Broadlands Hospital

Where is the agenda from September's meeting posted? I can't find it.

 

Go to page two of this Forum Topic. There is a thread titled September Agenda.
I started a few months ago posting the agenda on the Forums.

 

Cliff:

Looking through the HOA By-laws, I am having trouble finding where the HOA board has the authority to make such a resolution. Article 4 lists the duties of the board, and nowhere does it mention taking positions on zoning or political issues. Its authority is restricted to housekeeping functions (budget, common areas, etc). Furthermore, even if the board had the authority to make such a resoltuion, Article 8 states that "a majority vote while a quorum is present shall constitute the decision of the Board of Directors." I may not be a rocket scientist (sic) but that would indicate to me that 5 votes would be needed to pass a resolution.

 

Bingo! You have hit on the major reason BRMC says they will generate significantly less traffic than a comparable office park during rush hour. Their study defines the peak hours as 7:45 - 8:45 and 5:15 - 6:15. The hospital shift changes would occur before those peaks, but generate significantly more traffic than an office complex between 6:30 - 7:30 and 2:30 - 3:30 (the times many of our young children are boarding buses or heading to/from school). Another fact they don't mention is that their study actually calculated hospital traffic using two different formulas. The method they quote in their literature genrates 87 AM and 179 PM peak hour trips. The results from the method they don't mention show 503 AM and 513 PM peak hour trips -- numbers not significantly different than those for the office complex they cite in their study.

 

The Board has no decision making authority over whether the hospital gets approved or not.
We as a group, like any group, can speak to support or not support something.
The HOA has issued many letters of support for things in the past. School Boundaries, sign plans, Clyde's Restaurant, sheriff's deputies, to name a few.

Regarding the vote, it was 4 in favor, 0 against, 4 abstaining. By any rules of order, such as Robert's, the motion carried, by a 4-0 vote.
In fact, a vote of 2-0-6 would pass as well.

 

Just got some new propaganda in the mail. INOVA continues its campaign against BRMC by sending out a very nice, full-color postcard in celebration of Emergency Nurse's Week by planting the FUD that BRMC will cause emergency departments in Leesburg and Western Loudoun to shut down.

This is great... hasn't it been their mantra this far to say that BRMC is the wrong location, specifically because it DOES NOT support the needs of western Loudoun and Leesburg? Hahaha....

 

BRMC has very good propaganda also ... in their advertisments it makes it sound like there are no hospitals in the entire area and that people have been deprived of medical care. I forget the last time I read that people were turned away at hospitals because there wasn't any care available.

It's a joke on both sides of the argument. Just like the election.

 

Even more amusing (and disturbing), I ran the names through the VA state license lookup. Many of these people aren't even residents of the STATE, and therefore have absolutely no right to request or demand anything of Loudoun County supervisors. Several of them don't have active nursing licenses, so hopefully INOVA Leesburg makes sure these people renew their licenses sometime soon, before letting them continue to practice at their facility....

Yikes....

 

I read it just this morning, not to mention it happens all the time. It's called "ambulance bypass" and is more common that most people probably want to know.

As for people being turned away as walk-ins to an ED, there are laws against it - which may be why you don't "read" about it.

What really is interesting though is that emergency services are SUCH a financial loss, it's a wonder any hospital, even a competitor, cares about losing a portion of ED patients who, statistically, end up costing the hospital more money per patient than any other patient in the building. EDs provide the greatest amount of "charity" care because of this.

But as we seem to agree, it's all propaganda.

I wonder what others think: from where I sit, it seems most of the anti-BRMC sentiment is from interests outside of Broadlands itself, and mostly from INOVA in particular (individuals and organizations paid by INOVA); whereas the bulk of support for BRMC is from Broadlands residents.

Can't wait to see what happens at the meeting on the 15th....

 

you may not be turned AWAY at the ER if you walk in, but you COULD be there for 6+ hours
if you aren't bleeding from your eyeballs. and you COULD end up spending the entire stay on a cot in a hallway, where your HIIPA rights may be violated by your medical history, diagnosis, etc. being discussed while total strangers walk by and other patients are in close proximity...

i am sure INOVA isn't the only hospital this happens in.

 

Maybe the BRMC should include in its plans a high tech state of the art cardiac care unit so it can help all the people who are suffering from a broken heart because their 401(k) plans just lost half their value (estimate).

Better yet why don't we get this project included into the Emergency Stabilization Act the one that calmed down all the markets and solved all the problems.

 

A friend of mine is (by my estimate) a high-power trader (not in the whole mortgage thing, he always felt that stuff was doomed) and used to say of our respective professions (I'm a nurse):
"I give them heart attacks when I say how much they lost not listening to me, and you try to keep them alive afterwards."

He was, apparently, not joking.
(I've never seen any of his victims as patients, though...)

 

You may be correct...they are just lined up for hours and hours waiting for a bed then, at 2:00am, the beds are suddenly available. Probably because they kicked people out of them at midnight to make room for more "deserving" patients.

This is still happening TODAY. And people want to make the argument we don't need more beds NOW???
Ridiculous.

 

To an extent, this is also an effect of a "time-honored tradition" of emergency room management. That is, there's always been the "same old flow" when people come to the ED for treatment. Walk in door, see registration clerk. Tell life story. Wait a little bit. See nurse. Tell life story. Wait some more. Go to a room. See another nurse. See a doctor, repeat life story. Get treatment/get admitted to inpatient/go home. If inpatient, wait some more on a stretcher in hallway until inpatient bed freed up..... Or, come to ER with an axe in your head, go right to trauma room where everyone works on you at the same time right away.

I recently attended a conference where, in one session, a Pennsylvania-based hospital system exec explained how they re-vamped the emergency workflow/process itself. They've reduced ER wait times, door-to-doctor times, and streamlined patient throughput in a way that has so far continued to produce quality care, and has increased patient satisfaction. Technically speaking, they now have a door-to-doctor time of four minutes. However by the measures they report with, the time is 30 minutes on average. Compare to a national average more on the order of 120 minutes, and you can see they're doing something very right. One very interesting thing they did is changed the mindset that patients coming in on an ambulance automatically get priority... I suppose in the area they serve, some patients-in-the-know have used the ambulance as a fast-pass to treatment. Now, all patients go through the same process.

It was a fascinating topic. It doesn't mean we don't need more emergency services.... But I do think it means that there are ways besides building more hospitals to ensure access to emergency care for more people in a timely manner, and not only that in a manner that makes emergency services less of a money pit. That hospital I mentioned can now provide emergency services to less critical patients in a fraction of the time it used to, but still bills the same amount of money. So if they get paid, they make more money for the time... and if they don't, they didn't spend as much time on it (meaning, more likely to see paying patients in the same timeframe as previously).

I know I'm shifting a bit off-topic here but....
Healthcare, in general, is going to face a fundamental crisis soon. Possibly the next big crisis once the current financial one is done. And it can not be cured by throwing money at it, because unlike a financial market where money flows thru it in many ways, healthcare is a consumption market. In many ways, the industry and its components (hospitals, insurance cos, government) will need - like the hospital above - to adapt in fundamental ways to ensure access to quality healthcare for all. We're in for some very interesting times....

Sorry... I know...
I return you to your previously scheduled debate over BRMC.

 

To add to the last comment, this whole issue is also related to hospital executives not understanding the modern healthcare environment well enough to run it at the right numbers. There's a saying that execs hear, that they should run their hospitals at 85% capacity at night, to have room for a daytime surge in demand. Of course, this doesn't happen -- empty beds are bad business! So they run them around 94% capacity. When daytime hits, the demand jumps to 115% - outstripping capacity.
Capacity is not affected just by available beds, but by staffing to care for patients in the beds (and other factors). The disheartening thing is, patient census and flow can be fairly accurately predicted. A nurse manager with some numbers and some intuition knows she will need ten nurses on the unit today, in expectation of patient admissions. But ask any nurse manager if they can staff for predicted needs, and most will tell you "no." They can only staff to their current census, and so the unit that needs ten nurses today, will only have eight on it. And sure enough when the ED piles up into the halls, it's not just because all the beds are full -- there may be empty beds, but not enough nurses. And some facilities (fewer as time goes on) will put those patients in those beds anyway and hope that nothing press-worthy happens.
Change is in the winds.....

 

James A. Lapsley, Chief Executive Officer of Loudoun Medical Group:
"Loudoun County is still growing and the infrastructure is still evolving. A second hospital in Loudoun County located in Broadlands is not smart infrastructure planning. It is too close to the current hospital and will have a damaging effect on the opportunity of Loudoun County residents to have advanced or tertiary care services like open heart surgery and trauma services located right in Loudoun County."

Huh... having another hospital too close to another one... DAMAGES consumers' access to advanced tertiary care services?

Definition: In medicine, tertiary healthcare is specialized consultative care, usually on referral from primary or secondary medical care personnel, by specialists working in a center that has personnel and facilities for special investigation and treatment.

How does a new hospital damage the ability for patients to access such care?

 

Consider the source and his previous ties...

"From 1997 to 1998, Jim worked at Inova Health System Integrated Physician Services as the chief operating officer,..." (source: http://www.lmgdoctors.com/jlapsley_bio.html)

-Jim

 

In case anyone got the postcard from INOVA in the mail and would like the context of the county "comprehensive plan" amendment that they are selectively quoting from:

"7. The County may recognize areas around medical centers – present and future – which are appropriate for zoning districts that would allow healthcare-related businesses in those areas and create such zoning districts. The County recognizes that the residents of the Route 50 corridor do not have adequate access to emergency care or hospital related services. The Route 50 corridor should be given special consideration for the next full-service hospital and EMS ambulance receiving facility to be built in the County. The Cornwall Emergency facility, located in Leesburg presently serves as a much-needed receiving facility for EMS ambulances and residents in Western Loudoun. The County encourages the reestablishment of a full service facility at the Cornwall Campus. The County will encourage continued use and development of the Cornwall campus."


This was adopted in March of 2005 by the previous Board of Supervisors (though Inova would have us believe it was created at some higher level of government that the current Supervisors are willfully disobeying). Inova's card says "Tell the board of supervisors: stick to your plan." It would seem to me, this plan is not the plan of the current supervisors. I encourage the current ones to do what they think is right for the county after hearing all evidence and testimony available.

Make of it what you will, but here's the full context for interested parties.

 

The county's planning staff, in their report, says BRMC complies with the plan and explains why.
So, in essence, when Inova encourages others to tell the Board of Supervisors to "follow the plan", they are telling them to approve BRMC!