June 2017

Inside Regional Health's Automated Laboratory

Make Your Airline Miles Go Further

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MOMENTUM

BROOKINGS HEALTH SYSTEM STEPS INTO ITS FUTURE WITH BOLD NEW EXPANSION THE SOUTH DAKOTA REGION’S PRE M IER PUBLICATION FOR HEALTHCARE PROFESSIONALS

JUNE 2017

Does Your Patient Need Hand Therapy?

Vol. 8 No. 4

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Contents

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VOLUME 8, NO. 4 ■ J U N E 2017

BROOKINGS HEALTH SYSTEM STEPS INTO ITS FUTURE WITH BOLD NEW EXPANSION

REGULAR FEATURES 4 | From Us to You Best States for Children’s Healthcare, USD’s Center for the Prevention of Child Maltreatment, Regional Health expands home care

6 | Hometown Advantage: Dermatologist Melody Eide, MD

ON THE COVER

Inside Regional Health's Automated Laboratory

Make Your Airline Miles Go Further

Vol. 8 No. 4

By Peter Carrels

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10 | News & Notes Here’s what’s happening around the region

Could Your Patient Benefit from Hand Therapy?

31 | Learning Opportunities Upcoming Summer and Fall events

■ By Alex Strauss Highly specialized OT restores function to damaged upper extremities

IN THIS ISSUE 6 | SD Named Sixth Best State for Doctors 16 | Track and Follow Up on Your Tests

Midwest Medical Edition

Does Your Patient Need Hand Therapy?

JUNE 2017

5 | MED on the Web

■ By Jeremy Wale

19 | Madison Welcomes New Canine Volunteer and Sports Medicine Institute

23 | Avera to Build New Surgical Hospital in Sioux Falls 24 | FDA Approves Clinical Trials of Novel Therapy for PVD

26 | S anford to Help Study Cancer Drugs and Cross-Treatment Area doctors take part in a national

MOMENTUM

BROOKINGS HEALTH SYSTEM FUTURE WITH BOLD NEW STEPS INTO ITS EXPANSION THE SOUT H DAKO TA REGIO N’S PRE M IER PUBLI CATIO FOR HEALTHCA N RE PROFE SSION ALS

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22 | Regional Health Breaks Ground on Orthopedic

Vascular scaffolding developed in South Dakota offers an alternative to stents and balloons

forward

More Miles Than You Can Use? Consider Donation Airline miles are worth even more when they help make wishes come true

effort to study cross-treatment with approved cancer drugs

27 | Diagnosing and Treating Pediatric Heart Palpitations 28 | Finding a Home and a Mortgage:

What’s Working Now? ■ By Darren Melstad

On the hunt for a new home? Here’s why the market is good for both sellers and buyers.

30 | Healthcare MBA Student Applies Lessons in Real Time ■ By Alex Strauss

20 First-of-its-Kind Automated Laboratory Speeds Results for Patients in Rapid City

On the cover: Pharmacist Scout Hurd and Inpatient Care Nurse Staci Schulz in the newly expanded and redesigned Brookings Hospital. Photo courtesy Brookings Health System.

By Alex Strauss

As the challenges for rural hospitals mount, Brookings Health System is rising to meet them with a 62,000+ square foot hospital expansion that is changing the way they care for patients.

page

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From Us to You Staying in Touch with MED

H

ELLO AND WELCOME to the early summer issue of MED. The air may still be cool, but things are heating up with construction and renovations at healthcare institutions around the region. In this issue, we are featuring the recent expansion project at one of the area’s most dynamic rural hospitals. As many small hospitals struggle to hold their own amidst changing regulations and shrinking populations, Brookings Health System continues to thrive and grow. We talked to some of the key players to find out how they’re doing it.

Also in this issue, some good news for South Dakota doctors.

WalletHub has named the state one of the top 20 places to practice medicine. Find out what has put us so high on the list.

In recognition of Hand Therapy Month, a Sioux Falls hand therapist explains this highly specialized approach to rehabilitation. You’ll also find news of other building projects and ground breakings, a high-tech new hospital pharmacy management system in the Black Hills, and big news for USD’s medical school and nursing program.

Please keep in mind that MED is your publication, committed to being the premier communication tool for our large and diverse medical market. Have news you want to share? A new procedure to promote? An interesting case? MED reaches 5,000 of your colleagues across South Dakota, Minnesota, and Iowa.

Get in touch at info@MidwestMedicalEdition.com to find out how we can help you spread the word.

Cheers, —Alex and Steff

MED QUOTES In early June, the world of leaf and blade and flowers explodes, and every sunset is different.

—John Steinbeck

June 1 Next Advertising deadline June 5 Next Contribution deadline

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Steffanie Liston-Holtrop

VICE PRESIDENT

SALES & MARKETING Steffanie

Liston-Holtrop

EDITOR IN CHIEF Alex Strauss

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PHOTOGRAPHER studiofotografie

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WEB DESIGN Locable DIGITAL MEDIA

DIRECTOR Jaclyn Small MARKETING DIRECTOR Erika Tufton CONTRIBUTING WRITERS Darren Melstad

Jeremy Wale STAFF WRITERS Liz Boyd Caroline Chenault John Knies

COPY EDITOR Andrea Conover

Reproduction or use of the contents of this magazine is prohibited.

MED’s Steffanie ListonHoltrop and some of her fellow SDMGMA (South Dakota Medical Group Management Association) board members at this year’s Spring Conference in Deadwood, South Dakota.

Know of a conference MED should attend?

Let us know!

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PUBLISHER MED Magazine, LLC Sioux Falls, South Dakota

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©2011 Midwest Medical Edition, LLC Midwest Medical Edition (MED Magazine) is committed to bringing our readership of 5,000 South Dakota area physicians and healthcare professionals the very latest in regional medical news and information to enhance their lives and practices. MED is published 8 times a year by MED Magazine, LLC and strives to publish only accurate information, however Midwest Medical Edition, LLC cannot be held responsible for consequences resulting from errors or omissions. All material in this magazine is the property of MED Magazine, LLC and cannot be reproduced without permission of the publisher. We welcome article proposals, story suggestions and unsolicited articles and will consider all submissions for publication.

Please send your thoughts, ideas and submissions to alex@midwestmedicaledition.com. Magazine feedback and advertising and marketing inquiries, subscription requests and address changes can be sent to steff@midwestmedicaledition.com.

MED is produced eight times a year by MED Magazine, LLC which owns the rights to all content.

CONTACT INFORMATION Steffanie Liston-Holtrop VP Sales & Marketing 605-366-1479 Steff@MidwestMedicalEdition.com Alex Strauss Editor in Chief 605-759-3295 Alex@MidwestMedicalEdition.com Fax 605-231-0432 MAILING ADDRESS PO Box 90646 Sioux Falls, SD 57109 WEBSITE MidwestMedicalEdition.com

MED welcomes reader submissions!

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A MEDICAL COMMUNITY HUB! ARE YOU ON THE LIST? Add your business or practice to MED’s FREE online directory and get noticed!

MED’s comprehensive and searchable online business directory makes it easy to find any business or practitioner. Thousands of area healthcare professionals visit MED’s website every month. Take a moment to list your

2017 Advertising EDITORIAL DEADLINES Jan/Feb Issue December 1 March Issue February 1 April/May Issue March 1 June Issue May 1 July/August Issue June 1

business for free and make sure those who need your services can find you.

This month

Two states in MED’s coverage area are ranked “Best States for Children’s Healthcare”

only on the Web

The newly created Center for the Prevention of Child Maltreatment at USD names its first director.

Regional Health is expanding a new, one-stop resource for coordinated home care services to all of western South Dakota and adjacent areas.

Sep/Oct Issue August 1 November Issue October 1 December Issue November 1

Stay up-to-date between issues of Sign up for previews of upcoming articles and advance notice of the next digital edition.

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South Dakota Named 2017’s

6th BEST STATE for DOCTORS Personal finance website WalletHub recently named the state of South Dakota as one of the best states in which to practice medicine To identify the best states for those in the business of saving lives, WalletHub’s analysts compared the 50 states and the District of Columbia across 14 key metrics. The data set ranges from average annual wage of physicians to hospitals per capita to quality of the public hospital system.

PRACTICING IN SOUTH DAKOTA (1 = Best, 25 = Average): 7th Average Annual Wage of Physicians (Adjusted for Cost of Living) 3rd Hospitals per Capita

In a separate survey by the same company on the best states for nurses, South Dakota was found to have the shortest average commute time at 16.9 minutes. Iowa and North Dakota made it into the company’s top ten best states for nurses based on salaries, healthcare facilities per capita, and nursing job openings.

20th Insured Population Rate 10th Projected percentage of Population Aged 65 & Older by 2030

See the website for links to both full reports.

8th Projected Number of Physicians per Capita by 2024 18th Punitiveness of State Medical Board 17th Current Competition (Number of Physicians per Capita)

HOMETOWN ADVANTAGE

What brings physicians back to the region to practice?

E

VER SINCE she completed her residency program at Henry Ford Hospital in Detroit, Dermatologist Melody Eide, MD, MPH, has been gradually moving back toward her hometown

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in South Dakota’s Black Hills.

During medical school at Dartmouth, Dr. Eide did an eight week Family Medicine clerkship at Queen City Medical Clinic in Spearfish. “That experience showed me how rewarding it could be to practice in South Dakota,” says Eide, who was born and raised on her family homestead between Belle Fourche and Newell. “Even though people sometimes have to travel very far to see a doctor, everyone is connected in some way.”

Although she and her Michigannative husband first settled in Michigan, they got married in South

Dakota and returned to the region as often as possible. Ultimately, it was the birth of their first child, now 4 years old, that brought her back to the state to practice at Rapid City Medical Center.

“There is nothing like having children to make you reevaluate your priorities and think about how you want to raise them,” she says.

“I missed the trees and the hills and all the great state parks. The time had come to put down roots.”

Recently, Dr. Eide, who is boarded in both dermatology and clinical informatics, began providing outreach care at The Medical Center of Spearfish four times a

week, putting her even closer to home.

“Every day I’m seeing someone who is connected to me in some way, either through family or friends,” observes Dr. Eide. “It makes me feel more fulfilled as a physician to have these more complex personal relationships.”

Her experience growing up in a rural area has also translated into an interest in telemedicine and a deep sensitivity to the unique needs of patients who must travel for care.

“In general, it makes me more conscious of the care plans I put forward and how I map them out for my patients,” she says. ■

Midwest Medical Edition

SANFORD LAUNCHES

FIRST CANCER BREAKTHROUGHS 2020 TRIAL IN THE U.S. GROUNDBREAKING IMMUNOTHERAPY TRIAL TO USE VIRUS-BASED VACCINE Edith Sanford Breast Center is the first of four sites across the country offering this trial for patients with unresectable locally advanced or metastatic HER2-low-expressing (IHC 1+/2+) breast cancer. It f ocuses on the safety of the immunotherapy therapeutic vaccine ETBX-021, which uses a viral vector-based delivery system.

To refer a patient, call 1-87-SURVIVAL. Participants can

enroll at Edith Sanford Breast Center in Sioux Falls, SD.

Cancer Breakthroughs 2020 is the nation’s most robust cancer initiative seeking to accelerate research on immunotherapy as a standard of care for cancer patients.

019059-00855 4/17

Could Your Patient Benefit From Hand Therapy?

This highly specialized form of occupational therapy restores function to damaged upper extremities

By Alex Strauss

K

ENDRA HARMS, MOTR/L, CHT, knew that she wanted to be a hand therapist, a highly-specialized and highly-competitive subspecialty area of occupational therapy, from her first encounter with a patient whose hands had been disabled by a stroke.

“This patient had been a seamstress for the opera and had had some high end jobs,” recalls Harms. “I remember sitting with her as she brought out a book of pictures of some of the beautiful gowns that she had made and she began to cry, realizing that she may never be able to perform that part of her life again.”

To achieve certification, a hand therapist must work in the field for at least five years before sitting for an exam which historically has just a 40 percent pass rate. Harms, an OT by background, is one of just 5,300

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certified hand therapists worldwide and one of six in Sioux Falls. As part of the Hand Clinic at Orthopedic Institute, Harms work with another hand therapist, an occupational therapist, and OI surgeons to restore functional use to hands impacted by conditions such as ■ Rheumatoid arthritis ■ Congenital deformities ■ Traumatic amputations or injuries ■ Wounds and infections

■ Joint replacement ■ Carpal tunnel syndrome ■ Stroke-related contractures ■ Postoperative rehabilitation

“Our training is from the cervical spine all the way down, although we typically leave difficult shoulders to our physical therapists,” says Harms. “Any condition that affects the upper extremities should be seen by a certified hand therapist. We have an extensive evaluation process to determine if hand therapy could help them.”

Her patients range from infants to the elderly and are typically referred by rheumatologists, pediatricians, chiropractors and

Midwest Medical Edition

We understand the art of healing and the other specialists across a five-state area.

Sometimes, Harms says patients end up at the Hand Clinic after being seen by several other doctors who were uncertain about how to handle their case.

“It is surprising how many patients we have that have had multiple surgeries or multiple therapies,” says Harms. “Some just want to be able to play golf again. Others are serious athletes who want to get back to gymnastics or football. My job is never boring because every patient is so different.”

Unlike other body parts with fewer bones and less complex vasculature, Harms says injured hands often require several surgeries, going through stages of repair and therapy.

In these cases, a hand therapist may work closely with the surgeon and the rest of the clinical team to create a customized therapy plan. If that plan includes a splint, Harms and her colleagues offer custom splint fabrication.

These moldable plastic splints are remove to allow for postoperative wound care.

“You have to apply the appropriate postoperative protocol, protecting certain things while moving others,” says Harms.

“These custom splints allow us to help do that. No other practice does that but certified hand therapy.”

While Harms says she loves the challenge of complex medical cases, the best thing about her job is the satisfaction of seeing function restored.

“It is great to see someone go from disability back into life,” she says. “People come to us in a really vulnerable place and we are able to help them, literally hand-inhand, walk through the process of regaining function.”

“You get to know people, sitting two feet away from them for months. When someone comes back and says ‘I finally went fishing again and caught my first walleye!’, it feels so rewarding.” ■

June 2017

science of avoiding risk.

Medical liability and more.

MMIC is the Midwest’s leading provider of medical liability insurance and risk management services, helping health care providers improve patient safety and enhance performance. MMICgroup.com.

MidwestMedicalEdition.com

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Happenings around the region

South Dakota Southwest Minnesota Northwest Iowa Northeast Nebraska

News & Notes

AVERA Preston Renshaw, MD, Chief Medical Officer for Avera Health Plans and DakotaCare,

has been named a Fellow of the American Association for Physician Leadership, formerly the American College of Physician Executives. The primary focus is to help doctors gain skills to assume leadership roles. Dr. Renshaw is the first physician in South Dakota to receive this honor.

Avera Health is pleased to announce that

Michael Gibbs has begun his position as President of the Avera Heart Hospital effective May 1. Gibbs moved to this position from Rapid City, South Dakota where he was in administration at Rapid City Regional Hospital. Gibbs holds two master’s degrees in healthcare administration and biomedical ethics. He is a Fellow of the American Association for Physician Leadership.

BLACK HILLS Regional Health Urgent Care – North & West have received the designation of Certified Urgent Care by the Urgent Care Association of America.

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Shahid Ahmad, MD, is the recipient of the Anton Hyden Award from the

USD Sanford School of Medicine. Dr. Ahmad is a hospitalist at Rapid City Regional Hospital who earned his medical degree from the Kasturba Medical College in Karnataka, India, and completed his internal medicine residency at Florida State University College of Medicine in Tallahassee.

Regional Health is pleased to welcome two new physicians to the Dermatology Staff.

Roger Knutsen, MD, FACP

Siri KnutsenLarson, MD

Dr. Knutsen is board-certified in both dermatology and internal medicine. Dr. Knutsen-Larson is board-certified in medical and surgical dermatology. Both doctors received their medical degrees at USD Sanford School of Medicine in Vermillion. They both went on to residencies in Wisconsin and Colorado.

In May, the inpatient rehabilitation unit that resided at Regional Rehabilitation Institute was relocated to a wing

inside the Village and Skyline Pines Assisted Living. The move is part of plans for transforming the campus at Rapid City Regional Hospital.

Regional Health has expanded its general surgery services in Rapid City with the addition of Patrick Kenney, DO. Dr. Kenney

earned his medical degree at the Arizona College of Osteopathic Medicine in Glendale, Arizona.

He went on to complete his general surgery residency at LAC/ USC Medical Center in Los Angeles, California, and Huntington Memorial Hospital in Pasadena, California.

In preparation for a new emergency department and patient tower, Rapid City Regional Hospital closed the

south entrance on May 1. All patients and guests, apart from Emergency Department patients, are asked to use the north entrance. To expedite parking, free valet service will be offered at that entrance every weekday.

Volunteer Joyce Byork was honored for more than 24,000 hours of service to RCRH.

Rapid City Regional Hospital has honored their volunteers at a Volunteer Appreciation Brunch. In 2016, 340 volunteers

contributed 36,000 hours to RCRH. Awards were given for those volunteers who gave 250 hours or more.

Along with naming it in the top 5% of hospitals in the nation, Healthgrades has awarded Rapid City Regional Hospital with the Distinguished Hospital Award for Clinical Excellence.

Nearly 4,500 hospitals were surveyed nationwide and only 258 received this award including just two in South Dakota.

Regional Heart Doctors has changed its name to Regional Health Heart and Vascular Institute. The new name

encompasses the wide range of services the Institute provides. The Institute provides The Heart and Vascular Clinic, Heart, Lung, and Vascular Surgery, Black Hills Cardiovascular Research, and Spearfish Queen City Cardiac Services Clinic as four essential components to its program.

On April 10, members from across Regional Health gathered at Rapid City Regional Hospital for the Donate Life Flower Planting Ceremony.

The ceremony was to celebrate National Donate Life Month.

The flowers were planted at the base of a tree that honors donors, recipients, and their families.

SANFORD The Edith Sanford Breast Foundation has been named the Official Charity Partner for two upcoming IRONMAN and IRONMAN 70.3 triathlons in Chattanooga, Tennessee.

Members of the Edith Sanford Breast Foundation’s national team, TeamEdith, will compete while raising awareness and funds to end breast cancer.

Midwest Medical Edition

Alpha Media, Watertown is proud to announce their 17th Annual Watertown Radiothon for Kids raised $100,000.

The funds generated through this two-day event stay in South Dakota help pay for equipment, training, and programs that benefit the thousands of children treated at Sanford Children’s Hospital every year.

The Journal of Clinical Oncology published the results of a study conducted by Steven Powell, MD, on March 22.

The paper explained the benefit of pembrolizumab, an immunotherapy drug, for patients in the advanced stages of head and neck cancer. The paper is based on research that began in October of 2014. Pembrolizumab was granted FDA-approval for use in these patients in August of 2016.

As part of the celebration of National Skin Cancer month, dermatologists with Sanford Health and Regional Health offered free skin cancer screenings on May 1. This was

Sanford Children’s Hospital is part of I-PASS, a patient safety research group that is helping

to standardize provider communication particularly during patient handoffs. As part of their participation, Sanford Children’s Hospital received the 2016 John M. Eisenberg Award for Innovation in Patient Safety.

This award is presented annually by the Joint Commission and the National Quality Forum.

Sanford Cancer Center is pleased to welcome Bongi Rudder, MD, and James Kuzman, MD, to their team of oncologists and hematologists.

Dr. Rudder received her MD from the University of the West Indies in St. Augustine, Trinidad, and Dr. Kuzman received his medical degree from the USD. Dr. Rudder will also provide outreach services in Worthington, Minnesota. Both doctors are board-certified in internal medicine, oncology, and hematology.

done at the Community Health Center of the Black Hills in Rapid City and Lewis Southgate in Sioux Falls. Patients who had not had screenings in the last two years qualified.

Sanford Health Research is conducting a new clinical trial at locations in Sioux Falls, Fargo, and Bismarck to determine whether medication previously approved by the FDA for specific cancers can be cross-used for others. Patients

qualify by receiving genomic testing that identifies them as having targetable alterations. The study is open for cancer patients 18 and older who are not benefitting from conventional cancer treatments. To enroll a patient, call 1-87-SURVIVAL.

Sanford NICU Nurse Jordan Sluzzer, RN, and Central Resource Nurse Jesse Pechous, RN, were recently recognized with DAISY Awards for Nursing Excellence.

The Society of Cardiovascular Patient Care presented Sanford Heart Hospital with full Atrial Fibrillation with Electrophysiology Services Accreditation. In order to receive

the Accreditation from SCPC, Sanford Heart Hospital had to demonstrate adherence to stringent criteria and undergo a comprehensive onsite review.

SIOUXLAND Tracey Pick, ARNP, has joined the staff at South Sioux Mercy Medical Clinic. Pick holds

a Master’s Degree in Nursing/Family Nurse Practitioner from Clarkson College in Omaha, Nebraska.

Prior to joining South Sioux Mercy Medical Clinic, she was an Advanced Registered Nurse Practitioner at St. Luke’s Occupational Medicine.

UnityPoint Health–St. Luke’s is pleased to announce the appointment of Wendy Lindley, MSN, RN, NE-BC, to Chief Nursing Executive. Lindley has

served on the staff of St. Luke’s since 2012 as the Director of the Emergency Department. Prior to serving at St. Luke’s, Lindley lived in Salem, Oregon and served in several positions at Salem Hospital. Lindley is a veteran of the US Navy.

Mercy’s 5th Annual Donate Life Flag Raising Ceremony to honor individuals whose lives have been touched by organ, eye and tissue donation took place on Monday, April 3rd in the Central Medical Building Atrium. The flag was flown

throughout the month of April.

Approximately 65 percent of adults are registered donors in Iowa but the need still outpaces the number of donor organs.

There are more than 700 Iowans currently waiting for an organ transplant.

The Centers for Medicare and Medicaid Services has awarded The Sioux City Agency of UnityPoint five stars for home health services. This makes the

Sioux City Agency of UnityPoint the highest rated in Iowa.

June 2017

MidwestMedicalEdition.com

Mercy Medical Center-Sioux City has announced the appointment of Dennis Bickett to therapy manager. Bickett has been on

staff at Mercy since 2001 as a physical therapist. He achieved the distinction of senior therapist over 3 years ago. Bickett has served in the South Dakota National Guard as a lieutenant colonel for 29 years. He was also recently honored as Clinical Instructor of the Year by USD. Mercy Medical Center-Sioux City is also pleased to appoint Allison Gibler as Director of Risk

and Safety. Gibler has been on

staff at Mercy for over a year as a Decision Support Analyst. Gibler has just received a master’s in business analytics and has served in the healthcare field for nearly 25 years.

OTHER

The 2017 graduation convocation for the University of South Dakota Sanford School of Medicine featured 51

graduates at a May 5 ceremony at The Pentagon facility in Sioux Falls. Dr. Thomas J. Huber, a physician in Pierre and a member of the USD Sanford School of Medicine faculty, gave the convocation. The Class of 2017 includes 30 men and 21 women.

Forty-four of the graduates are from South Dakota, including small communities such as Geddes, Redfield, Wanblee, Faith, Hayti, Salem, Dell Rapids and Custer.

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forward MOMENTUM

By Alex Strauss

In many ways

General Surgeon Dr. Theresa Oey, CRNA Cory Kirby, OR Technician Jody Feucht and RN Mandy Newman work together in one of the hospital's three state-of-the art operating rooms.

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, the growth of Brookings Health System is a reflection of the growth of Brookings itself.

Since the first Brookings Hospital opened its doors in 1964, the community, located just an hour north of Sioux Falls, has grown by 60 percent. With that growth have come changes in the community’s healthcare needs.

According to CEO Jason Merkley, more than 70 percent of Brooking’s patients–many of whom hail from communities such as Watertown, Huron and Flandreau–now come to the hospital on an outpatient basis, reflecting a nationwide trend.

In contrast, back in 1964, 80 percent of the patients who came through the doors ended up as inpatients and were usually less sick than patients staying on the medical-surgical unit in 2017. That called for a change in the way care was managed and delivered.

Another reason for the hospital’s recent 62,000+ square foot expansion and renovation project: Expectation.

“Today’s patients expect a 5-star experience when they go to the hospital,” says Merkley. “In the old facility, we could not provide some of the everyday comforts that we tend to take for granted,

Midwest Medical Edition

BROOKINGS HEALTH SYSTEM STEPS INTO ITS FUTURE WITH BOLD NEW EXPANSION

Photos courtesy Brookings Health System

such as privacy, quiet, individual bathrooms, and large windows. We needed to make these things happen even from an infection control standpoint.”

Today’s patients and doctors also expect efficiency, easy access, and top-level technology, such as high-tech operating rooms, robotic capabilities, in-house MRI to accommodate all body types, and a dedicated area for outpatient surgery. On all counts, Brookings is now meeting–and even exceeding–expectations.

Redesigning Inpatient Care The newly expanded Brookings Hospital, which is licensed for 49 beds, opened for business in February. The project took a little over a year-and-a-half but put Brookings decades ahead of where it had been in its ability to efficiently care for patients.

June 2017

“The layout was designed by nurses with physician input, so it is very, very efficient,” explains Karen Weber, RN, a 31-year veteran of the Brookings hospital staff and Director of both the Emergency Department and Inpatient Care. Weber says the old layout, with patient rooms fanned out from a central circular nurses station, was often noisy, distraction-filled, and crowded, especially when physicians were doing rounds.

“We now have four decentralized nurses stations that comfortably fit two staff,” says Weber, explaining that patients are strategically assigned to the hospital’s 24 inpatient rooms to put them closer to nurses. In addition, 80 percent of supplies and medications needed for each patient are now located in locked cabinets in each room that can be restocked from the hallway. Even the storeroom is now on the unit, minimizing steps

MidwestMedicalEdition.com

Pharmacist Scout Hurd in the new pharmacy which is strategically located in close proximity to the inpatient care unit.

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Diagnostic Imaging Director Tim Watson with the hospital’s new wide-bore MRI

and maximizing time for provider-patient interaction.

“I think we are taking better care of patients because we are able to spend more time in the room with them,” says Weber.

The new layout also includes a workroom on the unit for brief, daily team planning meetings that have taken the place of lengthy twice-weekly care conferences.

“Every day the flow gets a little better,” says general surgeon Theresa Oey, MD, who will mark five years at the hospital this summer. “With private rooms and nice light coming in through all the windows, it’s easier for patients and their families to be comfortable, even though they are not at home. It’s a whole nother level of care.”

A newly-initiated hospitalist program provides an extra level of care for hospitalized patients overnight on weekdays and 24 hours a day on the weekends. “The bottom line is that the overall patient experience, in terms of privacy, comfort, healing environment, access to what they need–it’s all going to be better,” says Merkley.

Modernizing Surgical Care

Decentralized nurses stations put nurses closer to each patient and cut down on chaos and crowding.

The hospital’s five LDRP rooms are larger to accommodate family and friends. “Some people have said they are so beautiful that it makes them want to have another baby!” says Dr. Oey.

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In 1964, surgery usually meant a mandatory hospital stay. Today, 40 percent of procedures at Brookings, as at so many other hospitals, are now performed endoscopically. With two new suites dedicated to endoscopy, and three spacious new ORs, both same-day surgery patients and those who need larger operations will experience fewer delays getting scheduled.

“Surgery is one of our high-growth areas,” says Merkley. “Before the expansion, we were having trouble getting blocks for our surgeons because the same rooms were being used for things like colonoscopies and hernia repairs.”

The new ORs are nearly double the size of the old ones and are fully-integrated with high-tech lighting, high definition in-line video capabilities, more space for the robotic surgery system, and booms that keep equipment and cords off the floor.

“All of the equipment has been upgraded to allow us to do some amazing things here,”

Midwest Medical Edition

says Dr. Oey, who helped choose the new equipment. “Our lights are better and our rooms are bigger, which allows us to have everything that we need close at hand and circulators to move about with ease.”

Dr. Oey says the rooms are well-equipped to handle all different kinds of surgeries as the hospital expands its options.

Here, too, the “flow” has changed significantly as a result of the expansion.

Whereas same-day surgery patients were previously transported to the inpatient unit to be prepped for surgery, a new dedicated prep and recovery space with 12 rooms now allows patients and families to stay put.

still practicing medicine the way we did 30 years ago,” says Karen Weber. “Now, people are just amazed by the clean lines, the great art, and the space as soon as they walk in the door.”

“Now, the outside really reflects the great care that the staff provides, which also helps with recruitment,” agrees Dr. Oey. Other upgrades, including the updated heating and cooling system, strategically located private transport corridors, and new pharmacy are less visible but just as vital to the hospital’s ability to care for patients, both now and in the future.

“I’m a big proponent of providing the

Staci Schulz, RN, tends to a patient in one of the hospital’s 24 large inpatient rooms which are designed to put supplies close at hand.

The Brookings Health System Expansion at a Glance •H ospital Expansion: adds 62,400 sq. feet •M edical Plaza: adds 30,000 sq. feet

Video cameras and monitors, high-tech lights, and other equipment are boom-mounted in the new ORs, making it easier to move around the room.

“After their procedure and recovery, patients go straight back to the same room they were in,”says Dr. Oey. “They no longer have to be by the sick patients who are upstairs, which is better for both patients and families.”

Upgrading for the Future Some of the upgrades, such as the five LDRP suites (up from 3), the larger private rooms, and the redesigned entrance and public spaces are highly visible, designed to be physical reflections of the hospital’s forward momentum.

“We have always had high quality care, but from the street, we looked like we were

June 2017

highest quality of care we can possible provide. Volume follows quality,” says Merkley. While some rural hospitals flounder, Merkley says this growing community’s long-standing support of its hospital has allowed Brookings Health to maintain a positive balance sheet, opening the door to partnerships that, in turn, help keep it vital.

It is a delicate balancing act.

“As an independent rural hospital, we are poised to say ‘let’s keep one foot on the dock, and one on the boat’,” says Merkley.

“You don’t want to get lost in the shuffle.

We are providing a vision of future healthcare in our community. I hope ours lasts until 2067.” ■

MidwestMedicalEdition.com

• Renovation: remodels 17,750 sq. feet • Cost: approximately $46 million •F inancing: 70% funded by capital financing 20% funded by hospital reserves 10% funded by donations Project Groundbreaking July 2015

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Track & Follow Up on Your Tests

M

Find more ways to minimize legal risk on our website.

By Jeremy Wale ISSED OR DELAYED diagnosis is one

of the most often-litigated allegations in medical malpractice.1 These claims often result from tracking and followup procedure failures.

Lab testing is one of three key areas (the others are referrals to specialists and missed/canceled appointments) where tracking and follow-up are vitally important. A retrospective study researched the frequency of patients not being informed of test results, concluding there was a 7.1 percent failure rate.2 Tracking and follow-up procedural safeguards can be implemented and have a large impact on potential liability claims.

A RELIABLE TEST TRACKING AND FOLLOW-UP SYSTEM ENSURES THE FOLLOWING STEPS OCCUR:

1. The test is performed.

2. The results are reported to the practice.

3. The results are made available to the ordering physician for review and sign-off.

4. The results are communicated to the patient.

5. The results are properly filed in the patient’s chart.

6. The results are acted upon when necessary.

HERE ARE SOME SUGGESTIONS FOR IMPROVING YOUR PROCESS:

◆ Route all test results to the ordering physician for review.

Procedures to ensure the ordering physician receives each and every test result can help lessen the risk of a result “falling through the cracks.” Something as simple as a log book or email notification can help facilitate physician review. ◆ Ask the ordering physician to review and sign off on each ordered test result. Physicians order lab tests for specific reasons; physicians are encouraged to sign or initial each test result following review. ◆ Notify your patients. Several practices notify patients only when there is an abnormal result. Some practices choose to send a letter for normal results and call the patient for abnormal results. Others call patients with all results. In today’s technologydriven world, an email may be

appropriate for normal results, or an email directing patients to a portal where results can be reviewed.

Patient notification of all test results is advised—however your practice chooses to do so.

Ensuring all tests ordered by your physicians are handled in a consistent manner will help avoid tracking and follow-up errors. Develop a system which works within the context of your practice, and follow these protocols with every patient—helping to effectively and efficiently stay on top of test results. ■ Jeremy Wale is a licensed attorney and a Risk Resource Advisor for ProAssurance.

1 “PIAA Closed Claims Comparative: A comprehensive analysis of medical professional liability data reported to the PIAA Data Sharing Project,” 2015 Edition.

2 Casalino, L.P., et al., “Frequency of Failure to Inform Patients of Clinically Significant Outpatient Test Results.” Archives of Internal Medicine 169 (2009): 1123-9.

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Consider registering as an eye, tissue, and organ donor today!

Visit www.dakotasight.org/register to learn more

16

Midwest Medical Edition

Compassion.Experience.Trust 6 30 1

Compassion .Experience.Trust are very important factors to consider when you refer your patients to a plastic surgeon.

At Sioux Falls Center for Plastic & Reconstructive Surgery we take that seriously.

Our dedicated team of board-certified plastic surgeons; Dr. Richard and Thomas Howard, our Physicians Assistant Tammi Stranghor and our clinic staff are determined to partner with you and your patient to achieve the highest quality of care and the best end results.

Whether your patient needs a surgical procedure or noninvasive treatment call us today to schedule a referral.

605.334.1930 www.plasticsurgerysiouxfalls.com

Schedule a referral today 605.334.1930 6301 S Minnesota Ave., Suite 300

Sioux Falls, SD 57108

To donate, visit the Make-A-Wish website at southdakota.wish.org or call the dedicated “Wishes in Flight” donation line at 800-640-9198 with your Frequent Flier number and basic details.

One of the highlights on travel wishes for kids like Jessica is the flight itself and chance to visit the cockpit!

More Miles Than You Can Use?

Wish Teen Kins

ey enjoyed a vis it to the cockpit one of her flig ht s to New Ze aland.

CONSIDER DONATION! EACH YEAR, MAKE-A-WISH South Dakota grants wishes to sick children and their families that help to ease the pain and stress of facing a life-threatening illness. About 70 percent of those wishes involve travel, and it’s not cheap.

“Because we know that serious illness can impact the entire family, our commitment is to make travel-related wishes possible not just for the sick child, but also for the parents or guardians and for any siblings living at home,” says Make-A-Wish President and CEO Paul Krueger. “That can mean anywhere from three or four people up to as many as ten.”

Flying ten people to Disney World can

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add up. That’s why, for the last six years, Make-A-Wish has encouraged people with extra airline miles banked up to consider donating some of them as a way to offset their travel expenses.

“We receive miles donations from a variety of people,” says Krueger. “Some come from older people who know they are not planning to travel much. Others come from frequent travelers or people who get credit card miles and have so many miles that they wouldn’t miss 500 or a thousand.”

United Airlines requires a minimum donation of 500 miles and Delta requires a minimum of 1,000. (Some other airlines are involved but their requirements differ) There

is no maximum, and Krueger says the organization has received donations as high as 100,000 or more. In fact, each year, the organization’s spring “Wishes in Flight” campaign has brought in more than a million miles. This year, the number topped 1.3 million.

“That equates to saving us $20,000 to $25,000 in airfare dollars this year,” says Krueger.

Donations of miles are accepted yearround and, unlike miles that are held by an individual, miles donated to Make-A-Wish never expire. Although the gift is not taxdeductible, it represents an easy and unique way to help Make-A-Wish support the state’s sickest children. ■

Midwest Medical Edition

Madison Welcomes New CANINE VOLUNTEER OVER 65% of American households have at least one pet, and most people consider their pets to be members of the family. When patients are hospitalized, they may be missing more than just their human family members, but their four-legged ones, as well.

With this in mind, a new kind of volunteer has joined Madison Regional Health System. Ruby, a Standard Poodle, and her handler, Bertie Thompson, are part of Therapy Dogs International. As a certified therapy dog, Ruby knows how to navigate wheelchairs, IV poles and crutches, has passed a variety of obedience tests and knows not to pass through doorways before her handler.

Thompson puts a towel under Ruby’s head if the patient wants Ruby to put her head on their lap. She also makes sure Ruby’s paws are clean when going room to room by wiping them

down. It is important to note that according to the CDC, there has never been a report of an infection from animal-assisted therapy.

Animal-assisted therapy is a growing area of healthcare that is helping to take some of the stress out of hospitalization and rehabilitation. Some small studies have suggested that exposure to animals may lower blood pressure, reduce cholesterol and triglyceride levels, and improve feelings of loneliness or depression. Not only do patients feel better, but family members and friends often say that they enjoy the experience, too.

Ruby is new here, but Thompson is not a stranger to MRHS. She spent 30 years volunteering with the Hospital Auxiliary. The pair plan to come to MRHS every Tuesday and Thursday from 2:00 to 4:00 p.m. to visit those who want to see them. ■

Therapy dog, Ruby, spends time with Amiee Brown (left), registered nurse, and Arlyce Freet (center), a patient at MRHS. Bertie Thompson (right), Ruby’s handler, also visits with Arlyce about her pets and tells her about Ruby. Ruby and Bertie plan to spend every Tuesday and Thursday afternoon at MRHS visiting patients through the animal-assisted therapy program.

Photo courtesy of Madison Regional.

weighing you down,

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June 2017

MidwestMedicalEdition.com

19

First-of-Its-Kind

Automated Laboratory Speeds Results for

“

THE CORE LABORATORY at Rapid City Regional Hospital has begun

using a new state-of-the-art automated laboratory, the first of its kind in South Dakota. Hospital officials expect the new system from Beckman Coulter Diagnostics to hasten the delivery of critical test results to providers while decreasing the potential for error.

“Seventy percent of medical decisions are based on lab results,” says Regional Health Laboratory Senior Director Michelle Barthel. “Instrumentation, automation, and clinical IT solutions offered by Beckman Coulter were a perfect fit to meet our test volumes and clinical needs.” Routing specimens through four analyzers, the system will automate the preparation and transportation of approximately 200,000 specimens of blood and bodily

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fluids collected annually from within the Regional Health network, independent nursing homes, hospitals, and clinics across the region. By standardizing processes throughout the organization, the system promotes continuity of care for patients regardless of where they are seen within Regional Health’s network of 5,000 physicians and caregivers.

The system frees laboratory professionals to spend more time on analyses. It will also assist in the proper prioritization of tests and in most cases electronically post the results directly to patient records.

As many as 50 assays may be in process at any time, with test results posting as fast as every seven seconds. The typical amount of time it takes to process priority samples is around 35 minutes. Laboratory leaders expect the new system to reduce median processing times at the stroke and heart attack treatment center to between 25 and 30 minutes, while virtually

Seventy percent of medical decisions are based on lab results

”

Midwest Medical Edition

Regional Health

eliminating longer outliers. Patients, meanwhile, can look forward to needing fewer blood draws. Most samples undergo more than one test, and it’s not uncommon for additional tests to be added later. The new automation line will immediately process tests that have been added by providers.

“The best health system in America requires the best laboratory services, and that’s the thought process that went into the design of our facilities, both at the core and the satellite labs,” says Barthel. The system was put in place and laboratory operations were up and running in just six weeks, in contrast to the average sixmonth installation period. ■ See our website for more photos of the new laboratory system

June 2017

MidwestMedicalEdition.com

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Regional Health Breaks Ground on Orthopedic and Sports Medicine Institute REGIONAL HEALTH has broken ground

on a state-of-the-art Advanced Orthopedic and Sports Medicine Institute in Rapid City Located on an easily accessible 10-acre site, the 114,850-square-foot center will cost an estimated $55 million and will anchor a complex focused on musculoskeletal health, rehabilitation, sports medicine, and physical enhancement.

When the project is complete in the fall of 2018, the building will be a one-stop shop for a variety of related medical services, including orthopedics, sports medicine, performance enhancement, physical medicine and rehabilitation, podiatry, spine, pain management, and integrative medicine services.

The new institute will contain licensed inpatient beds, surgery and associated support areas, and will house physicians, surgeons, physical therapists, occupational therapists, speech language pathologists, athletic trainers, and related specialists.

“To have everything together promotes

22

the team connection,” says Rapid City Market President of Medical Services Mark Harlow, MD. “It brings all of these services under one roof so that all patients have a single destination to get comprehensive care.”

The institute’s two-story lobby with abundant natural light will welcome visitors into registration, a lounge and retail spaces, plus a bistro with an adjacent outdoor dining area. The modern building will contain a state-of-the-art orthopedic surgery suite designed to encourage efficiency in patient circulation and staff and physician workflow, as well as an integrated physician specialty clinic.

In addition to inpatient beds and support services, the first floor will include a physical therapy suite and treatment gym for the training of athletes and employee wellness.

The second floor will hold clinics for orthopedic specialties, wound care, pain and weight management, as well as administrative services. Additional amenities include

an outdoor fitness and agility training area and walking track.

The new institute will help meet the region’s growing need for orthopedic services. Regional Health recently hired four orthopedic surgeons and is in the process of recruiting others to begin practicing here this year.

Complementing the architecture of Regional Health’s main hospital campus, the exterior of the new building will blend local style and materials with modern elements. Vertical and horizontal components will represent the natural beauty of the Black Hills, Badlands and Great Plains.

Materials such as glass, stone, masonry and metal, as well as outdoor gardens for dining, contemplation and respite, will reinforce connections to nature.

According to the Rapid City Economic Development Partnership, the institute is expected to add an estimated 177 jobs and $11.8 million in payroll for Black Hills communities. ■

Midwest Medical Edition

Avera to Build New Surgical Hospital in Sioux Falls

20 HOSPITAL 2017 TOP RURAL COMMUNITY

THIS FALL, AVERA HEALTH will start con-

struction on $174 million worth of building projects in Sioux Falls, including a surgical hospital on a new health campus at 69th Street and Louise Avenue.

The Avera on Louise Health Campus will be a walkable campus constructed on 82 acres at an easy-to-access location in southwest Sioux Falls. The first phase of construction includes the surgical hospital and connected medical office building, comprising 260,000 square feet and slated to open in early 2020.

The campus will specialize in orthopedics and sports medicine, gastroenterology, rheumatology and internal medicine and will offer a range of surgical procedures, new technologies, and amenities.

The 24-bed surgical hospital will feature large surgical suites and an outpatient gastroenterology unit with several procedure rooms. The buildings will be connected by a multi-story commons space with dining options, gift shop, chapel, seating and more.

The surgical hospital will also house support services such as therapy, laboratory, imaging, pharmacy and biomedical equipment, with space reserved for future growth.

Orthopedics and gastroenterology are both growing specialty areas for Avera, which recently opened a new Avera Medical Group Orthopedics & Sports Medicine practice, including 24/7 orthopedic trauma services for Avera McKennan emergency departments, both at the main campus and at the Family Health Center on Marion Road. These seven orthopedic physicians are among 28 orthopedic providers in the Avera system.

In conjunction with this project, Avera McKennan plans an extensive renovation project on its main campus. ■

June 2017

Our mission : to provide high-quality, compassionate, personalized health care.

brookingshealth.org

Siouxland Rushes to Aid of African Bus Crash Victims Three Tanzanian school children who survived a horrific bus crash in Tanzania in early May are now recovering from their injuries in Sioux City, thanks to the quick response of several Siouxland providers and volunteers.

The children’s school bus swerved off a steep road in Tanzania on Saturday, May 6th, killing 33 children and three adults.

Dr. Steve Meyer, orthopedic surgeon with the CNOS Clinic in Dakota Dunes and President of STEMM (Siouxland Tanzania Educational Medical Ministries) was in Tanzania with several other people from the Sioux City area at the time of the bus accident and tended to the wounded on the scene.

Meyer helped facilitate the transport of three children who survived the accident to Mercy Medical Center in Sioux City on May 15th for treatment of numerous fractures and a serious concussion.

Dr. Meyer, his colleague Quentin Durward, MD, and Sioux City psychiatrist Rodney Dean, MD, donated their services to treat the children. Mercy set up a station for employees to volunteer time and donate needed items and Siouxland families stepped up and agreed to host families during their recovery.

Dr. Meyer spoke to the media several times in May to answer questions about the children’s cases and lay out a timetable for their treatment. ■

MED QUOTES

“

As to diseases, make a habit of two things - to help, or at least, to do no harm.

—Hippocrates

MidwestMedicalEdition.com

”

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Photo courtesy Avera.

A lab technician at Alumend, a subsidiary of Avera Health, works with collagen for the Alucent NVS Therapy treatment.

FDA Approves Clinical Trials of Novel Therapy for PVD

often require retreatment. More recent developments include re-absorbable stents and drug coated balloons, but the former absorb into the vessel in three to four years while the latter may not keep the vessel open.

NVS utilizes a photo-activated material which becomes a natural scaffolding to keep the vessel open, possibly negating the need for a stent. The therapy was developed by a team of Avera scientists led by Ron Utecht, PhD, chief scientific officer of Alumend and a former professor of chemistry and biochemistry at South Dakota State University who holds approximately 20 patents for NVS. Alucent plans to begin the FDA-approved Phase 1 clinical trials of NVS this summer at three locations across the US, including OhioHealth Heart & Vascular in Columbus, Lankenau Heart Institute in Wynnewood, Pennsylvania, and Wellmont Holston Valley Medical Center in Kingsport, Tennessee.

Alumend scientists in South Dakota will continue their research and development of other uses of the NVS chemistry, which has potential applications in cancer, orthopedics, cosmetics and more.

“We believe NVS could deliver a quantum advancement in the treatment of peripheral vascular disease, with the potential of totally eliminating vascular implants,” says James Corbett, chairman of the board of Alucent with 30 years experience in the medical device field. “There has never before been a cardiovascular application to the FDA for a new drug/device combination, and we feel there has never been an FDA application of this scope.” ■

THE FDA HAS APPROVED PHASE 1 first in man clinical trials of Natural Vascular

Scaffolding (NVS) therapy, a novel drug/device combination for the treatment of peripheral vascular disease (PVD).

NVS therapy, which marries balloon angioplasty with a pharmaceutical process, is the first combination product for vascular medicine to enter the FDA approval process. It has been in development for the past two decades by Alumend, LLC, Avera’s research and development company. Now that it’s ready for human clinical trials, NVS will be marketed through the name Alucent Medical, Inc., an owned subsidiary of Alumend.

“Avera has been supporting and investing in NVS research for nearly 20 years, and it is extremely exciting to see it near fruition,” says Dave Kapaska, DO, Regional President and CEO of Avera McKennan Hospital & University Health Center.

Balloon angioplasty can stretch the artery wall, necessitating a structure to keep it open for adequate blood flow. The existing standard of care involves the placement of stents, which

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Midwest Medical Edition

June 2017

MidwestMedicalEdition.com

25

Dr. Powell

Dr. Gaba

Dr. Reynolds

Sanford to Help Study Cancer Drugs and Cross-Treatment A NEW CLINICAL TRIAL at Sanford

Health will examine whether medications that are FDA-approved for one cancer can effectively treat another.

Sanford Health locations in Sioux Falls, Fargo and Bismarck are participating in this national effort. The Targeted Agent and Profiling Utilization Registry Study, or

TAPUR, is sponsored by the American Society of Clinical Oncology, the world’s leading organization representing oncologists.

“Precision cancer therapy shows great promise, but despite our advances in genetic testing, treatment options have been limited,” said Steven Powell, MD, the principal investigator for Sanford Health sites.

“ASCO’s TAPUR study will increase the treatment options for our patients.”

Patients who have had genomic testing and are identified to have a targetable alteration qualify for the study and will gain access to treatments matched to their needs.

Right now, the study is for adults with advanced cancers that have progressed on standard therapy or for whom no standard therapy exists.

Three medical oncologists from Sanford Health are principal investigators in the trial including Dr. Powell in Sioux Falls, Anu Gaba, MD, in Fargo, and John Reynolds, MD, in Bismarck.

AstraZeneca, Bayer, Bristol-Myers Squibb, Eli Lilly and Co., Genetech, Merck and Pfizer have volunteered to contribute medications to this effort. As more companies sign on, more drugs that target additional cancers may be added to the trial.

The study is open to cancer patients 18 and older who are no longer benefitting from standard cancer treatment. ■

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26

Midwest Medical Edition

Rapid City Medical School Campus Moves Downtown

DIAGNOSING AND TREATING

Pediatric Heart Palpitations AS WITH ADULTS, HEART palpitations

in children can range from a harmless annoyance to indicative of a more serious heart condition. According to pediatric cardiologist Vince Thomas, MD, of Children’s Specialty Physicians in Omaha, the key to knowing where to start with treatment is to determine whether the palpitations are truly an arrhythmia.

When a child has heart palpitations, Thomas recommends that the investigative process begin with the child’s history, including how the palpitations start and stop, how long they last, how often they occur and what the patient is typically doing when they occur.

After discussing the patient’s history, the investigation should move to family history.

“There are many different types of genetic arrhythmia syndromes that run in families and most pass on from generation to generation,” says Thomas.

Additionally, asking about stressors in the family can yield valuable insights. Providers can ask if anyone in the family is suffering from heart disease, such as a grandparent who may have recently had a heart attack, or parents that have separated or divorced. Some children who experience either of these events complain about their heart.

The focus then shifts to the physical exam. If the patient is having palpitations but their rhythm is normal, their palpitations are likely caused by stress, anxiety or misinterpretation of a fast but normal heartbeat.

However, if a patient has a heart murmur, or if an arrhythmia can be heard during the examination, further evaluation is needed.

If an arrhythmia is suspected, the patient should be referred for an ECG to check for potential genetic syndromes such

June 2017

as Wolff-Parkinson White Syndrome, Long QT Syndrome and hypertrophic cardiomyopathy.

If it is determined that the patient has an arrhythmia, treatment can include observation, medication, or an electrophysiology study and ablation, which eliminates heart tissue that sets up the arrhythmia. At Children’s, 3D mapping may be used to perform ablations with minimal radiation.

“We want to make sure providers are empowered to order the tests they think are necessary and feel confident in their decisions,” says Thomas. “If there is anything that they are concerned about or don’t understand, or if they feel it’s better for it to be taken care of by a specialist, they can always refer to us.” ■

THE RAPID CITY CAMPUS OF THE

University of South Dakota Sanford School of Medicine has moved downtown to 520 Kansas City Street from its previous location in the southern part of town.

“This new campus,” explained Dr. Simmons, “is centrally located in Rapid City, and is nicely positioned to support the medical education community while also engaging with the Rapid City community at large,” says Dr. Matt Simmons, Dean of the Rapid City campus of USD’s medical school.

Simmons says USD has prepared and educated nearly 200 of the physicians either practicing or retired in the Rapid City area.

The school’s faculty includes about 260 Rapid City-area physicians serving as teachers to medical students, including 59 physicians who serve as core faculty.

“The impact of the medical school in Rapid City and the Black Hills is profound,” says Dr. Simmons. “Our new campus will allow us to better serve our students, Rapid City and western South Dakota.” ■

Finding clarity in the expected, unexpected and everything in between.

Brandy Bunkers, CSW-PIP

Contact Brandy today!

101 S. Reid Street, Suite 307 • Sioux Falls, SD 57103 p (605)221-6244 • f (605)221-6201 • claritycounselingsf.com

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27

Finding a Home and a Mortgage WHAT’S WORKING NOW

By Darren Melstad

A

S MANY OF US HAVE BEEN HEARING in the news lately, there is a shortage of houses to pick from in almost all regions of the country, including the Sioux Falls area. In many price ranges, not only is there a shortage of properties to choose from, but those same properties are often seeing multiple offers. It’s also not unusual to see offers coming in higher than the listing price.

That being said, it is even more important than ever for potential buyers to be fully preapproved by their lender before entering the market. By being pre-approved, you are showing the potential seller that you have met with a lender and that your lender has verified your credit, income and assets. This is a step further than just being pre-qualified and could give you the edge over another buyer, or buyers, you may be competing with.

While we may be in what’s called a “seller’s market,” it’s important to understand that it is also a “buyer’s market” in that interest rates have remained at or near historically

low levels. After the Presidential election, interest rates started picking up and were headed in the direction that many experts thought they would go. But contrary to that forecast, rates have started to slide back to pre-election levels.

To put it in perspective, if a certain buyer was pre-approved for a $200,000, 30year mortgage at 3.875% interest; that buyer would only qualify for a $190,000 mortgage at 4.25% interest. So not only have house prices risen, but so has the amount someone can qualify for due to lower rates.

It’s a great time for a buyer to be in the

housing market because of low interest rates. But make sure you do your homework first. Choose a lender carefully and let a mortgage professional help you navigate through all your options. It’s important to know which loan program is best for you such as 15 and 30 year conventional loans, adjustable rate mortgages, FHA or VA. Some lenders also have attractive in-house programs for buyers who might be in unique situations that do not allow them to qualify for secondary market loans. For specific questions check with your preferred lender and make sure you are ready to “move” when your dream home hits the market. ■ Darren Melstad is a mortgage banker with Security National Bank in Sioux Falls.

USD Nursing’s BSN Degree Recognized The Baccalaureate of Science in Nursing (BSN) program offered by the University of South Dakota has received full status approval by the South Dakota Board of Nursing. USD Nursing’s BSN degree has two tracks, including a 4-year pre-licensure track, and the post-licensure RN–BSN track. The nursing board had awarded interim status for USD’s BSN program in 2011.

National Council Licensure Examination pass rates in 2017 for USD graduates in the pre-licensure track exceeded 92 percent for first-time testers. That surpassed national and South Dakota averages. The University of South Dakota offers nursing programs at five locations across South Dakota, including Sioux Falls, Rapid City, Vermillion, Pierre, and Watertown. ■

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Beckenhauer Construccon has been providing high quality construccon service to its clients for 139 years and counnng. Safety of the staff, paaents, visitors, and crews is always at the top of our list to control.

We do so by connnual training, monitoring, providing the best of equipment to assist us, and constant communicaaon with the client so they are aware of our every move. We go above and beyond the industry standard requirements when it comes to proteccng employees, client staff, paaents, and visitors. If you are not already one of Beckenhauer Construccon’s clients, we urge you to visit with any of our past or current clients to see what they have to say about doing business “The Beckenhauer Way”.

June 2017

MidwestMedicalEdition.com

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Healthcare MBA Student

Applies Lessons in Real Time

J

By Alex Strauss IM HARDWICK HAS A LOT IN COMMON WITH HIS KIDS. Like his high school daughter and college son he will soon experience (once again) what it’s like to be a new graduate. But unlike the kids, who are preparing for their next adventures, Hardwick, a Physician Assistant and the CEO of Pierre-based Rural Healthcare, Inc. is already living his.

“The organization I currently work for had a sudden change in leadership in 2011 and I was asked to step into the role of CEO,” says Hardwick, whose background is in Emergency and Internal Medicine. “To be honest, when they first asked, I told them no. This is clearly not what I was trained and educated for.”

Although he had been a paramedic, a police officer, a PA, and long-time Hughes County commissioner (in his 14th year), Hardwick felt overwhelmed by the prospect of taking the helm of a company. He finally relented when the Board of Directors appealed to his sense of compassion for the families who stood to lose their livelihoods if the company went under.

“At that time, we had 45 employees in six communities and the organization had no money,” says Hardwick.

“It was personal for me.

They were going to be devastated if someone didn’t try.”

So Jim agreed to try, although the learning curve was steep.

“It didn’t take very long to know that I needed to help myself a lot if I was going to continue to do what I was doing,” says Hardwick, who began working toward his Healthcare MBA through the University of Sioux Falls last summer. All of his classes are online and he will complete the 2-year program in 2018.

The flexibility and convenience of USF’s

online option was a big point in the program’s favor for Jim, who lives in Fort Pierre. So was the opportunity to engage with classmates virtually through interactive projects. Despite his very full life, Hardwick says he has welcomed the stimulation and challenge of the Healthcare MBA program, much of which he has already used.

“When I finished the accounting course, for someone who had never had accounting, it changed what I was doing day-to-day, almost immediately,” says Hardwick.

“Likewise, my Business Law class changed how I approach things, how I notate and sign things.”

Just as importantly, Hardwick’s willingness to grow his knowledge has also impacted his company where both business and budget have grown by 300 percent under his guidance, allowing for the addition of three new facilities and expansion into Minnesota.

“It’s real time application. I am literally implementing things the next day by putting these things into practice,” he says. “I don’t have to wait for my next job–I’m using it every day.” ■

We’re building a bright future!

For over thirty years Prairie Lakes Healthcare System has grown with Watertown, SD and the region. We are proud of our growth and look forward to the completion of the current construction project in fall of 2018.

The project includes a 65,000 square foot Specialty Clinic building, helipad relocation, and east entrance canopy.

To learn more about the project visit www.prairielakes.com.

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Midwest Medical Edition

Learning Opportunities

Summer 2017 June 8 and 9

June 15

3:30 pm - 7:30 pm, 7:45 am - 4:00 pm

12:00 pm - 1:00 pm

Avera Sports Medicine Symposium

Sanford Imagenetics Lecture Series:

Location: Ramkota Hotel

Frontiers in Genetic Medicine

Information: 605-322-7879

Location: Sanford USD Medical Center, Schroeder Auditorium

averaeducationevents@avera.org Registration: Avera.org/conferences

June 23 - 24 7:00 am - 5:00 pm, 8:00 am - 12:30 pm

June 8 - 9

Sanford Black Hills Pediatric Symposium

10:00 am - 8:00 pm, 8:45 am - 3:00 pm

Location: The Lodge at Deadwood

SD Association of Healthcare Marketing

Information: 605-312-1067, tammi.miller@sanfordhealth.org

and Public Relations Summer Conference

Registration: http://www.sanfordhealth.org/classes-and-

Location: Cedar Shore Resort, Chamberlain, SD

events/events/annual-sanford-black-hills-pediatric-symposium

Information: 605-366-1479 Registration: Steff@MidwestMedicalEdition.com

Save the dates:

June 16

August 18 Sanford Diabetes Care Conference

9:00 am - 5:00 pm Innovation in Management of Cancer Conference: A Focus on Breast Location: Prairie Center, Avera McKennan campus Information: 605-322-7879 averaeducationevents@avera.org Registration: Avera.org/conferences

Midwest Medical Edition MED reaches more than 5,000 doctors and other healthcare professionals across our region 8 times a year. If you know of an upcoming class, seminar, webinar, or other educational event in the region in which these clinicians may want to participate, help us share it in MED. Send your submissions for the Learning Opportunities calendar to the editor at Alex@MidwestMedicalEdition.com.

September 8 6th Annual Sanford Imagenetics Genomic Medicine Symposium

Adam Nichols, DPM Adam Nichols, DPM

Gregory Neely, MD Gregory Neely, MD

FOOT OR ANKLE PAIN? CHOOSE CHOOSE THE THE EXPERTS EXPERTS

Call (605) 328-2663 to schedule a referral today.

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014000-00727 5/17 014000-00727 5/17

Jason Anderson, DPM Jason Anderson, DPM

If your patients complain about pain keeping If your patients complain about pain keeping them from enjoying life, it’s time to send them them from enjoying life, it’s time to send them to Sanford Orthopedics & Sports Medicine. to Sanford Orthopedics & Sports Medicine.

From routine care to more complex surgical From routine care to more complex surgical procedures, you can trust our experienced team procedures, you can trust our experienced team to help relieve your patient’s pain and improve to help relieve your patient’s pain and improve function. Our specialists have the training and function. Our specialists have the training and experience to help get your patients back to what experience to help get your patients back to what they love as quickly and safely as possible. they love as quickly and safely as possible.

Our treatments include: Our treatments include: • Arthritic joints • Arthritic joints • Bunions, hammer toes or ingrown toenails • Bunions, hammer toes or ingrown toenails • Diabetic wounds and infections • Diabetic wounds and infections • Flat or high-arched feet • Flat or high-arched feet • Neuromas or nerve problems • Neuromas or nerve problems • Sports injuries, fractures or dislocations • Sports injuries, fractures or dislocations

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