagle Village. That road will be open as an entrance and an exit during the race.

“We’ll be monitoring usage on the connector,” Swisher said. “We’re thinking of it as an extra relief valve for traffic.”

The hospital has been a part of the half marathon since its start in 2008. Many staff members run in the 13.1-mile race, and others volunteer at the aid stations.

“It creates some challenges for us, but we’ve figured out how to overcome them,” Swisher said. “We like being a part of it.”

(The website for the Historic Half is here. The course map is here. Road closings throughout the city are here. And an essay on climbing the now famous Hospital Hill is here.) 

Long lines formed at vaccination sites like North Stafford High School, above, when H1N1 shots were offered in 2009.

Emily Smith has spent the last several months plotting the Health Department’s reaction to two ugly scenarios:
* The arrival of a new flu virus for which the public has no immunity.
* A terror attack involving a biologic agent such as anthrax.

Smith is the emergency planner for the Rappahannock Area Health District. This week she discussed the Health Department’s response plans with two dozen officials, representing local governments, schools, emergency services and nonprofits.

Smith and her boss, Dr. Brooke Rossheim, district director, told the group that if something bad happens and preventive medicines are recommended, they would need the group’s help in distributing them to the public within 36 hours. They also said that this is how the distribution might work:

* First, notify the public that medicines are on their way.
* Establish up to seven distribution sites. Each locality in the region would host a site. Because of their size, Spotsylvania and Stafford counties might have two.
* Use local schools. The distributions could occur in the cafeterias, or outside in the parking lots.
* Expect up to 330,000 people, or everyone in the region, if a new flu virus is involved and vaccinations are offered.
* Invite only heads of households, or 110,000 people, if a biologic attack is involved and antibiotics are offered. The heads of households would receive enough medicine for everyone in the family.
* Obtain the medicine from the national stockpile maintained by the federal Centers for Disease Control and Prevention. The CDC would send the medicine to the Virginia Department of Health, which would transfer it to localities.

These plans are reminiscent of what actually happened in 2009 when H1N1, a new flu virus, appeared. Local schools were hastily converted to vaccination sites, and more than 23,000 children received shots. That experience was “very helpful in our planning and in our meetings this year,” Smith said.

Staff members at Spotsylvania Regional's new treatment program include (seated, from left) Peggy Porter, Susan Walley. (Standing) Julie Sutherland, Wanda Mercado.

A new outpatient treatment program has started for those with mental-health problems.

The Spotsylvania Regional Medical Center opened its Partial Hospitalization Program on May 1. The program is intended as a supplement to the care provided at the hospital’s 10-bed psychiatric unit.

“This is a step down from inpatient,” said Julie Sutherland, senior leader for behavioral health services.

Mary Washington Healthcare offers a similar outpatient program at Snowden at Fredericksburg, its psychiatric hospital.

Patients at Spotsylvania Regional’s program meet weekdays for about two weeks at a new office near the intersection of Courthouse Road and Smith Station Road in Spotsylvania County. The program is voluntary and designed for adults, Sutherland said.

Patients typically suffer from disabling depression or anxiety, Sutherland said. Treatment includes a day-long series of group meetings led by therapists Susan Walley and Wanda Mercado, and nurse Peggy Porter.

The goal of the program is to educate patients about their illnesses and to provide them with the skills needed to deal with crises, Sutherland said.

The new addition at HealthSouth is scheduled to be completed by October.

The new roof is in place, and the framing for the walls is going up now. Construction of the addition at area’s only rehabilitation hospital should be completed by October.

“We’re hoping it’s sooner than that,” said Donna Phillips, chief executive officer at HealthSouth Rehabilitation Hospital of Fredericksburg.

HealthSouth is investing $3.3 million to expand its Fredericksburg hospital. The area’s other hospitals have unused beds, but that’s not the case at HealthSouth.

The hospital has 40 beds and has operated near capacity for more than a year, Phillips said. The average daily patient census for March was 36.

“This year has been very busy,” she said.

Construction will include 11 new private rooms, a new parking area and the conversion of one of its existing rooms. Loughridge & Company, which built the original hospital five years ago, is doing the 5,289-square-foot addition.

The hospital is located on Park Hill Drive, behind Mary Washington Hospital. Work is taking place on the end of the building closest to Mary Washington.

The new rooms also mean that the hospital will hire 20 new workers this summer. The hospital has 140 employees now.

The addition will include 12 new private rooms.

HealthSouth is the nation’s largest chain of inpatient rehabilitation hospitals, with hospitals in 27 states and in Puerto Rico. Typically, patients are discharged from an acute-care hospital and go to HealthSouth for additional therapy before going home. About 25 percent of patients have suffered strokes, Phillips said.

Don't send in the clowns?

“Imagine you are sick. Helplessly lying in a hospital bed. Full of drugs, pierced with an IV, and dreading the tests to come. And in walks someone with a pasty face, a brightly colored wig and a big red nose. You smile. Or maybe scream. Because clowns aren’t for everyone.”

That was the lead on yesterday’s FL-S editorial, called “Don’t laugh.” The piece speaks for the clown-repelled minority who want no part of outrageous hair and oversized shoes. In case you missed it, the editorial is here. The story that launched the protest is here.

On another note, the Spotsylvania Regional Medical Center has applied for a permit extension from the state Department of Health for its proposed radiology center. The hospital says now that the center will be open in April 2013. The hospital’s filing can be seen here. An earlier blog post about the project is here.

And finally, Fredericksburg Orthopedic Associates has expanded to Woodbridge. The practice will be doing business as FOA Orthopaedics in its fourth location which opened yesterday. The new office is at 12731 Marblestone Drive in Prince William County. Drs. Ali Reza Hashemi and David Arman Zijerdi will be seeing patients there. The practice was founded in 1971. Its main office is on Fall Hill Avenue in Fredericksburg.

Dr. Francis Moffitt

A committee of the Virginia Board of Medicine has dismissed allegations of disruptive behavior against a Fredericksburg doctor.

The medical panel ruled April 25 at a hearing in Richmond that Dr. Francis Moffitt did not violate state law while working at a clinic in Roanoke. Moffitt currently works as an obstetrician/gynecologist at Southpointe OBGYN in Spotsylvania County.

The board summoned Moffitt to the hearing because of allegations about his behavior in Roanoke from 2009 to 2011. It concluded that there was insufficient evidence to support a violation of state law and dismissed the notice against him.

NextCare operates urgent care clinics in the Fredericksburg area.

Two physicians who worked for NextCare Urgent Care, including its former medical director, have been summoned to appear before a committee of the Virginia Board of Medicine for possible disciplinary action.

Dr. Sebastian Sicari and Dr. Carlos Martinez will have separate hearings in Richmond on May 31.

Sicari has been asked to answer allegations that he entered a state computer database without authorization and disclosed private information that he found there. At the time of the alleged incident, Sicari, 51, was medical director of the Fredericksburg-area offices of the urgent care chain. He now works for Kaiser Permanente at its Fredericksburg office.

Martinez, 38, must answer allegations that he is “unable to practice medicine with reasonable skill and safety” because he has a problem with alcohol. He is also said to have lied to authorities when they asked him about his past.

The board alleges that Sicari, a family practitioner, obtained information about “Individual A” from the state’s Prescription Monitoring Program. The board alleges that Sicari did not have a “bona fide practitioner/patient relationship” with Individual A. He is said to have entered the database in September 2010 and used information from it during a legal proceeding in Virginia on June 6, 2011.

Sicari said yesterday that he knew Individual A and feared that she was using his name to obtain drugs. “This was beyond just me trying to dig up dirt,” he said. “This was me protecting myself.”

Virginia’s Prescription Monitoring Program is operated by the Department of Health Professions. It contains 74 million prescription records. Prescribers and dispensers can query the database to see a patient’s prescription history and to see if the patient is “doctor shopping” to obtain controlled substances, according to the program’s website. The state says that the database is used 14,000 times a week.

Martinez, a family practitioner, has been convicted several times for various alcohol-related incidents, according to the board of medicine. The incidents include:

* A 1997 conviction for driving under the influence in Fairfax County.

* A 2003 conviction, while he was in medical school, of driving under the influence in Connecticut.

* A 2004 charge of swearing and intoxication in Loudoun County. Disposition was deferred, and the case was dismissed in 2005.

* A 2010 charge of driving under the influence in Massachusetts. The court said there was sufficient evidence to convict him but continued the case without finding.

Martinez is also said to have failed to disclose the DUI convictions and court-ordered alcohol treatments to the medical board and to have lied about them when asked. He received his Virginia medical license in 2009.

Martinez started work at NextCare in 2009 and went to part-time status in 2010. He worked four shifts for the clinic in 2012, according to a statement from the company. NextCare fired Martinez Monday when it learned about his latest problems, according to the statement.

“Dr. Martinez’s contract with NextCare requires him to disclose any arrests within three days of occurrence. That obligation was not met in this case, and Dr. Martinez’s contract was terminated effective today,” the statement said.

NextCare, based in Arizona, operates a chain of urgent care clinics in six states. Mary Washington Healthcare joined with the company in 2008 to open NextCare offices in the Fredericksburg area. Mary Washington was majority owner of the offices here until 2010, when it sold a portion of its holding. Mary Washington is now 50-percent owner, according to the company’s 2011 audit.

The new player piano at Stafford Hospital.

It takes a couple of seconds as you enter Stafford Hospital to realize that the sound coming from the back of the lobby is the sound of a piano.

The music travels past the coffee bar, down the hallway to the gift shop and over the railing to the cafeteria below. The sound is soft but noticeable, meant to alter the way the hospital feels.

“It’s a chance for patients and families to have some soothing time,” said Cathy Yablonski, administrator.

The piano arrived this month as a gift of the volunteers in the Stafford Hospital Auxiliary. It was the auxiliary’s first major gift to the hospital and came at Yablonski’s suggestion.

She said she once worked in the Buffalo area at two hospitals that had pianos. She figured that the patients, visitors and staff at Stafford would enjoy one, and that the auxiliary would be able to point with pride to its gift.

“It creates a bit of a different environment,” she said.

Auxiliary members purchased the instrument locally for $8,900, said Frank Ringquist, auxiliary president. It is a baby grand player piano. A person can sit and play it, or it can be plugged to a wall socket for self-play. For now, the piano is turned on in the middle of each weekday. It has a built-in library of more than 500 songs, including seasonal, jazz, easy listening and spiritual music, Ringquist said.

To date, only the player function has been used, though Yablonski said the hospital also wants to unlock the keyboard and let community residents perform.

“At Christmas we have school groups come in,” she said. “I have this picture of the music teacher playing the piano, and the kids singing around it.”