MED Magazine April May 2022

Sanford Celebrates a Year of Top Level Stroke Care Local Rural Hospitals Win Top Honors

APRIL MAY

Caring for Staff and Family Members: What to Consider

VOL. 13 NO. 3

2022

JOINING FORCES, IMPROVING HEALTH The Center for Neurosciences, Orthopaedics & Spine

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

One number is all you need to connect with the very best care for critically ill children.

1.855.850.KIDS (5437) is your 24-hour link to pediatric specialists for physician-to-physician consults, referrals, admissions and transport.

CARE

|

ADVO CACY

|

RESEARCH

|

E D U C AT I O N

97 56

OF DRUG OVERDOSES

% are Accidental. % are Opioid Related.

Emergency room overdose cases are increasing at an alarming rate, especially among young people (15-34), according to the latest SUDORS* data.

What can we do?

If your patients are taking prescription opiates or are at risk for overdose, encourage them to keep naloxone on hand and to learn how to use it. Family and friends who have naloxone on hand have helped many overdose victims survive.

Help your patients understand:

• The risks of taking opiates (prescription or illicit) • The dangers of mixing them with other substances • How to recognize the symptoms of an overdose And, encourage them to take advantage of the State Standing Order and get naloxone.

It may save a life.

Refer your patients and their families to the

Resource Hotline 1-800-920-4343

It’s FREE, confidential, and available 24/7

For more information on naloxone, the State Standing Order, or key data, visit AvoidOpioidSD.com *2020 State Unintentional Drug Overdose Reporting System (SUDORS)

Brought to you by the South Dakota Department of Social Services. Funding made possible through a Substance Abuse and Mental Health Services Administration (SAMHSA) grant.

Nothing in this PSA constitutes a SAMHSA endorsement of content, services, or policies.

VO LU M E 13 , N O. 3 ■ A P R I L / M AY 2022

Inside This Issue

CONTENTS PAGE 6 | Area Rural & Community Hospitals Rank Among the Country's Best PAGE 8 | This Month Online Articles you'll find only on the website, upcoming events, a preview of our ND & NE news service, and Ten Facts You May Not Know About MED

On the Cover

PAGE 12 | USD School of Health Sciences Success Spotlight: Aaron Harstein

Joining Forces, Improving Health

PAGE 14 | [SPONSORED] Sanford USD Medical Center Reaches the First Anniversary of Top Stroke Certification

The Center for Neurosciences, Othopaedics & Spine ■

By Alex Strauss

CNOS in Dakota Dunes has a long history of providers joining forces to achieve their mission of improving health in the tri-state region of Iowa, Nebraska, and South Dakota.

This year, it happened again.

We talked with two providers about what it means for Siouxland.

PAGE

10

PAGE 16 | NEWS & NOTES New awards, certifications, providers, and publications PAGE 20 | Program Fights Gestational Diabetes in Rural Areas PAGE 20 | Spencer Gathers Supplies for Medical Teams in Ukraine PAGE 21 | Sioux Falls Surgeon Takes Part in Innovative Weight Loss Procedure Trial PAGE 22 | The Risks of Treating Family Members and Staff

By Eric Zacharias, MD

FROM US TO YOU he weather might not reflect it quite yet, but spring has sprung here at MED! In addition to this shiny new issue of MED Magazine, we are celebrating a fresh new website, a new digital newsletter for Nebraska providers, and a blossoming list of subscribers. (If you are not yet among them, sign up for free at MidwestMedicalEdition.com!)

Things are also looking bright for the physicians of the CNOS Clinic in Dakota Dunes, this month's featured provider.

We spoke with two of their doctors for more on their new location, new physicians, new specialties, new events, and new ways this longstanding independent clinic is serving the Siouxland community.

Also in this issue . . . expert advice on navigating the complexities of treating staff or family members, the region's best rural and community hospitals, a new program that is successfully fighting gestational diabetes, and an inside look at Sanford's Comprehensive Stroke Center on its first anniversary.

Enjoy!

T

All the Best, —Alex & Steff

CONTACT INFORMATION

2022 ADVERTISING DEADLINES

STEFFANIE LISTON-HOLTROP

ISSUE

VP Sales & Marketing

JAN/FEB

Publisher / MED MAGAZINE, LLC Sioux Falls, South Dakota

605-366-1479

MARCH

Steff@MidwestMedicalEdition.com

APRIL/MAY

Vice President Sales & Marketing STEFFANIE LISTON-HOLTROP

ALEX STRAUSS

JUNE

Editor in Chief

JULY/AUG

Editor in Chief / ALEX STRAUSS

605-759-3295

SEP/OCT

Alex@MidwestMedicalEdition.com

NOVEMBER

Oct 10

WEBSITE

DECEMBER

Nov 10

Staff Writer / KIM LEE Graphic Design / CORBO DESIGN Web Design / SAMPSON HOUSE Digital Media Director / ALYSSA MCGINNIS

MidwestMedicalEdition.com

DUE Dec 10 Feb 10 March 10 May 10 June 10 August 10

NEXT ISSUE

MAILING ADDRESS

Editorial contributions due May 1

PO Box 90646, Sioux Falls, SD 57109

Ads due May 5

The New

MidwestMedicalEdition.com

Your premier source for medical community news in the Upper Midwest.

News, Events, Jobs, Information & More

Now easier than ever to find what you want, when you want it!

For advertising inquiries and news submissions: info@midwestmediacaledition.com 605-366-1479

Area Rural & Community Hospitals Rank Among the Country’s Best

S

EVERAL SMALLER HOSPITALS across our region have been recognized for outstanding results on the Chartis Rural Hospital Performance INDEX this year.

Compiled by The Chartis Center for Rural Health, this annual recognition program honors outstanding performance among the nation’s rural and critical access hospitals. Areas in which top hospitals particularly distinguish themselves include quality and outcomes, patient satisfaction, costs and charges, market share, and financial stability.

“Despite unprecedented adversity, rural providers continue to display resiliency and a steadfast commitment to their communities,” said Michael Topchik, National Leader, The Chartis Center for Rural Health. “Honoring the Top 100 is one of the high points of our year.

We are delighted to recognize the exceptional performance and innovation of this year’s recipients, particularly in light of the extraordinary challenges facing America’s rural health safety net.”

THREE OF THIS YEAR'S TOP 20 RURAL & COMMUNITY HOSPITALS ARE IN SOUTH DAKOTA AND TWO ARE IN IOWA. Prairie Lakes Healthcare System in Watertown was recognized as both a Top 100 and a Top 20 Rural & Community Hospital. PLHS has received the Top 100 award every year since

6

MidwestMedicalEdition.com

the list was introduced in 2016.

This is the fifth year that PLHS has made the Top 20 Rural & Community Hospitals list.

This year also marked Spencer Hospital's seventh consecutive place in the Top 100 list. Spencer Hospital is the only mid-sized Iowa hospital to have earned this distinction every year it has been awarded. Spencer Hospital and Lakes Regional Healthcare in Spirit Lake were the only Iowa hospitals to earn this year's Top 20 distinction.

Brookings Health System also made it onto the Top 20 list.

It is the fifth time in six years that the hospital has made this list, which puts them in the top one percent of rural hospitals.

Also on this year's Top 100 Rural & Community Hospitals list from our region were Avera St. Luke's Hospital in Aberdeen, Avera Queen of Peace in Mitchell, Avera St. Mary's in Pierre, and Avera Sacred Heart in Yankton. Avera Sacred Heart also made it onto the Top 20 list. The Top 20 winners will be honored during the NRHA's Annual Rural Health Conference in May. South Dakota hospitals to make the Top 100 Critical Access Hospitals list include Madison Regional Health System, Avera Hand County Memorial in Miller, Faulkton Area Medical Center, Mobridge Regional Hospital, Philip Health Services, Community Memorial Hospital Avera in Redfield, and Sanford Vermillion Medical Center. The Top 20 Critical Access Hospitals will be named in September. ❖

P E A C E

O F

M I N D

B E YO N D C O V E R A G E

As a premier medical liability insurance carrier, we are committed to you. We are extended members of your team to help answer questions or navigate difficult situations. And when it’s urgent, you have 24/7 access to a physician via our Risk Management Hotline.

That’s Value Beyond Coverage.

CALLCOPIC.COM | 800.421.1834

More than a workers' compensation insurance provider.

We're your partner in driving injury prevention.

RASCompanies.com

❱V isit our website for more on the Chartis Rural Hospital Performance INDEX and links to this year's full list of winners.

Midwest Medical Edition

APRIL / MAY

7

THIS MONTH ONLINE Highlighting content and opportunities available exclusively at MidwestMedicalEdition.com

Three Specialists Join Yankton Medical Clinic Care Team Yankton Medical Clinic, P.C. is pleased to welcome the addition of three new physicians:

Dr. Elizabeth Nicholas , Family Medicine For Dr. Elizabeth Nicholas, the Yankton Medical Clinic is the perfect place to continue her medical career. Upon graduation from the University of South Dakota Sanford School of Medicine and completion of a family medicine residency at the University of New Mexico, Dr. Nicholas has returned to the place where she spent her third and fourth years of medical school.

Yankton Medical Clinic’s newest otolaryngology specialist is no stranger to the clinic or his colleagues. While a third-year medical student, Dr. Robert Nicholas completed rotations with Dr. Micah Likness and Dr. David Abbott, both ENTs at YMC.

Internal medicine specialist Dr. Alan (A.J.) Spanel is now seeing patients at Yankton Medical Clinic, P.C. – Norfolk. Dr. Spanel has joined a healthcare team at the clinic that also includes Dr. Charles Harper and Certified Nurse Practitioner Kelly Jueden.

8

2. T he creators of MED launched the region's first medical news magazine in 2000 3. I n addition to this print magazine, MED includes a digital magazine, a comprehensive news website. and three digital newsletters

10

5. M ED now curates and shares medical community news and information in South Dakota, North Dakota, and Nebraska 6. M ore than 12,000 subscribers receive MED's digital newsletter every month

7. M ED accepts news and editorial contributions 24/7 from a five-state region 9. B etween them, MED's five-person team owns seven dogs, five cats, and one donkey

Upcoming EVENTS Sanford Heart & Vascular Symposium 7:00 am – 5:00 pm Location: Delta Hotel

by Marriott, Fargo

1. M ED has been serving healthcare professionals in the Upper Midwest for 12+ years

8. M ED is on Facebook and LinkedIn (Come find us!)

GET THE FULL STORY ON EACH OF THESE PHYSICIANS ON OUR WEBSITE.

April 9

TEN FACTS You May

4. M ED is created and produced entirely in the Dakotas

Dr. Alan Spanel , Internal Medicine

Sioux Falls Go Red for Women Event 5:30 pm – 9:00 pm Location: Sioux Falls Convention Center

Were you an essential worker during COVID-19 in the United States before a vaccine became available? If so, researchers at the University of Nebraska at Omaha invite you to participate in an online survey about your experiences. This survey should take no longer than 20 minutes to complete.

See our website for a link to the survey.

Not Know About MED:

Dr. Robert Nicholas , Ear, Nose & Throat

April 7

TAKE PART IN PANDEMIC RESEARCH

April 9

10. A subscription to MEDs Regional News Distribution Service is FREE

5:00 pm – 10:00 pm The 25th annual Northern Hills Hospice Ball Location: Spearfish Holiday Inn and Convention Center

April 13 – 14

11:30 am – 6:00 pm SDAHO Post-Acute Partners in Care Conference Location: 1201 Northwest Ave, Sioux Falls

April 22

8:00 am – 5:00 pm Innovations in Management of Pancreatic Conditions Location: Mayo Clinic Virtual Conference

MidwestMedicalEdition.com

Job Search

Digital Partners

If you are looking for a job in healthcare, or you have a position to fill, MED can help.

Search jobs by region or see all current jobs at MidwestMedicalEdition.com and click on the 'Jobs' tab at the topof the screen.

ONLY ONLINE

MidwestMedicalEdition.com is the only place online to find the very latest healthcare news headlines from South Dakota, North Dakota, and Nebraska.

Here are some recent examples:

♦ Sanford Health Welcomes New Adult and Pediatric Neurosurgeon to Bismarck

♦ Essentia Health Launches Cardiometabolic Clinic ♦ Columbus Community Hospital Trauma Center Receives

NURSING

Rapid City • Sioux Falls Vermillion • Online

State Designation

♦ Brain Injury Alliance of Nebraska Provides COVID-19 and

0 May 7

Concussion Management Tool for Nebraska Educators

♦ Physicians Thrive Releases The 2022 Edition Of Annual Physician Compensation Report

♦ Dr. Yeh Explores Innovative Treatments for Eye Inflammation Want news like this delivered directly to your Inbox every two weeks? Join the VIP List at MidwestMeditionEdition.com and select which of the three digital newsletters you'd like to receive.

9:00 am – 5:00 pm SD Team Hope Walk for Huntington's Disease Location: 4300 Oxbow Ave, Sioux Falls

FOLLOW US! Facebook.com/medmagazinesd Linkedin.com/company/midwestmedicaledition

Save the Date:

September 23 8:00 am - 4:00 pm CNOS Orthopaedic Symposium Location: Holiday Inn Express, Dakota Dunes

9

JOINING FORCES, IMPROVING HEALTH

The Center for Neurosciences, Othopaedics & Spine

MidwestMedicalEdition.com

T

HE CENTER FOR NEUROSCIENCES,

but they also want to stay here and support their local

Orthopaedics & Spine (CNOS) has a

healthcare facilities. This group and this model allows us

long history of providers joining forces

to treat people locally with advanced specialty care so

to achieve their mission of improving

they do not have to travel anywhere."

health in the tri-state region of Iowa, Nebraska, and South Dakota.

Fourteen Siouxland-area neurologists, neurosurgeons,

and orthopaedists — specialists that in some regions may

In addition to strengthening and expanding CNOS' orthopaedic offerings, the alignment with Tri-State allows CNOS to expand into two new specialty areas: dermatology and general surgery.

even view each other as competitors — combined their

"This coming together means we can meet more of

practices in 1998 to form the original clinic in Dakota

the needs of the community, not only in orthopaedics but

Dunes, South Dakota.

also in areas we have not been able to offer before," says

In the nearly 24 years since then, the team has expanded to 38 doctors, ten specialties, four clinic locations, 22 outreach sites, and more than 300 employees. Through partnerships with the Dunes Surgical Hospital, Mercy Medical Center and Unity-

CNOS 38

BY THE NUMBERS Physicians

22

309

Outreach locations Employees

9

Specialties

4

Clinic Locations

Point Health–St. Luke's, CNOS providers have contributed to HealthGrades 5-Star ratings in joint

neurosurgeon Hendrik Klopper, MD, who has been with

replacement, total knee replacement, total hip replace-

CNOS since 2017. "This is good for patients in the area and

ment, hip fracture repair, cervical spine and treatment of

good for us as an independent organization."

stroke.

Now, CNOS has formed yet another strategic alignment, this time with Tri-State Specialists, an independent multi-specialty practice in Sioux City.

NEW FACES, NEW SPECIALTIES

The group plans to add a gastroenterologist this fall.

INDEPENDENCE AND QUALITY TRACKING Both Althaus and Klopper say the fact that CNOS has remained independent for nearly 24 years, was a big selling point for them.

Tri-State and CNOS combined forces under the CNOS

"I feel like working for an independent organization

umbrella in January adding seven new physicians and

gives me the opportunity to treat patients the way I want

two new specialties. Former Tri-State orthopaedic surgeon

to treat them," says Dr. Althaus. "At CNOS, I have a lot of

Aaron Althaus, MD, a native of Sioux City, is one of them.

control to do what I want to do and to decide how I'm

"It was a very complimentary situation," says Dr.

going to approach each individual case."

Althaus of the merger. "We were able to bring some new

Like Althaus, Klopper is also a native of the Upper

things to the group. And they are a strong practice with

Midwest. Dr. Klopper grew up in Philip, South Dakota and

some advanced expertise and tools like the Mako Robotic

attended the University of South Dakota School of Medi-

System for joint replacement which allows us to offer

cine. He completed his neurosurgical residency at the

state-of-the-art care."

University of Nebraska Medical Center in Omaha and

Althaus, a native of Sioux City and a graduate of the

worked for a larger hospital system in Sioux Falls before

University of Iowa Carver College of Medicine, completed

coming to CNOS. Klopper says the advantages of inde-

his fellowship training at the Insall Scott Kelly Institute

pendence were especially apparent early in the

for Orthopaedics and Sports Medicine at the NYU Hospital

pandemic.

for Joint Diseases in New York City. He has both a broad

"One of the disadvantages in a bigger organization is

knowledge of orthopaedic injuries and conditions and

that there is some bureaucratic inertia and there is not

a deep understanding of the patients he serves.

much physician involvement in the day-to-day decisions,"

"We have a strong agricultural base and a largely blue

he says. "When COVID hit, there was a lot of change from

collar workforce that is loyal to the area," says Althaus.

a regulatory standpoint. We were able to make quick deci-

"People here want and need high quality orthopaedic care,

sions about how we were going to implement things and

Midwest Medical Edition

APRIL / MAY

11

USD School of Health Sciences

Success Spotlight Aaron Harstein Degree: PhD in Health Sciences Current Position: Associate Professor, Division of Physical Therapy, Shenandoah University Physical therapist Aaron Harstein already had a

manage this risk, sometimes within a couple of hours."

At the same time, Klopper says he appreciates the organization's commitment to tracking quality measures and continually improving, something he says is less common in independent practices.

faculty position as an Associate Professor of Physical Therapy at Virginia's Shenandoah University when he found the USD School of Health Sciences interprofessional PhD program in Health Sciences.

"Because I had been through both a residency and a fellowship program to hone my skill as a PT and had

"We are part of a national registry where every

achieved a level of clinical proficiency, I assumed that it

patient that has spine surgery is followed," explains

would be no problem to teach students in the classroom,"

Klopper. "We look at outcome measures–patient

he says.

reported and objective criteria–and compare these to

But after a few years of teaching, he realized that it

national benchmarks. We work to continue to stay

required a different skillset - one that he had not yet

above the national averages for these quality outcome measures. Not a lot of places outside of major medical centers are doing this."

PAVING THE WAY FOR FUTURE GROWTH CNOS has continued to expand its footprint across the region. In need of more space to accom-

mastered.

"I had a lot of depth in my profession, but not a lot of breadth," he says. "I could treat mechanical back pain very well, but I didn't have the breadth to understand things like how healthcare works in a larger organization."

Harstein says USD's program was not only flexible enough to meet his needs as an adult learner, but also offered the breadth of curriculum he was looking for.

modate the new physicians, the group opened its

"I was very attracted to the way USD splits credits

fourth clinic location in South Sioux City, Nebraska

between teaching, research, leadership, dissertation and

in March. In addition to the main clinic in Dakota

discipline-specific things," says Harstein, who says being

Dunes, the group also has clinics at Northside and

a part of a cohort of people in different disciplines also

Sunnybrook in Sioux City.

made for a richer experience.

The providers of CNOS now serve patients in 22 outreach locations from Spencer, Iowa in the north and Onawa in the south, west to Norfolk, Nebraska and as far east as Fort Dodge.

“We are between two fairly large medical markets and it is our goal to make sure the people in this area have access to the highest quality care, too,” says Dr. Althaus.

Althaus says the newest partnership between CNOS and Tri-State not only helps make this possible in the short term, but also paves the way for continued

"I can't say enough good things about the PhD in Health Sciences," he says. "I not only understand what works and what doesn't in the classroom, but I'm also a better clinician now. At the end of the day, we are educating our patients. Early in my career, I overemphasized skill and mechanics. Thanks to this program, I realize that those joints live inside of a person with beliefs, ideas, and experiences and all of that matters."

Congratulations to this USD School of Health Sciences success story!

growth and improvement.

“Having this larger, strong team improves our ability to recruit new well-trained specialists to the area," he says. "We also have established doctors who have been around for 30 years who have phenomenal experience. The combination of the two is invaluable.” ❖

12

This SUCCESS SPOTLIGHT brought to you by:

USD.EDU/HEALTH

MidwestMedicalEdition.com

Midwest Medical Edition

APRIL / MAY

13

[ S P O NS O R E D ]

SANFORD USD MEDICAL CENTER REACHES THE FIRST ANNIVERSARY OF TOP STROKE CERTIFICATION “Comprehensive Stroke Centers can handle any and all levels of complexity with stroke cases.

You really can’t have any better or higher level of care than this,” Dr. Sandhu said.

To earn the designation, the Sanford USD Medical Center had to adhere to a long list of eligibility requirements. Comprehensive Stroke Centers must have a dedicated neuro-intensive care unit with specialists able to provide care 24/7 and establish outstanding stroke research and education programs.

For surgical stroke care, centers must have a cerebrovascular neurosurgery team able to manage brain vessel pathology of any difficulty with microsurgical and endovascular approaches.

Hospitals must prove a commitment to performance improvements and meet strict outcome criteria to keep the designation. They also need to care for a minimum number of patients every year with various treatments, including surgical and pharmaceutical interventions.

Patient outcomes and safety must be the number one priority of a Comprehensive Stroke Center.

“There have to be redundancies of redundancies of redundancies and fail-safes for fail-safes for fail-safes,” Dr. Sandhu said. “There can be no such thing as a failure of the system.”

O

When applying for the certification, Sanford

ne year ago, the Sanford USD Medical

Health leaders found the hospital was already

Center was named a Comprehensive

meeting many of the stringent eligibility

Stroke Center by The Joint Commission.

standards. One area the leaders increased focus

It remains the only hospital to have

on was specialized education for all staff. The

earned this top certification in South Dakota.

Divyajot Sandhu, MD, is an Interventional Neurologist at the Sanford USD Medical Center and has seen firsthand the certification’s impact on

certification requires that anyone who provides any level of care to a stroke patient needs to undergo extensive training.

“The training applies to everyone from bedside

the community.

14

MidwestMedicalEdition.com

“This certification isn’t just a plaque hung on the wall. It has real results.” nurses to interventionalists to neurosurgeons —

the most advanced certification has its benefits.

basically everyone a stroke patient comes in contact

“This certification isn’t just a plaque hung on the

with. They all need to know how to care for patients

wall. It has real results,” Dr. Sandhu said. “Numerous

with stroke needs,” Dr. Sandhu said. “That’s part of

studies and patient analyses prove consistently

why we can provide better care than any hospital that

across the board that patients in locations across

isn’t a Comprehensive Stroke Center.”

the world that meet these standards do better. As

Like all other aspects of the designation criteria,

in a several percentage point increase in the number

the education standards

of stroke patients who

were demanding.

survive their stroke or

“It wasn’t just an

the number of people

online test that you could

who were discharged

do at home with a glass of

back home instead of to

wine,” Dr. Sandhu said. “It

a nursing home.”

required a lot of education

The Sanford USD

and testing to be better

Medical Center has seen

prepared for neurovascu-

these results in the last

lar patients.”

year.

Even after a hospital

“Because of the desig-

has met the eligibility

nation and the increase

criteria and completed

in the number of folks

thorough surveys, the

we can help, we have

designation is an ongoing

seen more patients do

process that requires a

better than a year or two

systematic review every

ago. It’s not just volume.

two years. To remain a

We’ve had more people

Comprehensive Stroke

do better,” Dr. Sandhu

Center, hospitals must

said.

prove they have main-

In addition to meeting

tained or improved their

the higher certification

standards and care for

standards, the specialists

stroke patients.

“The certification does require quite a bit more work than we had to do before we were a Comprehensive Stroke Center,” said Dr. Sandhu. “But all of that work is worth it.”

The Joint Commission offers a range of stroke care designations, including several with less rigorous requirements than the Comprehensive Stroke Center certification. These lower designations are awarded

at the Sanford USD Medical Center are holding themselves to higher standards.

“We’ve been keeping a much closer eye on ourselves and are harsher critics of ourselves than before,” Dr. Sandhu said. “And now we’re doing better than we ever were before.”

Sanford Health is proud to be the only location in the region to offer stroke care at this caliber.

to hospitals with dedicated stroke programs. However,

“The closest Comprehensive Stroke Center would

they cannot care for certain complex cases, and while

be Sanford Fargo. And then Minneapolis to the east

they have certain specialists on staff, they aren't

and Omaha to the south. For the west, I think you’d

available on-call 24/7.

have to hit Denver,” said Dr. Sandhu. “As far as stroke

For Comprehensive Stroke Centers or international locations that meet similar standards of care, pursuing

Midwest Medical Edition

APRIL / MAY

care is concerned, you can’t go anywhere better than here. There’s no need for a patient to travel.” ❖

15

Happenings around the region

News & Notes

South Dakota | Southwest Minnesota | Northwest Iowa | Northeast Nebraska

SANFORD JARED ANTCZAK

MONUMENT Monument Health was selected as the 2021 Collaboration Champion in the Workday Healthcare Innovation Awards.

Workday software is used throughout Monument Health for financial management, human capital management (HCM), payroll and supply chain operations. It also helps with inventory and procurement. The goal behind Monument Health's award-winning project was to collaborate with Workday and other Workday users who were planning to implement procurement and inventory. The teams organized monthly discussions to brainstorm solutions to supply chain problems. Since going live, the project has evolved to include optimization, customer networking and discussions in HCM, Finance and Payroll.

AMBER STEINER Amber Steiner, RN, with Rapid City Hospital Oncology, has received the prestigious DAISY Award for extraordinary nursing. She was nominated by a traveling nurse who said Steiner went above and beyond to help her feel welcome and set an excellent example for all of her fellow caregivers to follow.

16

Jared Antczak is the new chief digital officer at Sanford Health. Antczak comes to Sanford Health from Highmark Health in Pittsburgh where he served as vice president and head of digital product, leading the digital vision for their enterprise. In his new role, Antczak will lead Sanford Health’s overall digital strategy. His hiring comes at an opportune time, following the launch of Sanford Health’s virtual care initiative. The initiative includes construction of a 60,000 square-foot building scheduled to begin later this year which will expand access for patients and residents by utilizing advanced technologies to provide care closer to home. Antczak holds an MBA from Wake Forest University.

Sanford Health is updating its recommendation for when to get a colorectal cancer screening. Those at average risk should start regular screenings at age 45, which is lowered from age 50. According to the CDC, while colorectal cancer rates have decreased for people over 50 years old, they have climbed 51% since 1994 for those under 50. Lowering the recommended age for a screening will help detect an issue early before symptoms begin and when the cancer is most preventable.

Dr. Paola Vermeer, PhD, an associate scientist at Sanford Research, along with neuroscientist colleague Jeff Barr, and other scientists in her lab recently published a study illuminating how intra-tumoral neurons impact cancer.

The study was conducted in partnership with the University of Pennsylvania.

The study titled "IntraTumoral Nerve-Tracing in a Novel Syngeneic Model of High-Grade Serous Ovarian Carcinoma" appears in the December issue of the journal Cells.

MidwestMedicalEdition.com

EARN 2 FREE CMEs Complete the South Dakota CHW Planning and Assessment Toolkit www.chwsd.org/chw-toolkits/

WOR K I N G H AN D I N H A N D : T H E VALU E OF COMMU NITY H E ALTH WORKERS (C HW HWs)

I wish to have a game room Pate, 7

ild h C rA

Lymphoma

Refeto receiveg awish. ngin

ha life-c

Photo credit: Anna Mira Photography

Midwest Medical Edition

APRIL / MAY

Scan to refer a child.

REFER TODAY AT WISH.ORG/MEDICAL-REFERRAL

17

• Happenings around the region

News & Notes

Happenings around the region

Expanding Here Today

COMMITTED TO CARE ALWAYS

CNOS has added a new location to the Riverfront area at 201 E 4th Street, Suite 202, in South Sioux City. Our team looks forward to continuing expanded, comprehensive and patient-centered care.

NEUROLOGY • NEUROSURGERY • ORTHOPAEDICS PODIATRY • RHEUMATOLOGY • SPINE DERMATOLOGY • GENERAL SURGERY

Sanford Health has launched a new brand campaign, “Here for all.

Here for good.” which emphasizes the health system’s commitment to providing world-class care for families and communities across the upper Midwest. Central to this campaign is a focus on improving access to care in rural communities – where two-thirds of Sanford Health patients live. The multi-faceted brand campaign includes TV commercials, billboards, social media content and high-impact visuals in hospitals, clinics and landmarks across Sanford Health communities – including grain bins on rural farms across the region.

Sanford Health will soon be partnering with Flexwise, a healthcare technology provider based in Nashville, to implement data analytics and artificial intelligence designed to optimize the scheduling of its more than 10,000 nurses. The partnership aligns with Sanford’s goal of improving clinical staffing by scheduling workforce activities through a system-wide application of patient demand forecasting. By working with a hospital’s existing electronic medical record, staff scheduling and time & attendance applications, the Flexwise platform brings all data together in one place to optimize clinical workforce staffing decisions.

AVERA Avera Health marked the second anniversary of the COVID-19 pandemic by sharing some notable statistics. The health system has • Performed over 690,000 COVID-19 tests with over 88,000 positives • Delivered over 247,000 vaccinations • Given 15,700 various treatments for COVID • Hospitalized over 8,300 people • Cared for over 8,400 people in its specialized at-home monitoring program • Facilitated over 220,000 virtual visits between patients and their providers

REFER TO 605-217-2667, OPTION 7.

CNOS.NET

18

❱ Intrigued by something you’ve read here? Want to go deeper? Read the full versions of these and other recent news items on our website.

MidwestMedicalEdition.com

INDEPENDENTS Yankton Medical Clinic, PC, has expanded its 25-year-old scholarship program this year thanks to a $5,000 donation from Yankton residents Neal and Marie Bowden. The donation will provide an additional five $1,000 scholarships to students enrolled in a nursing program who meet the conditions of the YMC scholarship program for the 2022-23 academic year. In addition to the five nursing scholarships, YMC awards five $1,000 scholarships to area high school students, one $1,000 to a nursing, radiology, medical lab or respiratory therapy student, and a $5,000 scholarship to a medical student at USD.

Midwest Medical Edition

APRIL / MAY

SIOUXLAND CINDY DUNCAN

AMADIN OSAYOMORE Amadin Osayomore, MD, has joined the ER staff at Prairie Lakes Healthcare System. Dr. Osayomore is a board certified family physician. He has served patients in Emergency Medicine for almost 10 years. Dr. Osayomore completed his internal medicine residency at the University of Benin Teaching Hospital in Edo State Nigeria. He joins Dr. Erickson, Dr. Filler, and Dr. Singh in providing for patients with emergent medical needs.

St. Luke’s College Respiratory Care Program Director, Cindy Duncan has been appointed to serve on the Board of Respiratory Care and Polysomnography for the state of Iowa.

Duncan applied to serve on the board and was chosen by Governor Reynolds to represent respiratory care professionals in western Iowa. Duncan has been a strong advocate for the Respiratory Care profession and has represented her peers in multiple capacities for the Iowa Society for Respiratory Care. Her three-year appointment will begin in May of 2022.

MercyOne says it is strengthening its commitment to helping individuals live their best lives with the launch of a subscription-based wellness platform called Circle+ powered by MercyOne. Members who sign up and complete the initial assessment unlock access to a suite of app-based resources from Circle+ powered by MercyOne partners. The apps include workout videos, recipes, fitness tracking and other resources. Membership is open to anyone, regardless of whether or not they are MercyOne patients.

19

• Happenings around the region

News & Notes

Fighting Gestational Diabetes in Rural Areas

A

VERA WOMEN’S HEALTH profes-

takes funding and reimbursement can take a

sionals knew the problem they faced

long time. “The Health Resources & Services

— gestational diabetes — was tough to

Administration grant got this program started,”

treat in rural settings. But a federal

McKay added. The program now serves patients

grant and a dedicated, patient-centered approach

in Minnesota and soon will reach patients in

has helped “the little program that could” succeed

Iowa and Nebraska, as well.

for moms and babies.

“We met with moms-to-be in bathrooms, break rooms and teachers’ lounges,” said Kimberlee

THE THREAT WORTH FACING AND STOPPING Gestational diabetes is often symptomless

McKay, MD, with Avera Medical Group Obstetrics

and if unnoticed, can lead to high blood pressure,

and Gynecology. “We made it convenient for every

preeclampsia and other serious complications. It

patient, and we were able to coach, chart and coax

also doubles the chance the newborn will contract

them, even if they were hours away from us.”

type 2 diabetes later in life.

Teams including registered dietitians and

“We developed a specialized blood sugar

certified diabetes educators used Avera’s virtual

monitor to track numbers,” McKay said. “We also

visit platform to meet with moms in South Dakota.

had to do a lot of talking and teaching. That can

The program began in 2016, and now can show its results, which include: ◆ A decrease in vaginal delivery complications of almost 27% ◆ A decrease in cesarean delivery complications of 17.6% ◆ A reduction in the number of infants born at weights of 4000 grams or more “Our hypothesis was whether or not this sort of coaching and counsel would work – and it does,” says McKay. “The tools can help every patient.”

But making them available to every patient

be daunting via telehealth.”

Since it began, the program has served more than 450 patients.

CREATIVE COACH FOR PATIENTS IN “FOOD DESERTS” The Avera teams knew the limits of the locations where their patients lived. Advising them to “eat more fresh food” wasn’t always easy.

McKay says coaches were able to make it simpler by advising on things like healthier choices at convenience stores or fast food restaurants.

“When we can provide an ‘easy’ button, we can help ensure better outcomes,” says McKay. ❖

SPENCER GATHERS SUPPLIES FOR MEDICAL TEAMS IN UKRAINE IN MARCH, SPENCER HOSPITAL’S SUPPLY chain team and plant operations team gathered medical supplies — many items to be used in trauma care as well as orthopedic surgical items — and filled a van which transported the items to Montgomery County Memorial Hospital in Red Oak. Those items, along with donations from several other Iowa hospitals, will be prepared to be shipped the more than 5,000 miles to Ukraine, to support medical teams there. ❖ Pictured, left to right: Joel Wassom, Plant Operations director; Karen Brandt and Brad Smith, Supply Chain leaders.

20

MidwestMedicalEdition.com

SIOUX FALLS SURGEON TAKES PART IN INNOVATIVE WEIGHT LOSS PROCEDURE TRIAL

A

S A BOARD-CERTIFIED general

but the ESG is specifically for a category of

surgeon with Surgical Institute of

patients who fall into a sort of gray area — a

South

Dr.

group of people who often struggle because

Bradley Thaemert has performed

they might be overweight or have diabetes

more than 1,000 bariatric weight

but don’t qualify for weight-loss surgery,”

Dakota

since

1998,

loss procedures, including gastric bypass,

said Dr. Thaemert.

gastric band and gastric balloon proce-

The MERIT study followed 280 patients

dure, as well as the innovative procedure

who had the ESG procedure done. One year

of Endoscopic Sleeve Gastroplasty (ESG).

into the two-year study, participants had 45%

As one of only a handful of surgeons in

more excess weight loss as compared to just

the country who do the ESG procedure, Dr.

making lifestyle diet and exercise changes.

Thaemert recently took part in a

After two years, 91% of patients had

multicenter trial sponsored by the

maintained their weight loss.

Mayo Clinic. The Multi-center ESG

“We are seeing good results

Randomized Intervention Trial, or

and received expected outcomes,”

MERIT, included the participation

Dr. Thaemert said. “We weren’t

of nine medical groups throughout

expecting

the United States.

patients to lose as much weight

the

MERIT

study

“The trial was based on the ESG

with this procedure as patients

procedure, a non-surgical outpa-

with gastric bypass would, and

tient weight loss procedure, done through the mouth, where the stomach

that is exactly what happened. The results fulfilled our expectations.”

volume is reduced by 80%,” Dr. Thaemert

A fellow of the American College of

explained. “There are only a handful of us

Surgeons, Dr. Thaemert graduated from the

that do the procedure and it is not covered

University of Minnesota School of Medicine

by most insurance companies.”

and completed his general surgery residency

Modifying that was one of the study’s

at Gunderson Medical Foundation-Lutheran

primary goals. “We hope the results of this

Hospital in LaCrosse, Wisconsin. His

research helps communicate to insurance

bachelor’s degree is from the University of

companies that the procedure is safe and

Minnesota-Duluth.

effective and should be covered,” Dr. Thaemert said.

Professionally, Dr. Thaemert is an active

Because ESG is a minimally invasive

Association (SDSMA), the American College of Surgeons (ACS), the American Society for

and on an outpatient basis, it is an excellent

Metabolic and Bariatric Surgery (ASMBS),

option for people who are obese but not inter-

the Society of Laparoendoscopic Surgeons

ested in a permanent procedure. Those who

(SLS), the Society of American Gastrointes-

want to lose about 50 pounds; who have a

tinal and Endoscopic Surgeons (SAGES) and

fear of surgery; or who don’t want scars from

the Seventh District Medical Society. He

incisions are good candidates for the proce-

served as the South Dakota chair of the

dure. Patients who opt for the ESG procedure

Committee on Trauma for the American

typically have a body mass index of 30-40.

College of Surgeons and is the medical

not as significant as with gastric bypass,

Midwest Medical Edition

APRIL / MAY

”

member of the South Dakota State Medical

weight loss procedure done endoscopically

“Weight loss with the ESG procedure is

“

WE HOPE THE RESULTS OF THIS RESEARCH HELPS COMMUNICATE TO INSURANCE COMPANIES THAT THE PROCEDURE IS SAFE AND EFFECTIVE AND SHOULD BE COVERED.

director for the Avera McKennan Bariatric Institute. ❖

21

The Risks of Treating Family Members and Staff

BY ERIC ZACHARIAS, MD

CASE STUDY 1 An ENT physician schedules his wife for a nasal reconstruction procedure that he will perform. Upon learning this, the surgery facility manager calls the physician to discuss concerns about the appropriateness of him performing this procedure.

The physician says he is “the best at this surgery in town” and wants to ensure his wife receives top-notch care.

Analysis

URI might lead to a lymph node biopsy

In the first case, the physician is

normally, you might have waited three

unaware that his actions represent a

months. Personal feelings may com-

concern outlined by the American

promise the objectivity of the clinician

Medical Association’s (AMA) Code of

and make the delivery of sound care

Medical Ethics1 which states “When

a challenge.

the patient is an immediate family member, the physician’s personal feelings may unduly influence his or her professional medical judgment.”

In the second case, the patient survives but has an expensive and extensive hospital stay. The physician struggles seeing the medical assistant every day and feels guilty. Six months later, the physician feels the medical assistant's performance is poor, but is hesitant to fire her as there may be a risk of litigation.

CASE STUDY 2 A rural family practice physician often treats her staff and their family members for free. She sees her medical assistant’s 12-year-old son for an upper respiratory tract infection.

The physician opts for conservative treatment and makes no record of the visit. Three days later, the patient presents to the ER with shaking chills and pneumonia. A prolonged hospitalization follows.

Concerns and Risks Confidentiality — We recognize that in smaller communities, you might truly be the best provider for

see family members or staff, you should complete the same documentation as you would for any patient.

When possible, you should treat the person in the office. If there is an emergency situation, then you should communicate any actions taken with the person’s provider. The natural tendency to “curbside” treat and either not or insufficiently document can result in serious diagnostic oversights, medication and prescription errors borne out of informal and quick assessments, and a minimization of serious illness that could possibly lead to preventable harm.

Embarrassing illnesses — Employ-

records might be easy for a coworker

ees/family members might present

to peruse whether electronically or in

with STDs, injuries from abuse, or

a paper form. HIPAA violations might

other ailments that they don't want

occur. If you are treating employees,

others to know about. Would you have

then there should be a strong confiden-

concerns in dealing with this? Will you

tiality policy in place. Your policy

be able to perform the complete phys-

should be consistent and well commu-

ical exam necessary with someone you

nicated to the whole staff.

see every day? More importantly, will

Diagnostic reasoning — We practice best in situations when we have of a sage clinician. Professional relationships with your patients are usually fiduciary in nature. When you

22

Documentation — If you decide to

your staff. But be aware that office

the calm diagnostic decision making

❱F or more background on the stance of the AMA and the American College of Physicians, read the extended version of this article online

because of an affection bias, whereas

you ask the necessary questions to properly diagnose and treat the person?

Eric Zacharias, MD, is with the COPIC Department of Patient Safety and Risk Management.

care deeply about someone, this might tilt your clinical acumen one way or the other. A small lymph node after a

1. w ww.ama-assn.org/delivering-care/ethics/ treating-self-or-family 2. N Engl J Med. 1991 Oct 31;325(18):1290-4.

MidwestMedicalEdition.com

KNEE

The first to offer ROSA robotic technology in the Black Hills

KEEPS US MOVING. A new knee for a more active you.

Thanks to robotic technology.

Having chronic knee pain shouldn’t mean giving up the things you love. Thankfully, Monument Health has a new way to keep you moving: ROSA Knee robotic technology. Our specially trained surgeons use ROSA Knee to personalize the approach to total knee replacement — providing a solution that works for you and your unique anatomy. Contact Monument Health today to find out whether treatment is right for you, and the risks of knee replacement.

Learn more at monument.health/rosa

Zimmer Biomet is a medical device manufacturer that provides products and other services used by health care professionals to create personalized care plans.

Zimmer Biomet is not a medical professional and does not practice medicine.

Zimmer Biomet is not responsible for the content of monument.health/rosa. The persons in these advertisements are models and not actual recipients of Zimmer Biomet products and services. Results are not necessarily typical and will vary due to health, weight, activity and other human variables. *Not all patients are candidates for joint procedures or ROSA Knee robotic technology. Only a medical professional can determine the treatment appropriate for your specific condition.

Talk to your surgeon about whether joint replacement is right for you and the risks of the procedure, including the risk of impact wear, loosening, breakage, failure or risk of infection, all of which could require additional surgery. For general information on joint pain and technology, visit www.zimmerbiomet.com or call 1.800.447.5633. ©2019 Zimmer Biomet.

Monument Health Orthopedics Rapid City 1635 Caregiver Circle | 605-755-6100 Spearfish 2479 East Colorado Blvd. | 605-644-4460

THE ONLY JOINT COMMISSION APPROVED ADVANCED COMPREHENSIVE STROKE CENTER IN SOUTH DAKOTA

For more information, contact the Sanford Neuroendovascular team.

For emergent or urgent needs 24/7, call Sanford One Call: (605) 333-4455.

With the highest level of stroke certification, Sanford Health’s advanced stroke care team is certified to treat even the most complex stroke cases. A rapid response from our skilled specialists can make all the difference.

The faster you can spot a stroke – the sooner we can stop it. Call 911 at the first sign of stroke to visit the nearest Sanford Health emergency room.

DIVYAJOT SANDHU, MD Interventional Neurologist

982-374-302 Rev. 3//22