ORTHOPEDICS Medical Group
Contents Midwest Medical Edition
December 2010
Cover Feature
Regular Features 2 |
Publisher’s/Editor’s Page
20 |
Grape Expectations
Adding Sparkle to Your Holiday By Heather Taylor Boysen
31 |
News & Notes News from around the region
32 |
Learning Opportunities Upcoming Symposiums, Conferences and CME Courses
Top Stories
In This Issue
By Alex Strauss
3 | Using Social Media: Guidelines for Physicians 5 | Midwifery and Home Birthing: A Perennial State Legislative Issue
2010
By Dave Hewett
12 | Strategic Focus: Planning Your Health IT Team By Jamie Husher
A Season in Review
13 | Sanford Opens Simulation Training Center 19 | Kapaska Named CEO of Avera McKennan Hospital & University Health Center 26 |
Slips, Trips and Falls in the Workplace By Lori Berdahl
30 | AHA ‘Go Red’ Conference Set for February
In Review Nudge: Improving Decisions about Health, Wealth and Happiness
by Richard H Thaler and Cass R Sunstein House Calls and Hitching Posts: Stories from Dr. Elton Lehman’s Career Among the Amish
As told to Dorcas Sharp Hoover
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Just in case you missed it . . . Midwest Medical Edition (MED) Magazine came on the scene in 2010 with a mission to inform and educate area healthcare providers on the extraordinary people and programs advancing medicine in the upper Midwest. In our Cover Feature this month, we review our first year’s Top Stories. We hope that these excerpts will inspire you, not only to respect the individuals featured, but to nominate others you think would make a great cover or feature story in 2011. Fill out and fax the Nomination Form in this issue, or email the publisher at Steff@MidwestMedicalEdition.com.
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From Us to You
Staying in Touch with MED
Steffanie Liston-Holtrop
Alex Strauss
H
appy Holidays from all of us at MED. As we close out our first year of publication, we want to extend our heartfelt thanks to all of you who have helped to make this dream a reality. We appreciate all of the marketing directors, advertisers, advisors, consultants, and – especially – you, our readers. Without your continued support, feedback and contributions, this magazine could not continue to exist and grow. In addition to our wrap-up of cover feature stories this month, we once again bring you columns from experts around the region. SDAHO’s president discusses the highly charged politics behind lay midwifery. We have tips for running a more technically savvy practice from a healthcare IT specialist. There are news items from hospitals and health systems from around the region, tips for buying sparkling wine, once again, reader reviews of books you may want on your own shelf. As always, we welcome your contributions, whether it be your thoughts on a book, your memories for our Then & Now column, an event or news item you’d like to publicize, or something else. Our mission is to be a premium communication tool for this wide and diverse medical market. Put us to work for you and let us know how we’re doing! Finally, we enjoyed seeing so many of you at the opening events for the Avera Cancer Institute last month. It is always gratifying to celebrate this type of milestone event in our medical community. We look forward to many more in the months and years to come. Our best wishes for a happy and health holiday season for you and yours, —Alex & Steff
MED is looking for reader contributions to our In Review and Then & Now columns. If you have thoughts on a book or movie that you think would interest your colleagues, please take some time to share them. Then & Now welcomes contributions from readers who can share insights on the many ways things have changed in our medical community over the years. Send your ideas and articles to Alex@MidwestMedicalEdition.com.
Publisher Editor in Chief
Cover Design Design/Art Direction Web Design Contributing Writers Advisory Board Published by
Steffanie Liston-Holtrop Alex Strauss Darrel Fickbohm Corbo Design 5j Design Charlotte Hofer Kenneth Scott, MD Heather Boysen Dave Hewett Lori Berdahl Jeff Boonstra Jamie Husher Paul Krueger Patty Peters, MD John Berdahl, MD Mary Berg, MD Michelle L. Daffer, MD James M. Keegan, MD Timothy Metz, MD Patty Peters, MD Juliann Reiland-Smith, MD Luis A. Rojas, MD Daniel W. Todd, MD MED Magazine, LLC Sioux Falls, South Dakota
Contact Information Steffanie Liston-Holtrop, Publisher 605-366-1479 Steff@midwestmedicaledition.com Alex Strauss, Editor in Chief 336-295-3017 Alex@midwestmedicaledition.com Fax 605-271-5486 Mailing Address PO Box 90646 Sioux Falls, SD 57109 Website MidwestMedicalEdition.com
2010/11 AD / Editorial Deadlines Jan/Feb Issue Dec 5th
April/May Issue March 5th
Sept/Oct Issue August 5th
March Issue Feb. 5th
June Issue May 5th
November Issue October 5th
July/August Issue June 5th Reproduction or use of the contents of this magazine is prohibited.
©2010 Midwest Medical Edition, LLC Midwest Medical Edition (MED Magazine) is committed to bringing our readership of 3500 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.
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Midwest Medical Edition
AMA urges physicians to take action against inaccurate insurance claims The American Medical Association (AMA) is urging physicians to take action this fall against inaccurate payments from private health insurers. The AMA designated November as Heal that Claim™ month and is supplying physicians with tools to fight flawed and inefficient claims processing by health insurers. One in five medical claims is processed inaccurately by commercial health insurers, according to the AMA’s National Health Insurer Report Card. A 20 percent error rate costs an estimated $15.5 billion annually. The administrative costs of ensuring proper insurance payments takes a heavy financial toll on physicians, and can consume up to 14 percent of their earned revenue. “The AMA’s goal is to significantly reduce the administrative costs of processing claims from 14 percent to one percent and allow doctors to focus on caring for patients, instead of battling health insurers over delayed, denied or shortchanged medical claims,” said AMA President Cecil B. Wilson, M.D.. Fall is an ideal time for physicians to bolster their efforts at appealing inappropriately denied claims since health insurers often increase claim denials during the last quarter of the year. The AMA is helping physicians overcome claims obstacles by offering online resources to help prepare, track and appeal claims. These resources include template appeal letters, printable checklists and logs that help physicians simplify their claims management system. More information is available on the AMA’s website. ■
December 2010
Using Social Media Guidelines for Physicians
Millions of Americans use social networks and blogs to communicate, but when those users are physicians, challenges to the patient-physician relationship can arise. The American Medical Association has adopted a new policy aimed at helping physicians to maintain a positive online presence and preserve the integrity of the patient-physician relationship. The new policy encourages physicians to:
• Use privacy settings to safeguard personal information and content to the fullest extent possible on social networking sites.
• Routinely monitor their own Internet presence to ensure that the personal
and professional information on their own sites and content posted about them by others, is accurate and appropriate. • Maintain appropriate boundaries of the patient-physician relationship when interacting with patients online and ensure patient privacy and confidentiality is maintained. • Consider separating personal and professional content online. • Recognize that actions online and content posted can negatively affect their reputations among patients and colleagues, and may even have consequences for their medical careers.
MidwestMedicalEdition.com
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Call for Nominations Nominee:
MED Magazine is seeking Nominations for Cover Article topics for 2011. MED is committed to focusing on pioneering physicians, institutions, programs and technologies that are paving the way for the future of healthcare in our region. If you know of a person or program that deserves a closer look, please let us know. Please fill out the form and fax or email to:
Steffanie Liston-Holtrop, Publisher Midwest Medical Edition 4609 S. Baha Ave #201 Sioux Falls, SD 57106
Title:____________________________________________________________________________ Location of Practice:_____________________________________________________________ City:____________________________________________________________________________ State:____________________________________________________ Zip____________________ Phone__________________________________________________________________________ Email:___________________________________________________________________________ Reason for Nomination:__________________________________________________________ Your Name:_ ____________________________________________________________________ Title:____________________________________________________________________________
Phone: 605-366-1479 Fax: 605-271-5486 steff@midwestmedicaledition.com
Phone:__________________________________________________________________________ Email:___________________________________________________________________________
Deadline December 31, 2010
The Med Magazine Advisory Board
Mary Berg, MD, Family Practice Sanford Clinic Family Medicine, Sioux Falls
Michelle L. Daffer, MD, Dermatology Midlands Clinic, PC, Dakota Dunes
James M. Keegan, MD, Infectious Disease Regional Health System, Rapid City
Timothy Metz, MD, Anesthesiology Anesthesiology and Pain Management, Sioux Falls
Patty Peters, MD, Family Practice Avera McGreevy Clinic, Sioux Falls
The less cancer there is, the more birthdays there will be. Patients count on you to remind them of what they can do to prevent cancer. Remind your patients of appropriate screenings and healthy lifestyle choices. © 2010 American Cancer Society, Inc.
John Berdahl, MD, Ophthalmology Vance Thompson Vision, Sioux Falls
Juliann Reiland-Smith, MD, Breast Surgery Comprehensive Breast Care, Sioux Falls
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Luis A. Rojas, MD, Gynecologic Oncology Avera Women’s Center for Gynecologic Cancer, Avera Cancer Institute, Sioux Falls
You can help create a world with more birthdays. Visit morebirthdays.com. Or call 1-800-227-2345. Together we’ll stay well, get well, find cures and fight back.
Daniel W. Todd, MD, Otolaryngology Midwest Ear, Nose & Throat, P.C.
Midwest Medical Edition
Midwifery and Home Birthing A Perennial State Legislative Issue By Dave Hewett, President/CEO, SDAHO
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hen South Dakota’s 86th Legislative Session convenes this coming January 11, physicians and the rest of the health care community can expect the lay midwifery issue will, once again, be part of the “issue mix” in Pierre. The issue has been around for years, and by all accounts those who favor legislation proposing the state licensure or certification of lay midwives have been getting farther in the legislative process. Typically, the myriad of health care provider groups opposing the legislation wait until some midwifery bill is introduced and react to it. That approach has proven sufficient…until now. But it needs to be understood that the proponents of this legislation are advocating on this issue throughout the year and it is the only issue they are talking to legislators about whether it’s during Session or sometime in July. For those of us who oppose this legislation, the issue boils down to one thing – ensuring the public safety. A July editorial from The Lancet.com probably summed up our concerns the best when it said:
But statistics and studies alone won’t be enough this coming legislative session. The clinical knowledge, personal experiences, and genuine prestige that South Dakota physicians bring to this debate is the most effective way to present this issue. Birthing outcomes have improved so much over the years that the public generally assumes that all outcomes are good. We know that despite all the advancements that isn’t always the case. Our outcomes are better because of better research, training, facilities and equipment. That cannot be taken for granted. That is the message South
Dakota’s State Legislators need to hear from their physicians as they begin this 86th Legislative Session. ■
A recent meta-analysis published in the American Journal of Obstetrics & Gynecology provides the strongest evidence so far that home birth can, after all, be harmful to newborn babies . . . The data show that planned home births to healthy and low-risk mothers compared with planned hospital births in the same group of women doubled the risk of neonatal deaths. December 2010
MidwestMedicalEdition.com
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MED Magazine takes pride
in bringing our readers a wide range of stories each year, from the largest health systems, to the most progressive independent practices and exceptional individual providers. The people and programs featured on our Cover have been nominated by their peers and represent some of the best and brightest in their respective specialty areas, working to further the cause of high-quality healthcare in our region (and sometimes outside our region). This month, we take another look at those Top Stories – as well as some of the more noteworthy news items –from our first year. Following are excerpts from the pages of this year’s MED Magazine.
Top Stories
2010
A Season In Review By Alex Strauss
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Caring for a Needy World Local Doctors Travel the Globe to Give Back
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hile most doctors today would not seriously consider forgoing the technology and other advantages in their modern offices for the chance to practice in a more primitive way, some do get that opportunity by volunteering to practice with charitable organizations that put their skills to use in some of the most impoverished parts of the world. MED talked to several area physicians who have made medical missions work a part of their professional lives. Dr. John Berdahl, Ophthalmologist, Vance Thompson Vision has devoted a portion of his medical career to performing cataract surgery and other eye care in such exotic locales as Mexico and Burma, the poorest country in Asia. “We always have people who don’t recognize themselves in a mirror because they had been blind for so long. We have people who have never seen the face of a grandchild or didn’t recognize a spouse. Not only does this surgery quickly restore their sight, but it offers a permanent solution,” says Dr. Berdahl. Dr. Adam Stys and Dr. Tom Stys, Cardiologists, Sanford Heart Hospital, brothers who grew up outside the U.S., have worked in an African leprosy hospital, delivering basic care in exchange for room and board. “Subspecialty medicine such as cardiology is almost non-existent in these remote missionary places, so we end up treating a broad spectrum of conditions,” says Dr. Tom. “We saw traumatic injuries, infections, fractures. You sometimes have to approach very complex conditions, very simply.” Dr. Patty Peters, Family Practice, Avera McGreevy Clinic has been active in medical missions since the mid 1990’s. Four of her trips have been to Jeremie, Haiti. “You’re diagnosing on your background without the benefit of things like X-rays or lab tests,” she explains. “Sometimes patients die, despite our best efforts. So it is frustrating when American patients think they should be entitled to every test immediately or get angry if the doctor is running a few minutes late. In these poor countries, people are just so grateful and appreciative.” Dr. Terry Graber, Family Practice, Custer Regional Medical Clinic has travelled extensively serving indigenous church-based programs. He happened to be in Haiti when the recent earthquake struck and was able to offer immediate emergency care. “You could say, what good could it do for an American doctor to go all the way over there and pass out a little bit of medicine?” says Dr. Graber. “But I think we are sending a message when we do this, that there is a non-material realm to life, a right way to live, and that service comes out of that.” ■
Dr. John Berdahl in Burma
Dr. Terry Graber in Haiti
News Flash Avera McKennan Hospital & University Health Center and Sanford USD Medical Center have again been named among the nation’s 100 Top Hospitals® by Thomson Reuters. This is the eighth time Sanford has been recognized with this honor and the fourth consecutive year for Avera McKennan.
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Top Stories 2010
Eugene Hoyme, MD, and Fetal Alcohol Syndrome Sanford Researcher has Devoted Career to Understanding and Preventing FAS and Related Disorders
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DC studies put the rate of Fetal Alcohol Syndrome in the U.S. between 0.2 and 1.5 cases for every 1000 live births. Other studies using different methods have found it to be even more common – as many as 1 case out of every 500 live births. And scientists believe that there are at least three times as many cases of FASD as there are cases of FAS. Few physicians have seen as many cases of Fetal Alcohol Spectrum Disorders as Dr. Eugene Hoyme. He is the Chief Medical Officer of Sanford Children’s Hospital, Senior VP for Children’s Services at Sanford Clinic in Sioux Falls, and a renowned clinical researcher into the mysteries of these sometimes baffling disorders. Although there is still much that is not fully understood about the prenatal effects of alcohol use, much of what is known has been uncovered by Dr. Hoyme and the other three clinical geneticists who form the dysmorphology core of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) of the NIH. He and his colleagues have helped to more clearly define FAS and related disorders through years of research around the world. “One of the most interesting things we have come to understand is that most of these babies are not born to women who drink daily,” says Dr. Hoyme. In the course of his research, Dr. Hoyme has personally examined more than 3000 children who have been exposed to alcohol in utero and nearly 400 with full-blown FAS in the last 15 years. “Most children with FAS are born to mothers who are binge drinkers, that is, they don’t drink during the week, but on the weekend may consume a case of beer, for example. That is a huge amount of alcohol for a fetus to be exposed to.” Recognizing that the first step toward possible life-changing intervention for FASD patients is accurate diagnosis, Dr. Hoyme and his research colleagues developed a set of diagnostic categories for use by primary care physicians. “I would love nothing more than, by the time I retire, to have had some impact on reducing the incidence of this condition around the world.” ■
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Dr. Eugene Hoyme
News Flash News Flash The Sanford School of Medicine is now offering for the first time an accredited pediatrics residency program. Starting in the summer of 2011, the program will accept six residents per year for the three-year training program.
The American College of Surgeons Committee on Trauma has verified Sanford USD Medical Center as a Level II Pediatric Trauma Center – the first and only one in the region. The verification means trauma patients have access to a team of board certified pediatric surgeons, specially trained emergency physicians, a pediatric trauma flight team and state-of-the-art operating rooms. Midwest Medical Edition
Opening New Doors
Courtesy SFSH
Sioux Falls Surgical Hospital Builds on its Strengths
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HEN it Opened it’s doors in 1985, the Sioux Falls Surgical Center was a singlestory building in the shadow of what was then McKennan Hospital. About two dozen doctors and staff performed a handful of procedures every week in the facility’s six operating rooms. Today, the Sioux Falls Surgical Hospital is an eye-catching multi-story building with 13 modern operating rooms and 35 private patient rooms. Two hundred and forty surgeons and staff members from independent practices as well as both area health
The newly renovated Sioux Falls Surgical Hospital
systems now perform everything from total joint replacements to pediatric surgery, delicate neurological procedures and cancer surgery. With a volume of more than 800 procedures per month– about 10,000 a year – this physician-owned facility has carved out a significant place for itself among the region’s surgical options. The Sioux Falls Surgical Hospital (SFSH) adopted its new name in January of 2009, in the midst of its biggest expansion project to date. This project added two floors to the hospital, increased the number of overnight beds and included a renovation of the lobby and reception area, staff lounge,
preoperative admission rooms, and post anesthesia unit (PACU). SFSH can accommodate a wide range of surgeries, including those that require specialized equipment such as balloon sinuplasty, or hip surgery from an anterior approach, for which the hospital just acquired a special operating table. The facility has multiple lasers available and is considering the addition of robotic technology. The hospital is accredited by the Accreditation Association for Ambulatory Health Care (AAAHC) and Becker’s Hospital Review named SFSH one of the 32 best physician-owned hospitals in the country. ■
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Top Stories 2010
The Pine Ridge Regional Medical Clinic Fighting a Legacy of Chronic Disease
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Courtesy Regional Health
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en living on Pine Ridge Indian Reservation have an average life expectancy of just 48 years old. For women, it’s 52. In the Western Hemisphere, the only population with comparably low life expectancies is the poverty- and AIDS-stricken country of Haiti. “Almost every chronic condition you can name is 200, 300, even 500 times higher on Pine Ridge than it is nationally,” says Sandra Ogunremi, DHA, Director of Grant Services at Regional Health who is well versed in the health care challenges of Native Americans. “End stage renal disease, diabetes and its complications, heart disease – these are all much more common in this population.” In an effort to address the spiraling problems associated with chronic disease as well as alleviate some of the pressure on area hospitals, the South Dakota Department of Social Services in 2008 approved a grant to fund a unique new collaborative effort. Housed within the Pine Ridge IHS Hospital and staffed by Regional Health physicians and specialty providers, the Pine Ridge Regional Medical Clinic is dedicated to diagnosis, treatment, education and ongoing management of the most prevalent chronic conditions on Pine Ridge. As a joint effort with a state government and a health care system, the clinic is unique within the IHS. The Pine Ridge Regional Medical Clinic focuses on four health concerns that are rampant among the Native American population on Pine Ridge: Congestive Heart Failure, Chronic Obstructive Pulmonary Disease (COPD), Diabetes, and the management of blood thinner medications such as Warfarin. The clinic, which is open two days a week, is staffed by physicians or mid level practitioners with expertise in cardiology, pulmonology, endocrinology and pharmacology. “Diabetes is so common here and the people really seem to appreciate the time we are able to spend with them, helping them sort out their sugar levels, etc.,” says Endocrinologist Stephen Haas, MD. “This kind of time investment is so important not only for teaching people what they need to know about selfcare, but also for sending the message that it is important. When they see us treating it seriously, they are more likely to take it seriously, too.” ■
News Flash Avera has been recognized as one of the nation’s ‘Most Wired’ and ‘Most Wireless’ health systems according to Hospitals & Health Networks magazine. This is Avera’s 12th consecutive ‘Most Wired’ and seventh consecutive “Most Wireless” Award. Sanford Health & Fargobased MeritCare further unified their two organizations under a single brand name and wordmark. The organization is now encompassed under the Sanford Health brand.
The Avera Cancer Institute A New Home for Cancer Care in South Dakota
Kristy Shanks
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vera McKennan has opened the doors of its most far-reaching cancer care effort to date – a 260,000 square foot, 5-story, $93 million cancer center. The largest building project in the hospital’s history, the new Avera Cancer Institute unites clinical, diagnostic, treatment and support services in a building that was designed to be as aesthetically pleasing as it is technologically advanced. ACI gathered under one roof cancer care services that had been spread across the campus. The goal was to improve access to care for faster diagnosis and treatment. In addition to the Avera Women’s Center for Gynecologic Oncology, the new center houses Avera Hematology and Transplant, Avera Radiation Oncology and Avera Medical Oncology and Hematology. Like other Avera clinics, these clinic areas were designed according to LEAN principles to maximize patient privacy and staff efficiency. Other clinical features include a dedicated imaging suite and a separate area for breast health and imaging, lead-reinforced radiation vaults, infusion centers, a pharmacy, and a blood draw station. Integrative Medicine services such as massage and nutritional counseling are also available on site. The fourth floor houses the Avera Surgery Center’s eight operating suites and 28 pre- and post-operative rooms and the fifth floor remains free for expansion. More than just a ‘pretty face’, the Avera Cancer Institute is also home to some of the area’s most advanced cancer technology. The center will be one of only a handful of in the U.S. to own Siemens’ newest linear accelerator, the ARTISTE. The machine offers advanced treatment delivery tools that enable clinicians to make critical adjustments instantly and deliver individualized Adaptive Radiation Therapy (ART) with the highest speed and precision. ACI is also utilizing a new Intra-operative electronbeam radiation therapy (IORT), made possible by a $2.5 million grant from the Helmsley Charitable Trust. “I would venture to say that it is one of the nicest cancer buildings in the United States,” says Hematologist Kelly McCaul, MD, of Avera Hematology and Transplant. “We have incorporated positive design features from all over the country to create an ideal cancer care environment.” If you know of a person, institution, or program that you would like to see featured in MED, please share your ideas with us. Fill out the Nomination Form in this issue and mail or fax it to us any time. ■
Siemens’ newest linear accelerator, the ARTISTE, at ACI
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Strategic Focus
Planning Your Health IT Team By Jamie L. Husher, MS, RHIA, CHPS Editor’s Note: This article expands on the six health information technology (IT) workforce roles discussed in the November issue.
P
eople and process are critical factors in a successful implementation of an electronic health record (EHR) system. Purchasing and installing new hardware and software are only part of the equation. Providers need to consider the people power necessary for a successful EHR installation. Conducting a gap analysis to identify staff needs during an EHR implementation is critical. Will current staff need new training? Will new staff members be needed? Will external resources by utilized? It is likely most providers will use a combination of training current staff, adding new staff along with external support from the EHR system vendor and local health IT regional extension center. In a message issued by Dr. David Blumenthal, the National Health Information Technology Coordinator, trained health IT professionals can help physicians: • Assess workflows • Select hardware and software • Work with vendors • Install and test systems • Diagnose IT problems • Train practice staff on systems The Office of the National Coordinator for Health Information Technology (ONC) funded health IT training programs to prepare six health IT workforce roles. While six separate health IT roles are identified, providers may not necessarily have six different or new roles within their setting. The important point
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is that the skills of the six roles are necessary at various times in the EHR implementation cycle. All roles are focused on improving patient care and achieving meaningful use criteria to allow for Medicare or Medicaid incentive payments to eligible hospitals and professionals.
EHR implementation Cycle Assess > Prepare > Select > Implement > Evaluate > Improve
Mobile Support Four health IT roles are categorized as mobile adoption support positions – working at one site for a specific period of time – then moving on to the next implementation site.
Practice Workflow and Information Management Redesign Specialist Assist healthcare providers reorganize workflow to take full advantage of EHR features.
Clinician/Practitioner Consultant Similar to the “redesign specialist,” this role brings to bear the background and experience of licensed clinical or public health professional.
Implementation Support Specialist Provide on-site user support before and during implementation of EHR systems including providing support services above and beyond vendor services. Specialists ensure the EHR system functions properly and is configured to meet the redesigned practice workflow.
Implementation Manager Managers provide on-site management of the mobile implementation teams during the implementation phase.
Permanent Staff The remaining two health IT roles provide ongoing support of EHR systems implemented in office practices, hospitals, health centers, long-term care facilities, health information exchange organizations and public health agencies.
Technical/Software Support Staff Key functions include supporting and maintaining the EHR system on an ongoing basis including patching and upgrading software and providing one-on-one support in a traditional help-desk model.
Trainer Using adult learning principles, trainers design and deliver training programs to employees in clinical and public health settings. The important, hard work of adopting and optimizing an EHR system begins after the initial implementation and “go live” concludes. Providers need to strategically plan who will be capable of performing the various tasks required during and post-EHR system implementation. ■ Jamie Husher, MS, RHIA, CHPS is an HIT Educational Specialist with Dakota State University’s HIT Workforce Development Training Program.
Midwest Medical Edition
Sanford Opens Simulation Training Center (Sioux Falls, SD) –Sanford Health has opened a new training center for employees that features a new method of simulation-based learning in healthcare for the region. The new Sanford Simulation Center will allow Sanford employees to use the newest high-tech methods to receive hands-on training in a safe, no-risk environment. By utilizing a combination of task trainers, mannequin simulators and standardized patients, Sanford employees will have a chance to learn new skills and improve the process, accuracy and delivery of every aspect of patient care. “The center will help prepare Sanford staff to offer exceptional care by providing practice in the latest techniques, treatments and collaborative problem solving methods,” said Becky Nelson, Sanford Health Senior Vice President and Chief Operating Officer. “This state-ofthe art training facility will also be used for cutting-edge research into how simulation-based learning can impact clinical judgment, interdisciplinary collaboration and patient outcomes.” Two simulation suites, two high-tech
debriefing rooms and a multi-faceted task trainer room make up the 2,400 squarefoot facility located at the Sanford Health Center for Learning in the Sanford Stevens Center. The Sanford Simulation Center will
also be made available in the future to community members, such as firefighters, emergency medical technicians and first responders as well as other organizations and companies that have simulated learning needs. ■
Thomas Repas, D.O., First Physician to Receive CPI Certification in South Dakota
Thomas Repas, D.O., of Rapid City was recently awarded the title of Certified Physician Investigator (CPI). December 2010
He is the first physician to receive this certification in South Dakota. A physician investigator is a physician who serves as a primary, sub- or coinvestigator who monitors, supervises, and/or designs clinical research trials. A physician investigator accepts responsibility for the safe and ethical conduct of a clinical trial, defined as a systematic experiment designed to evaluate the pharmacokinetics, pharmacodynamics, pharmacoeconomics, safety, efficacy, and effectiveness of a drug, biological, medical device (therapeutic or diagnostic), procedure or MidwestMedicalEdition.com
other intervention involving human subjects. Certification is granted by the Academy of Pharmaceutical Physicians and Investigators (APPI) in recognition of a physician’s education, training and experience as a primary, sub- or coinvestigator, monitor, supervisor, and/or designer of clinical trials and is based upon training and experience as well as successful completion of the written CPI examination. According to APPI, as of 2009, 925 physicians were Certified Physician Investigators. ■ 13
Hospital collaboration brings liver transplant care closer to home The Avera Transplant Institute in Sioux Falls is collaborating with Aurora St. Luke’s Medical Center of Milwaukee to provide liver transplants complemented by local pre- and posttransplant care. This program saves patients in the Sioux Falls area from having to spend up to six months at a transplant center in another state. The Avera Transplant Institute at Avera McKennan Hospital & University Health Center is currently developing its own liver transplant program to add to its kidney, pancreas and bone marrow transplant programs. In its 17-year history, the Avera Transplant Institute has provided more than 800 solid organ and bone marrow transplants. Avera has two transplant surgeons and two hepatologists. In addition, surgeons rotate between Avera and Aurora
transplant programs, increasing depth and breadth of transplant surgery experience and coverage. “We have the specialists and expertise in place to care for virtually any disease of the liver or hepatobiliary system,” said Dr. Tariq Khan, hepatobiliary surgeon with Avera Transplant & Hepatobiliary Surgery. All hepatobiliary cases are reviewed at a weekly conference by a multidisciplinary team, including hepatologists, oncologists, pathologists, interventional radiologists and surgeons. “Many cases can be cared for entirely in Sioux Falls, because not every patient with liver disease needs a liver transplant. And for those patients who do need a liver transplant, we now have a program in collaboration with Milwaukee,” Dr. Khan said.
Dr Elgouhari
Dr. Khan
Dr. Hesham Elgouhari, hepatologist with the Avera Center for Liver Disease, said there are many stages in transplant care. The process begins with pre-transplant evaluation and testing by a multidisciplinary team in Sioux Falls. If the patient is deemed to be a liver transplant candidate, he or she is added to a waiting list, based on a scoring system which determines how urgent the need is. After a patient is listed for transplant, medical staff in Milwaukee determine when the patient needs to come to Milwaukee in advance of surgery, and temporary housing is arranged. After surgery, patients are hospitalized until they are well enough to be discharged.
Inpatient Medically Complex Program Our specialty hospital provides excellent 24-hour nursing care for your pediatric patients!
Julie Johnson, MD Medical Director of Rehabilitation Services
James Wallace, MD Medical Director of Respiratory Care Services
The 18-bed specialty hospital at Children’s Care offers cost-effective care for children through age 21 who need 24-hour medical monitoring. Services include: • • • •
IV Medication Delivery • Suctioning, Oxygen Administration Tracheostomy Care • Ventilator Use & Weaning Skilled Nursing Observation following casting or surgeries Nutritional therapy via gastrostomy, jeujostomy, NG or NJ
Call Rebecca Weeldreyer, RN, for details: (605) 782-2475
CHILDREN’S CARE HOSPITAL & SCHOOL For Children with Special Needs and Their Families 2501 W. 26th St., Sioux Falls, SD 57105-2498 (605) 782-2300
www.cchs.org
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Midwest Medical Edition
Patients can receive their post-transplant care in Sioux Falls, with any needed post-transplant hospitalization at Avera McKennan. Dr. Elgouhari says the cooperative arrangement with Milwaukee brings Avera McKennan a step closer to offering its own liver transplant program, and is helping to prepare the Avera Transplant Institute team for that day. ■
FDA Approves Oral Anticoagulant Tested by Regional Heart Doctors Regional Heart Doctors and area patients helped pave the way for an MED ad Doug June 2010:Layout 1 7/12/10 important new advance in heart care,
announced last month. The FDA recently approved the first new oral anticoagulant medication in 50 years. Pradaxa has been approved for the prevention of stroke and blood clots in patients with atrial fibrillation. Regional Heart Doctors Black Hills Cardiovascular Research was the fourth largest test site in the nation for the trial of Pradaxa®, with 74 patient participants. According to the FDA, atrial fibrillation affects more than 2 million Americans and is one of the most common types of abnormal heart rhythm. People with atrial fibrillation have an increased risk of developing blood clots, which can cause a disabling stroke if the clots travel to the brain. The RE-LY® clinical drug study compared Pradaxa® with the longprescribed anticoagulant warfarin (also known by brand names Coumadin, Jantoven, Marevan, Lawarin, and Warfarin). In an Oct. 19 news release, the 10:45 Page 1 FDA AM stated patients taking Pradaxa®
DOUG
had fewer strokes than those who took warfarin. Additionally, patients on Pradaxa do not need to undergo periodic blood monitoring as they do with warfarin. “Regional Heart Doctors and our patients are proud to have participated in a drug study that will make a difference in the lives of so many people,” said Roger DeRaad, Regional Heart Doctors Research Director. “Warfarin, also known as Coumadin, has been the only blood clot preventing drug option for many years. Its side effects are numerous and there are many people who could not be prescribed the drug due to risk of those complications. Our local participation contributed significantly toward the approval of a safe and effective alternative to warfarin. This is substantial news and we are excited to have played a part in it.” Regional Heart Doctors and Black Hills Cardiovascular Research are currently participating in more than 30 clinical trials. ■
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December 2010
MidwestMedicalEdition.com
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Lance Armstrong, Michelle Lavallee, David Kapaska
Avera Celebrates Grand Opening with
Building December 2010
An estimated 3,600 people attended the Building Hope Gala on Friday, Oct. 29, celebrating the grand opening of the Avera Cancer Institute and Avera Surgery Center, located in the Prairie Center on the main campus of Avera McKennan Hospital & University Health Center. Champion cyclist and cancer survivor Lance Armstrong was keynote speaker at the black-tie optional Gala. Armstrong battled and beat testicular cancer which had spread to major organs, and later went on to win seven Tour de France titles. Hundreds turned out to ride with Armstrong in a Twitter ride, which began from the Avera McKennan campus at 4 p.m. the afternoon of the Gala. Also speaking at the gala was Dr. David Kapaska, newly appointed regional
president and CEO of Avera McKennan Hospital & University Health Center. The program was held in a huge tent just west of the Prairie Center; the rest of the gala took place on three floors of the Avera Cancer Institute as well as the Avera Surgery Center on fourth floor. Each floor featured different food buffets and live music. The Prairie Center is the largest building project in Avera history at a total cost of $93 million. The five-story, 260,000-square-foot building has space equivalent to five acres. From conception to opening, the Center was three years in the making. Most cancer services including diagnostic imaging, radiation therapy, chemotherapy, and, in some cases, same-day surgery – are available in the new center. â–
Hope Gala MidwestMedicalEdition.com
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American Cancer Society Awards CEO Cancer “Gold Standard” Award
By Charlotte Hofer, American Cancer Society
T
he American Cancer Society announces that Avera McKennan Hospital & University Health System has become a CEO Cancer Gold Standard company, certified by the CEO Roundtable on Cancer. Joining such national companies as the Dana Farber Cancer Institute, Johnson & Johnson and MD Anderson, Avera McKennan is the first employer in South Dakota to receive this distinction. The CEO Cancer Gold Standard accreditation recognizes the commitment of organizations to reducing the risk of cancer for employees and their families by promoting healthy lifestyle choices, encouraging early detection through cancer screenings and ensuring access to quality treatment. Avera McKennan partnered with the American Cancer Society’s Corporate Relations Workplace Solutions program along the way to the accreditation. Workplace Solutions helps companies connect their employees with health and wellness programs that reduce their risk of cancer. “The American Cancer Society salutes Avera McKennan’s commitment to helping their employees to live healthier and longer lives,” said Laurie Jensen Wunder, Vice-President of Mission Delivery, American Cancer Society in Sioux Falls. The American Cancer Society estimates that this year in South Dakota, more than 4,000 people will be diagnosed with cancer and 1600 will die of the disease. Avera McKennan is one of 69 hospitals nationwide to receive the CEO Gold Standard accreditation. ■
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Kapaska Named CEO of Avera McKennan Hospital & University Health Center
December 2010
Dr. David Kapaska has a varied resume, from basketball recruiter and coach, to U.S. Air Force pilot, to sales and marketing rep, to family practitioner to chief medical officer. Each experience has uniquely prepared him for his newest role as Regional President and CEO of Avera McKennan Hospital & University Health Center in Sioux Falls. Previously senior vice president for Medical Affairs at Avera McKennan, Dr. Kapaska was named the 16th top administrator in the 100-year history of Avera McKennan. He succeeds Fred Slunecka, who has been named Chief Operating Officer for Avera Health. Raised in Sac City, Iowa, Dr. Kapaska went to the U.S. Air Force Academy in Colorado Springs on a basketball scholarship. After pilot training, USAF Capt. Kapaska f lew the C-141 cargo jet as a pilot and aircraft commander for a total of 2,500 hours worldwide, in the Vietnam Conf lict as well as peacetime missions. MidwestMedicalEdition.com
During his service in the Air Force, he earned his MBA at Southern Illinois University. After a civilian career as a sales and marketing manager, Dr. Kapaska the University of Osteopathic Medicine in Des Moines. He completed a family practice residency at Iowa Lutheran Hospital and practiced family medicine for 10 years in Iowa. After completing a graduate program in medical management with the American College of Physician Executives, Dr. Kapaska came to Avera McKennan as chief medical officer in 1999. He says it is a growing trend for physicians to serve in hospital administrative roles. “There’s a realization that we need physicians who are more engaged in the intricacies of hospital operations. In fact, 90 percent of the costs of caring for patients are ordered by physicians. For physicians not to be part of management and cost containment may be a big oversight.” ■ 19
Grape Expectations
Add Some ‘Sparkle’ to Your Holidays By Heather Taylor Boysen
I
absolutely love the holidays. I love the snow and helping my kids write their Christmas wish lists to Santa. I love hearing Bing Crosby and David Bowie’s “Little Drummer Boy” duet which, by the way, is the best Christmas song ever. I even love the crazy and frantic pace in our store that doesn’t end until the first of January. And my husband and I really love sparkling wine. The term “sparkling wine” encompasses all wines which have a certain amount of effervescence or “fizz”. Sparkling can only be called champagne if it comes from the Champagne region of France. Prosecco and Asti are from Italy, cava is from Spain, sekt from Germany and sparkling wine from everywhere else. Wherever it hails from, there is just something about the festive nature of a sparkling wine that can, with one sip, revive your senses, cleanse your palate, refresh your mind and just taste great. Unfortunately, only a small percentage of wine buyers consume sparkling wine other than during the holidays from Thanksgiving to New Year’s Eve. Although closely associated with
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celebrations such as weddings, baby showers or ship launches, I have come up with my own list of celebrations. How about getting through a tough day at work? Or hey, the kids are in bed and my husband and I have a quiet hour alone together. Other favorites include getting the laundry done, the sun is shining and the wind chill isn’t below zero. As Madame Bollinger once said, “I drink champagne when I am happy, and when I am sad. Sometimes I drink it when I’m alone. When I have company, I consider it obligatory. I trifle with it if I’m not hungry and drink it when I am. Otherwise I never touch it – unless I am thirsty.” From 1941 to 1971 Madame Bollinger ran the prestigious French champagne house, doubling it sales to more than a million bottles. In 1969 Madame Bollinger also introduced the first champagne to be made exclusively from pinot noir grapes. Until then and still today, most champagnes were a blend of chardonnay, pinot noir and pinot meunier. Sparklers can vary greatly in price, but there is a bottle for every budget just as there is a style to suit everyone’s taste. They can range from very sweet such as an Italian Moscato d’Asti, to a bone dry French Extra Brut. If you like Chardonnay, perhaps you can begin with a Blanc de Blanc, meaning the wine was only made with chardonnay grapes. If you are a Pinot Noir fan try the Blanc de Noir style made with only pinot noir grapes. And I am serious
when I tell you that hot buttered popcorn and an Extra Dry style sparkling is a great pairing! If you are not the popcorn type, then try sushi especially when lightly seasoned with the traditional ginger, wasabi and soy sauce. More than anything sparkling wine is a state of mind. Say it with me, “I am special and deserve sparkling wine!” There is anticipation in the opening of the bottle, hearing the hiss of the release as you gently remove the cork, the pouring of the wine into the flute and feeling the light spritz of liquid on your face as you bring the glass to your lips. With over 56 million bubbles in a bottle of champagne, how could one not find celebration and joy in every glass? Remember, you are special and deserve sparkling wine! ■
Midwest Medical Edition
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Amputee Rehabilitation Part 2 By Jeff Boonstra, CP
U
nder the current standard of amputee care, success is too often measured in how far a patient can walk, instead of how well he or she walks. Unfortunately, being able to walk 300 feet down a straight hallway, or being able to navigate a few small environmental barriers, doesn’t demonstrate that an amputee’s gait is fully optimized. With the current standard of care, amputees are more likely to exhibit poor gait mechanics that produce: a trunk forward posture, decreased stance time on their prosthesis, increased loading onto their sound side, and even a compensatory limp. Amputees constitute less than 5 percent of the total rehabilitation population. Most therapists only see one or two amputee cases a year, making it difficult to develop the expertise required to generate the outcomes that are truly possible. Some hospital systems try to better serve this population by holding monthly “Amputee Clinics”. While the concept is good, it still leaves the patient travelling back and forth between the therapist and the prosthetist for weekly care, which can be time consuming, frustrating, inefficient and ineffective. When a patient experiences problems under the current system of care, a therapist can only call or email the prosthetist her understanding of the problem. If the prosthetist can’t see the issue first-hand in the therapy setting, it is much harder December 2010
to know how to rectify the problem. Each time a problem goes unsolved, the patient returns to therapy unable to perform exercises and activities meant to improve their function.
A Better Approach Any therapist who has gait trained an amputee with high level therapy techniques has learned that an ill-fitting or misaligned prosthesis doesn’t uphold therapy activities. This is especially true in the early stages of limb loss rehabilitation when the residual limb undergoes the greatest amount of change. It is important that limb loss rehabilitation starts with specific isometric mat exercise that begins to build a foundation of strength to support upright standing posture. Once the patient graduates to standing activities with the prosthesis, focus shifts toward continuing strength building under single leg weight bearing conditions with some walking. If a prosthesis becomes loose due to limb shrinkage, the socket pressures are not maintained in weight tolerant areas. This loss-of-limb to socket interface reduces the patient’s control of the prosthesis, and their ability to properly manage their body mechanics. If the fit of the prosthesis is not properly maintained, weight-bearing exercises/ activities will not be possible. This is the time where there needs to be seamless coordination between prosthetist and therapist; both working to balance prosthetic fit with therapy activities. MidwestMedicalEdition.com
When a proper gait has been established and the rehab focus switches to endurance training, this is a great time for the therapist and prosthetist to analyze the patient’s gait and fine tune prosthetic alignment. A rehabilitation program in which the therapist and the prosthetist work in the same facility can direct a patient toward building a quality and functional gait that yields a more favorable outcome. It is impossible for a patient to make meaningful progress in therapy if the fit of a patient’s prosthesis isn’t monitored and adjusted throughout all stages of gait training.
Beyond Physical Therapy Once new patients excel in a quality rehab program, the importance of prosthetic technology cannot be overstated. Some of the newest socket interface and suspension technology embraces the use of elevated vacuum applied within the socket. For the right candidate, vacuum technology provides the wearer a great many benefits including limb volume management, improved linkage and increased prosthetic control. When a well-fitting socket and suspended socket is paired with one of two new prosthetic feet, patient satisfaction and function are greatly enhanced. The Proprio Foot and Echelon both provide wearers with improved ground compliance. Both feet provide increased ankle movement, in both plantarflexion and dorsiflexion, improving the ability to walk on uneven ground as well as level terrain. ■ 21
New Leadership at Make-A-Wish A Note from Paul Krueger I am excited to work with the staff, board of directors, volunteers, donors, and the children and families of Make-A-Wish. To be a part of an organization that gives so much hope and joy to families is an honor and I look forward to sharing our important mission with others across the state. To physicians and healthcare professionals across South Dakota, thank you for referring children to Make-AWish. To date, we have granted 858 wishes. Sixty three wishes were granted last year. One of our goals is to make sure that every child in South Dakota who is eligible for a wish receives one. This is where you can continue to help us. If you know of a child who has been diagnosed with a progressive, degenerative or malignant medical condition, please call us at 1800-640-9198. You can learn more about Make-A-Wish and our chapter at www.southdakota.wish.org.
The Board of Directors of the Make-A-Wish Foundation® of South Dakota has named Paul Krueger of Sioux Falls its new President and CEO. Krueger started his position on October 11, replacing Mary Olinger who is retiring after 18 years. “I am confident this whole organization will continue to thrive with Paul at the helm,” says Brad Buche, chair of the Make-A-Wish Board of Directors.“His genuine passion for the kids, along with his energy and enthusiasm will prolong Make-AWish Foundation® of South Dakota as one of the best performing chapters in the nation,” Most recently, Krueger served as a director of development at Augustana College. He worked at Augustana for more than 11 years and also worked two years at the University of South Dakota Alumni Association in Vermillion. Krueger holds a B.A. in journalism and communications from Augustana College and an M.S. in Administrative Studies from the University of South Dakota. He and his wife Joni have three children, Emily, Matthew and Sarah. ■
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Midwest Medical Edition
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National Research Corporation Names Sanford Medical Centers
“Top Hospitals” For the fifth year in a row, Sanford USD Medical Center Sioux Falls and Sanford Medical Center Fargo have been selected by National Research Corporation as Consumer Choice Award winners. The award identifies hospitals which healthcare consumers have chosen as having the highest quality and image in over 300 markets throughout the U.S. Ginny Martin, President of NRC’s Ticker Division, said winners are determined by consumer perceptions on multiple quality and image ratings collected in the company’s Healthcare Market Guide Ticker study. Of the 3,200 hospitals named by consumers in the study, the winning facilities rank highest in their Core Based Statistical Areas (CBSAs), as defined by the US Census Bureau. The Ticker study surveyed over 250,000 households representing over 450,000 consumers in the contiguous
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48 states and the District of Columbia. “Healthcare has become an increasingly important issue across the country and empowered consumers are making decisions for themselves and their families when selecting their healthcare facilities and services,” Martin said. “These Consumer Choice award winners exemplify the dedication it takes to provide quality healthcare to their communities, and we are pleased to honor them through the eyes of their patients.” NRC’s Ticker Survey is the nation’s largest and most comprehensive study of its kind. No other study used to measure hospital performance and preferences contains more consumer responses than NRC’s study. The study has a margin of error of + or – 0.2 percent at a national level. Co-winners are named when scores fall within the statistical margin of error for a given market. ■
In Review What You’re Reading, Watching, Hearing
By Richard H Thaler and Cass R Sunstein.
Nudge
Improving Decisions About Health, Wealth, and Happiness Reviewed by Kenneth M. Scott, MD
N
udge: Improving Decisions about Health, Wealth and Happiness by Richard Thaler and Cass Sunstein discusses that how a choice is presented effects which choice people will tend to make. It also discusses how institutions and individuals are using this knowledge to intentionally nudge us toward the choices they would prefer us to make. Both authors are professors, one in the University of Chicago School of Business and the other in the Harvard University School of Law. They refer to
anyone responsible for organizing the context of our choices as a “choice architect”. These choice architects can nudge choices toward their favored results by manipulating the way the options are presented to the chooser. As physicians, we are near the top of the authors’ list of choice architects because we present our patients with treatment options every day. We are also on the other end as we make endless choices everyday in the grocery store, cell phone store and also when interacting with administrators, government
agencies, and insurance companies. These agencies all have their own reasons to nudge us into making the decisions that they would prefer. I highly recommend this book. It reminded me how biases can creep into many decisions I make or offer to others and could have a significant effect on my life and profession. Keeping these lessons in mind helps me to be a more informed consumer but also reminds me of my responsibilities as a choice architect for my patients and staff. ■
As told to Dorcas Sharp Hoover
House Calls and Hitching Posts
Stories from Dr. Elton Lehman’s Career Among the Amish Reviewed by Patty Peters, MD
H
ouse Calls and Hitching Posts as told to Dorcas Sharp Hoover tells the story of Dr. Elton Lehman, a general practitioner who has worked with the Pennsylvania Amish population since the 1960’s. I found it fascinating to read how he worked in his first office in his home with his teacherwife as his assistant. The Amish did not use telephones, cars, or even electricity
so this doctor’s medical practice was understandably challenging. In 1998, Dr. Lehman was named the Country Doctor of the Year as well as Family Physician of the year by the Ohio State Society of the American College of Osteopathic Family Physicians. I would recommend it to anyone who is interested in some recent history of how a country doctor worked without
beepers and cell phones. This book also does a good job of portraying the spiritual side to medicine. It is a quick read, but the stories really come to life when the author talks about delivering babies at farm houses and during blizzards. Overall, I found it to be a good representation of the true call to be a physician, along with all of its heartaches and fulfillments. ■
Have you read a book, seen a movie, heard a concert, etc. that moved you? Whether it made you mad or make you laugh, MED wants to help you share it with your colleagues. Send your reviews to Alex@MidwestMedicalEdition.com
December 2010
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Slips, Trips and Falls in the Workplace By Lori Berdahl, OTR/L, CEES
W
orkplace slips and falls frequently result in severe injuries requiring extensive and expensive recovery and lost time. A slip/trip/fall prevention team can be a valuable asset in the reduction of these incidents throughout a healthcare facility. Team members should include representatives from environmental services, a representative from administration, safety officer(s), and departmental supervisors or employee representatives from at risk areas. Proactive tasks for the prevention team can include: Completing a hazard assessment twice each year in all areas of the facility to identify dangers including inadequate lighting, loose tiles, uneven thresholds, curled mats, cracks in pavement, slippery surfaces, pooling water, poor drainage, damaged steps, trip hazards or obstructions in walkways. Reviewing the facility’s history of slip/trip/fall incidents to identify trends. Incidents should be investigated immediately and thoroughly to determine the root cause. Problem-solving and implementing any needed changes in procedure, environmental structure, equipment or staff education based on the hazard or trend assessments. Distributing and enforcing a footwear policy which encourages the wear of closed-toe, closed-heel, securefitting footwear, with an anti-slip soft rubber sole indented with deep treads or channels.
A little team effort can go a long way in reducing the frequency of employee, patient and visitor slip/fall incidents. ■ Lori Berdahl is an Occupational Therapist and holds the Certified Ergonomic Evaluation Specialist designation. She is an Ergonomic and Loss Control Specialist with Risk Administration Services in Sioux Falls, SD.
Reviewing housekeeping practices and cleaners used on floors. Floor cleaner data sheets should be reviewed to assure that slippery surfaces are not created. Floor waxes should have non-slip characteristics which do not decrease the coefficient of friction for the floor. Appropriate degreasing cleaners should be used in food service areas. O v e r s e e i n g on-going prevention ef for ts including laying out appropriate length matting at all entrances, providing umbrella bags at employee and visitor entrances on rainy days, applying ice melt in advance of and after precipitation, placing buckets of salt/ sand mixture at employee exits during winter months, providing a regular supply of absorbent materials to staff for quick clean up of spills, and hanging awareness posters in designated employee areas.
Slips, trips and falls are the second leading cause of workplace injury in the healthcare industry.
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Six Tips for Avoiding Workplace Injuries 1. C onduct hazard assessment twice each year 2. R eview the facility’s history of slip/trip /fall incidents 3. P roblem-solve and implement any needed changes in procedure 4. I mplement a workplace footwear policy 5. R eview housekeeping practices and cleaners used on floors 6. O versee on-going prevention efforts
Midwest Medical Edition
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Children’s Newborn and Pediatric Transport Team
I
t has been a busy year for the Newborn and Pediatric Critical Care Transport Team at Children’s Hospital & Medical Center in Omaha. On Tuesday, Nov. 2 the team marked its 500th patient transport trip of 2010. “In all of 2009, we went on 216 transport calls. To more than double that number over a shorter time frame shows significant need for this service,” says Robert Chaplin, MD, medical director of the Children’s Critical Care Transport Team. October 2010 was a record-setting month for Children’s with 67 transports. The hospital anticipates the team could reach 600 total patient transports by the end of the year. Children’s Hospital & Medical
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Center began offering specialized transport services in 2006 with the creation of the hospital’s neonatal transport team for newborns and infants up to two months of age. In September 2009, Children’s expanded its program to include pediatric transport service for all other ages. The team serves Nebraska, western Iowa, northern Missouri, northern Kansas, eastern Colorado and South Dakota. In fall 2009, Children’s partnered with American Medical Response (AMR) to provide ground transportation in its own dedicated pediatric ambulance. In July 2010, the Children’s Transport Team partnered with LifeNet, in association with AirMethods Corporation, to provide helicopter service for the sickest children.
The team has been present for the delivery of newborns with anticipated complications, and in 2010 has transported these babies (just minutes old), as well as children through age 18, from hospitals and medical care centers in Nebraska, Iowa, Kansas and Missouri. The shortest trip by ambulance this year has been just shy of two miles to The Ambassador Omaha. The longest ambulance journey took the team 182 miles north to O’Neill, Nebraska. They’ve covered roughly the same distance by air with the longest helicopter flight taking them to Kearney. The Children’s Newborn and Pediatric Critical Care Transport Team is available 24/7 by physician referral and request via the Physicians’ Priority Line, 1.888.592.7955. ■
Midwest Medical Edition
New service aims to make On-Call less stressful
Finding Balance low sex drive 7 out of 10 women complaining of low sex drive have a hormone imbalance
hot flashes
A company called First Call, LLC is offering a unique service to help lessen the ‘on call’ burden for area physicians. Staffed by Obstetric-trained RNs, PAs and NPs, and using protocols developed by ObGyn physicians, First Call will direct after-hours calls to a nurse first who can advise patients on acute problems. First Call nurses are trained to determine the level of urgency of the call and either offer appropriate advice or decide whether physician involvement is needed. The goal is to allow physicians to enjoy a less stressful call schedule, while ensuring that patients are served quickly and accurately. The new business is based in Sioux Falls. ■
December 2010
8 out of 10 women complaining of hot flashes have a hormone imbalance
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AHA ‘Go Red’ Conference Set for February The Go Red for Women Conference and Luncheon will take place at the Sioux Falls Convention Center from 10 am – 1 pm February 25, 2011. The American Health Associationsponsored conference includes morning breakout sessions, in which women and men can learn about their risk of heart disease and how to decrease that risk, and a silent auction and luncheon including an inspirational keynote speaker. The Go Red for Women conference attracted more than 500 people in Eastern South Dakota who support the cause, including health care professionals, business leaders, legislative leaders, cultural leaders, community leaders, and citizens. The luncheon aims to educate attendees about their risk of heart disease and stroke–the number one and number three killers–and what they can do to
decrease that risk. It also encourages attendees to spread the word throughout the community, including among at-risk populations like Native Americans, Hispanic Americans, and African Americans. The auction raises money for research, awareness, and education. In the past 2 years in South Dakota, for every dollar raised, the American Heart Association has spent three dollars on research, education and awareness. This year’s luncheon features a special group of men and women called the Circle of Red, featuring those who have made a $500 personal commitment to the American Heart Association. Cardiologist Tom Stys of Sanford health is one of the chief organizers of the event. Find more information at www.heart.org/ southdakota. ■
February 25, 2011. 10 am – 1 pm Conference and Luncheon Sioux Falls Convention Center
National Wear Red Day Friday February 04, 2011
CDC Names Local Physician to Advisory Committee on Breast Cancer in Young Women The Centers for Disease Control and Prevention has invited Dr. Donald Warne to serve on the Advisory Committee on Breast Cancer in Young Women, a federal advisory committee established by the Affordable Care Act, subject to prescribed appointment procedures. Dr. Warne was recently named Director of Native American Health at Sanford Health. He is the former Medical Director of the Aberdeen Area Tribal Chairmen’s Health Board, as well as the former President of the Board of the Native American
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Community Health Center, Inc., and President and CEO of the American Indian Health Management & Policy, Inc. (AIHMP). In his role on the CDC Committee, Dr. Warne will help to develop initiatives to increase knowledge of breast health and breast cancer among women, particularly among those under the age of 40 and those, such as the American Indian population, at heightened risk for developing the disease. Dr. Warne is one of 15 clinicians chosen for the committee from around the country. ■
Midwest Medical Edition
News & Notes
Happenings around the region
Regional
Sanford
James Engelbrecht, M.D., and Shari Fechner, Certified Nurse Practitioner (CNP) have joined the staff of Regional Medical Clinic. Engelbrecht specializes in rheumatology and earned his medical degree from the University of Iowa. He completed his internal medicine residency and rheumatology fellowship at the University of Utah Affiliated Hospitals in Salt Lake City. Shari Fechner, CNP, also specializes in rheumatology.
North Dakota seniors can now choose Sanford Select for their Medicare supplement insurance needs. The North Dakota Insurance Department has completed its approval process, allowing independent local agents to offer Sanford Health Plan’s Medicare Select supplemental health insurance plan in south east North Dakota and a Standard Medicare supplement product to residents across North Dakota.
Queen City Regional Medical Clinic centralized patient care areas, and more convenient parking. The project also includes an extensive remodel of Spearfish Regional Medical Clinic, which will follow the completion of Queen City in early 2012.
Avera Fechner
Engelbrecht
Borders Books Music & Cafe in Rapid City will team up with Children’s Miracle Network (CMN) to bring new toys and books to children in the hospital this holiday season. Borders will sell new children’s holiday gift items and have a donation drop box in their Rapid City store from Nov. 2 through Dec. 24. The gifts will be donated to CMN and given to children in the Pediatrics Department at Rapid City Regional Hospital for the holidays. Five Regional Medical Clinics recently received awards for maintaining immunization rates of 90 percent or greater while serving children between 24 and 35 months old. Golden Syringe Award (Clinics with 50 or more clients in the 24-35 month age group): Massa Berry Regional Medical Clinic, Sturgis, Spearfish Regional Medical Clinic. Consistently Maintaining Award (Clinics with at least five clients in the 24-25 month age group):Belle Fourche Regional Medical Clinic, Buffalo Regional Medical Clinic, Newell Regional Medical Clinic. Spearfish Regional Medical Clinic has received the Golden Syringe Award consistently for the past four years. Around this time next year, Queen City Regional Medical Clinic patients in Spearfish will enter a newly-expanded and renovated facility. The clinic broke ground in November on a $5 million, 14,000-square-foot construction project that will allow for the addition of new clinic services, enhanced patient care,
December 2010
The first STAR Ankle replacement surgery in the region was performed in early November at Avera McKennan hospital. STAR is the latest technology for ankle replacement approved by the FDA. It offers certain advantages over other types of artificial joints for replacement of arthritic ankle joints. Avera McKennan Hospital & University Health Center in Sioux Falls has been named as one of 10 “Trailblazing Hospitals” nationwide for innovation by FierceHealthcare. FierceHealthcare recognizes hospitals
that are not only considered among the best according to national ranking organizations, but also are considered to be technologically innovative. Two considerations were used to determine which hospitals were most “innovative”: The hospital had to appear on at least one of three major lists which rank high quality hospitals (HealthGrades, Thomson Reuters, or U.S. News & World Report’s list of best U.S. hospitals) and the organization had to appear on either the “Most Wired” and/or “Most Wireless” hospitals lists compiled by Hospitals & Health Networks Magazine. Avera Medical Group and Orthopedic Consultants/Alvine Foot & Ankle Center announced a new partnership effective in November. The new entity will be called CORE Orthopedics Avera Medical Group.
Other Cheri Kraemer, Pharm.D, owner of Pharmacy Specialties, Inc. in Sioux Falls recently received the Outstanding Service alumni award from SDSU. Of the 75,000 alumni, fewer than 300 have been chosen for such an award. She was nominated by the college of pharmacy and chosen by the alumni committee. Pharmacy Specialties, Kraemer Inc. is an independently owned compounding-only pharmacy that opened in 2001.
Workers’ Compensation
INSURANCE CARRIER OF CHOICE At RAS, Workers’ Compensation is our primary focus.
It’s what we do, and who we are. We have a proven history of solid performance with healthcare facilities throughout the Midwest. We have the knowledge and experience to address your unique concerns or situations. We have a team approach to deliver exceptional service, including:
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MidwestMedicalEdition.com
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www.rascompan i e s . c o m 1.800.732.1486
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Learning Opportunities Happenings around the region
December 2010 and February 2011 December 1, 2010 12:00 pm
Internal Medicine Grand Rounds: Survivors of Pediatric Cancer: From Specialty to Primary Care Location: Sanford School of Medicine–HSC–Room 106 Credits Offered: AMA PRA Category 1–1.00; Attendance–1.00
December 10, 2010 12:00 pm
Obstetrics and Gynecology Grand Rounds: TBA Location: Sanford School of Medicine–HSC–Room 106 Credits Offered: AMA PRA Category 1–1.00; Attendance–1.00
December 10, 2010 12:00 pm
Internal Medicine Grand Rounds: Obstetrics and Gynecology Location: Sanford School of Medicine–HSC–Room 106 Credits Offered: AMA PRA Category 1–1.00; Attendance–1.00
Just for fun…. December 19, 2010 4:00 pm
Children’s Care Holiday Jam! Featuring the Hegg Brothers Location: Orpheum Theatre Information: www.cchs.org
December 30, 2010 8:00 am
Test Event: Psychiatry Winter Update Location: Sanford School of Medicine, Test Facility, Conf Room 1Credits Offered: AMA PRA Category 1–1.00; Attendance–1.00
February 3–5, 2011
SDAFP Winter Seminar Location: The Lodge at Deadwood Information: www.sdafp.org CME Offered: Up to 70, with follow-up materials
February 16, 17, 2011 8 am – 5 pm
Fundamental Critical Care Support Program Location: Avera McKennan Education Center, Classroom 1Information: 605-322-8950
February 25, 2011
American Heart Association, Go Red for Women Conference Location: Sioux Falls Convention Center Information: heart.org/southdakota
MED reaches more than 3000 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.
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Midwest Medical Edition
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Intensive Care for Newborns
In whose hands will you place her?
Physicians’ Priority Line
1.888.592.7955
When a newborn is critically ill, a single call gives you instant access to our neonatal intensive care specialists and a full range of pediatric and surgical subspecialists, all supported by state-of-the-art technology and equipment. It can also link you to our neonatal transport service team, who will arrange for transport to Children’s Hospital & Medical Center based on the child’s needs. Twenty-four hours a day, seven days a week, one call links you to physician-to-physician consults, referrals and admissions. There’s no problem too large, no child too small.
www.ChildrensOmaha.org
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