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Inspiring Health SPRING 2018

A Blessing in Disguise Imaging procedures reveal an unexpected problem

Meet Mako Brookings Health System’s newest technology for joint replacement surgery

Medication Safety: Prevention of Adverse Drug Events How pharmacists and providers work to keep patients safe

A Decade of Service Jim Booher’s decade of service to Brookings Health System’s Board of Trustees was inspired during a golf game with a county commissioner.

While on the board, Booher served as the finance committee chairman, board secretary and was a part of the building committee credited for the neighborhood concept throughout Brookings Health System’s nursing home. Additionally, Booher’s professional life outside of the board is very accomplished. He is one of the founders of the South Dakota Athletic Trainers Association, authored two books and a multi-Hall-of-Famer. Booher is well-known for the development of the athletic training- physical therapy program at South Dakota State University and considered one of the 10 most recognizable people in athletic training. Walt Wosje, board president, is immensely proud to have served with Booher. “Jim Booher has been a very steadying influence on the BHS board. His knowledge and enthusiasm for the health industry has been invaluable to our board of trustees.” Thanks Jim for your decade of service to Brookings Health System!


Protect Yourself from Salmonella Salmonella is a bacterium widely known for causing food poisoning in the United States. It can occur in raw poultry, eggs, beef, unwashed fruits and vegetables.

Thoroughly cook raw foods to the proper temperature, not under or over.

Although there is no preventative vaccine, there are ways you can keep salmonella out of your kitchen: clean, separate, cook and chill.

Infected persons may notice symptoms 6-48 hours after exposure. Symptoms may include diarrhea, fever, or stomach cramps. Always consult a physician if you think you have been infected.

Wash your hands and kitchen utensils before and after handling foods. Maintaining a clean workspace will decrease the chance of contamination. Always keep food groups separate from each other. For example, don’t use the same plate for your salad as you used to season your chicken.

Let your leftovers chill before refrigerating them.

Most recently in 2017, the U.S. experienced salmonella outbreaks in contaminated papayas and from contact with infected pet turtles.

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Medication Safety:

Prevention of Adverse Drug Events

An adverse drug event can happen after a patient receives any medication and the severity can range from minor (e.g., nausea, foggy feeling) to severe (e.g., hallucinations). An allergy to a medication (e.g., rash, swelling of airways) is different than an adverse drug event and is less predictable than an adverse effect from a medication. Pharmacists carefully review all patients’ medication history after they are admitted to the hospital as a practice to prevent adverse drug events. This review process includes gathering information about their current medications, allergies to medications, previous reactions to medications and immunization history. “Reviewing the medications and discussing the medications with the patient is an opportunity for us to identify any past and potential adverse medication events,” said Steve Timmerman, director of pharmacy at Brookings Health System. When an adverse event happens, nurses note what side effect(s) the patient has and work with the pharmacists to try and determine if a medication may have caused the problem. “The nurses, from the pharmacy stand point, are our eyes and ears on what’s going on because they have the direct patient contact,” said Timmerman. Reactions may appear as a result of a number of different things: wrong dosage, not tolerating the

current medications, an allergy, or interaction with another medication. Luckily, there’s a screening tool in place that helps determine what the side effects come from. The screening tool takes a health care provider through questions like: what time did the event happen, when was the medication given, etc. to reveal a step by step timeline creating a true cause and effect. If the patient takes multiple medications at the time of their reaction, and the reaction was non-life threatening, patients may receive a rechallenge of the new medication to see if the same reaction develops. If it does, the new medication takes fault. If it doesn’t, then the reaction likely resulted from something else. The time that healthcare providers take to sort through adverse effects and allergies is worthwhile as it can help guide decisions on future medication use. If a patient gets nausea from an oral medication then they may be able to tolerate an IV medication. Therefore, it is important that the adverse effect of nausea is not inappropriately labeled as an allergy in a profile. If a patient has an allergy to a medication then it changes the decision about the use of alternative forms of the medication or medications that are similar to the one listed in a record/profile. To learn more about the prevention and care of adverse drug events at Brookings Health System visit:

spring 2018


A Blessing in Disguise 4

In September, Dennis Micko’s visit to Brookings Hospital for a Crohn’s Disease episode was a blessing in disguise; all thanks to the imaging technology available. After Dennis was admitted to the emergency department, the care team performed an ultrasound to figure out what was going on. On that ultrasound, the team noticed spots on his liver which raised concern going forward with his stay. A spot, or spots, on the liver will appear different from the rest of the liver tissue and can mean a number of things. Infections, inflammatory reactions and various types of noncancerous and cancerous tumors can emerge as such. “Outside of those spots I have a real healthy liver, so it was a little bit unique,” said Dennis. Following the ultra sound, Dr. Matt Bien ordered two computerized tomography (CT) scans and a magnetic resonance image (MRI) to obtain more detailed images that would better determine what the spots were from. When the results came back the spots were declared cancerous. Thanks in part to the imaging procedures offered at Brookings Health System, Dennis was able to catch a potentially deadly cancer in the early stages when it’s more treatable.

“It’s just nice to know that there’s the kind of care and expertise locally,” said Dennis. Generally, a person experiencing the early stages of liver cancer won’t even know they are. Symptoms disguise themselves until the cancer is further advanced, sometimes too far advanced to treat. “I probably would’ve never known of the liver spots that were identified had I not had the Crohn’s episode,” said Dennis. “I had no symptoms from the liver disease at all.” After the diagnosis, Dennis was shifted over to Avera’s liver transplant team where he was put through a series of tests to be placed on the liver transplant list. Although Dennis’s stay at Brookings Health System was only six days, the kindhearted staff and care he received was second to none. “The one thing I observed more than anything was just how caring people were at Brookings Hospital.” Want to know more? Listen to Dennis tell his story online at


Mandy Wilde, CNP! Brookings Health System proudly welcomes family nurse practitioner Mandy Wilde, CNP, as the new primary care provider at Arlington and Volga Medical Clinic starting on Monday, March 26. “I am very excited for the opportunity to serve as the healthcare provider in Arlington and Volga. I have lived and grown up near Volga my entire life and am thrilled to begin this position. It will be a privilege to serve these communities,” said Wilde. Wilde has three years of experience as a registered nurse in the critical care setting and most recently as a family nurse practitioner at Brown Clinic in Watertown, S.D. She received her Master of Science in Nursing from South Dakota State University (SDSU) in 2017 and her Bachelor of Science in Nursing from SDSU in 2014. Wilde is a member of the Nurse Practitioner Association of South Dakota, American Association of Nurse Practitioners and State Emergency Registry of Volunteers in South Dakota. She is certified in advanced cardiovascular life support (ACLS), pediatric advanced life support (PALS) and basic life support (BLS). To schedule your appointment with CNP, Mandy Wilde, please call Arlington Medical Clinic at (605) 983-3283 or Volga Medical Clinic at (605) 627-5701.

New Clinic Hours Arlington

Monday  8 a.m. – 5 p.m. Wednesday  11 a.m. – 7 p.m. Friday  8 a.m. – 5 p.m.

spring 2018


Starting in April Tuesday  8 a.m. – 5 p.m. Thursday  8 a.m. – 5 p.m.


Welcome DR. MARK MAYER! Brookings Health System proudly welcomes Dr. Mark Mayer, M.D. of Avera Medical Group Specialty Care. Dr. Mayer specializes in orthopedic surgery and robotics and serves the needs of area patients of all ages. Dr. Mayer completed his five year residency at William Beaumont Hospital in Royal Oak, MI. He received his medical degree from Wayne State University School of Medicine in Detroit. Dr. Mayer belongs to the American Academy of Orthopaedic Surgeons and is board certified by the American Board of Orthopaedic Surgery. Dr. Mayer is passionate about knee replacements, hip replacements, fracture surgery, shoulder surgery and carpel tunnel release. He is available to provide care in all areas of orthopedics. As a local physician, Dr. Mayer offers patients the opportunity to have their medical needs attended to close to home, near family and friends.


To schedule your appointment with Dr. Mark Mayer, call Avera Medical Group Specialty Care of Brookings Health System at (605) 696-2700.

Meet Mako Brookings Health System is expanding its surgical robotic program, becoming the second facility in South Dakota to offer robotic-arm assisted total knee, partial knee and total hip replacements with Stryker’s Mako System. This highly advanced robotic technology transforms the way joint replacement surgery is performed, enabling surgeons to have a more predictable surgical experience with increased accuracy. Dr. Mark Mayer, who will join Dr. Patrick Moriarty at Avera Medical Group Specialty Care Clinic and Brookings Hospital, will provide general orthopedic services and offer the advanced robotic-assisted surgical options to patients. Mayer, who is relocating to Brookings from Michigan, has already performed numerous Mako robotic procedures. “With Mako, we can provide each patient with a personalized surgical experience based on their specific diagnosis and anatomy,” said Operating Room Director

Candace Johnson. “Using a virtual 3D model, Mako allows surgeons to create each patient’s surgical plan pre-operatively before entering the operating room. During surgery, we can validate that plan and make any necessary adjustments while guiding the robotic-arm to execute that plan. It’s exciting to be able to offer this transformative technology across the joint replacement service line to perform total knee, total hip and partial knee replacements.” The demand for joint replacements is expected to rise in the next decade. Total knee replacements in the United States are estimated to increase by 673 percent by 2030, while primary total hip replacements are estimated to increase by 174 percent. The Mako Total Knee application is a knee replacement treatment option designed to relieve pain caused by joint degeneration due to osteoarthritis. Through CTbased 3D modeling of bone anatomy, surgeons can use the Mako System to create a personalized surgical plan


and identify the implant size, orientation and alignment based on each patient’s unique anatomy. The Mako System also enables surgeons to virtually modify the surgical plan intra-operatively and assists the surgeon in executing bone resections. The Mako Partial Knee application is a treatment option designed to relieve pain caused by joint degeneration due to osteoarthritis that has not yet progressed to all three compartments of the knee. Following the personalized pre-operative plan, the surgeon guides the robotic-arm during bone preparation to execute the pre-determined surgical plan and position the implant. By selectively targeting only the part of the knee damaged by osteoarthritis, surgeons can resurface the diseased portion of the knee while helping to spare the healthy bone and ligaments surrounding the knee joint. The Mako Total Hip application is a treatment option for adults who suffer from degenerative joint disease of the hip. During surgery, the surgeon guides the robotic-arm

during bone preparation to prepare the hip socket and position the implant according to the pre-determined surgical plan. “We are proud to be the second hospital in South Dakota to offer this highly advanced robotic technology,” said CEO Jason Merkley. “The addition of Dr. Mayer to our orthopedic team and the Mako robot to our surgical program further demonstrates our commitment to provide high-quality, compassionate, personalized health care to our community.” The public is invited to test-drive the Mako robot and meet Dr. Mayer on Monday, April 16 from 3 – 6 p.m. at Hy-Vee. For more information about the Mako robotic-assisted surgical system and orthopedic services at Brookings Health System, please visit

spring 2018

300 22nd Avenue Brookings, SD 57006

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Inspiring Health is published by Brookings Health System. This publication in no way seeks to serve as substitute for professional medical care. Consult your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines.

A Way to Give Back The Brookings Health System Foundation recently implemented the MyThanks Matters grateful patient program in support of patient’s desires to say thank you to our team members for the care they received while at Brookings Health System.

This program presents patients the opportunity to give back by whichever means best suits them.

Assisting parents in the labor and delivery process as a labor or postpartum doula

Share Your Contribution

Registering participants at New Beginnings Baby Café, a breastfeeding support session

A financial gift made to Brookings Health System Foundation helps support ongoing programs including:

Visiting with hospice patients and supporting family members

Financial assistance for in-need patients Continuing education for care providers Health and wellness education within the community Facility, equipment and technology upgrades Your contribution may also honor a caregiver who made a difference in your stay, including a doctor, nurse, housekeeper, dietary aide or any team member.

Share Your Time Volunteer opportunities include: Helping patients and visitors navigate Brookings Hospital at the information/wayfinding desk Assisting with daily operations and sales at the Brookings Hospital gift shop Providing companionship to patients in the hospital’s Inpatient Care unit

Assisting with resident activities at The Neighborhoods at Brookview skilled nursing home

Share Your Story Telling others about the exceptional care experience at Brookings Health System helps bring more patients to our doors. Ways to share your story include: Recording your story with us for use in web, radio and print ads Rating us and leaving positive reviews on web and social media sites like Facebook and Google For more information or questions about MyThanks Matters, please visit or contact the Brookings Health System Foundation at (605) 696-8855 or

Inspiring Health Spring 2018  
Inspiring Health Spring 2018