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Coping with COVID-19 as a Medical Professional SD Rural Hospitals Dominate the Top 20 List

DELIVERING CARE BEYOND HEALING AMANDA SEDLACEK, DO Palliative Medicine Specialist April / May 2020

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

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VOL. 11 NO. 3

2020


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VO LU M E 1 1 , N O. 3 ■ A P R I L / M AY 2020

Inside This Issue

CONTENTS PAGE 6 | FIVE ESSENTIAL CYBERSECURITY THREATS TO FOCUS ON The experts at Copic introduce an HHS publication with an easy-to-understand approach designed specifically for healthcare

■ By Copic

PAGE 8 | THIS MONTH ONLINE Robotic Whipple procedures at SISD, America’s 6th happiest city, Website-only articles PAGE 10 | [Interview] Clarissa Barnes, MD: Coping with COVID-19

ON THE COVER

PAGE 14 | NEWS & NOTES

DELIVERING CARE BEYOND HEALING

PAGE 18 | Giving Kids a Helping Hand Constraint-Induced Movement Therapy

■ By Alex Strauss

As a board certified palliative medicine specialist, Amanda Sedlacek, DO, cares for patients’ wellbeing when physical healing is no longer an option PAGE

12

at LifeScape ■ By Alex Strauss PAGE 19 | Sanford Unveils Plans for Clinic Expansion and New Orthopedic Hospital PAGE 20 | South Dakota has More Top 20 Rural Community Hospitals Than Any Other State SD surges to the head of the rural hospital pack in 2020. Here’s why one doctor thinks that is. ■ By MED Staff PAGE 23 | Upcoming Events The latest cancellations, plus what conferences are still on

CONTACT INFORMATION

T

HEY SAY NOTHING IS certain but death and taxes, and now even the certainty of taxes may be changing as the government tries to adapt to COVID-19. That leaves death. And while many physicians dedicate their lives to helping patients stave off that inevitability, Amanda Selacek, DO, is devoting hers to helping them and their loved ones get through it as a palliative medicine specialist. Dr. Sedlacek is the focus of this month’s cover feature. By now, we all know about the importance of cybersecurity. But if you think your password-protected computers and a firewall are enough, it may be time to re-think your strategy. We have some important resources for you in this issue. Plus, how healthcare workers cope with crises, help for pediatric hemiplegia at LifeScape, and why South Dakota dominates this year's Top 20 rural hospitals list. Enjoy! —Alex and Steff

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CYBERSECURITY THREATS 5 ESSENTIAL TO FOCUS ON HHS publication provides an easy-to-understand approach designed specifically for healthcare

BY COPIC’S PATIENT SAFETY AND RISK MANAGEMENT DEPARTMENT

W

HILE THE ISSUE OF cyber liability is something medical providers have been warned about for years, the question

of “where to start” to protect yourself can be complicated. Last year, the Department of Health and Human Services released a publication titled “Health Industry Cybersecurity Practices: Managing Threats and Protecting Patients” to help medical practices and facilities prioritize what issues to tackle first. Based on recommendations that focus on

the most impactful threats, the publication notes that “Given the increasingly sophisticated and widespread nature of cyber-attacks, the health-

THREAT: EMAIL PHISHING ATTACK REAL WORLD SCENARIO: Your employees receive a fraudulent email from a cyber attacker disguised as an IT support person from your patient billing company. The email instructs your employees to click on a link to change the billing software passwords. An employee who clicks the link is directed to a fake login page, which collects that employee’s login credentials and transmits this information to the attackers. The attacker then uses the employee’s login credentials to access your organization’s financial and patient data.

care industry must make cybersecurity a priority and make the investments needed to protect its patients…Hackers look for targets that require the least time, effort, and money to exploit. Do

VULNERABILITIES

not make the mistake of thinking that your prac-

• lack of awareness training

tice, no matter how small, is not a target for indiscriminate cyber-attacks.”

• lack of IT resource for managing suspicious emails

The most impactful threats the publication

• lack of software scanning emails for malicious content

identified are: 1. Email phishing attack 2. Ransomware attack 3. Loss or theft of equipment or data 4. Insider, accidental or intentional data loss 5. Attacks against connected medical devices that may affect patient safety The HHS publication includes a two-page sum-

• lack of email detection software testing for malicious content • lack of email sender and domain validation tools

IMPACT • loss of reputation in the community (referrals dry up, patients leave) • stolen access credentials used for access to sensitive data

mary regarding each threat with real-world

• erosion of trust or brand reputation

scenarios, quick tips, and a table that outlines vulnerabilities, impact, and practices to consider.

• potential negative impact to the ability to provide timely and quality patient care

The following is an example of one of the five

• patient safety concerns

threats to highlight the useful information available in the HHS publication:

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PRACTICES TO CONSIDER

In addition to the “Health Industry Cybersecurity Practices: Managing

•b  e suspicious of emails from unknown senders

Threats and Protecting Patients”

• t rain staff to recognize suspicious emails and know where to forward them

publication, there are two supporting

•n  ever open email attachments from unknown senders

cybersecurity practices for managing

• t ag external emails to make them recognizable to staff • implement incident response plays to manage successful phishing attacks • implement advanced technologies for detecting and testing email for malicious content or links • implement multifactor authentication

technical volumes that outline ten the key threats. (One volume is designed for small healthcare organizations, the other is for medium to large organizations.) There is also a “Resources and Templates” document that includes a variety of cybersecurity resources. ❖

• implement proven and tested response procedures when employees click on phishing emails •e  stablish cyber threat information sharing with other healthcare organizations ❱ D ownload links for all of these materials are available on the MED website.

April / May 2020

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

Sioux Falls is Exclusive online articles Orthopedic Specialist Offers Treatment America’s 6th Yankton for Dupuytrens Disease Happiest City

Jessica Reissig, DO, of Yankton Medical Clinic has recently started offering injections of collagenase clostridium histolyticum (Xiaflex) for the treatment of Dupuytrens contracture in the hand. The treatment can replace surgery and offers a faster, easier treatment for this common condition with no downtime. You can read our exclusive conversation with Dr. Reissig about Xiaflex on the website.

Maintaining a Sustainable Future for Your Healthcare Facility The personal finance site WalletHub has named Sioux Falls America’s 6th Happiest City. WalletHub compared

Sustainability initiatives can help healthcare facilities become more efficient, gain a competitive edge, save money, and positively impact their environment and communities. Unfortunately, it’s not a oneand-done effort.

more than 180 of the largest US cities across 30 key indicators of happiness. The data set ranges from depression

MED’s Steff Liston-Holtrop, Tara Allen,

rate to income-growth rate to average

and Kristin Hoefert-Redlinger at March’s

leisure time spent per day. Click here

“Rising in Excellence” Award Ceremony sponsored by SME Sioux Falls. The award was created

in your digital issue or check out the website to see how Sioux Falls stacks up in different metrics and find a link

to recognize an individual in the South

to the full report.

Dakota business community between 25 and 45 who is viewed as a future leader. Holtrop won the very first Rising

BECAUSE YOU ASKED . . .

in Excellence award two years ago, Hoefert-Redlinger was last year’s winner, and Allen received the honor this year.

“What is a MED Digital Partner anyway?” You see their logos in every print and digital issue of MED Magazine. You see them in your semi-weekly News Roundup (you ARE on the VIP mailing list, right?). You see them at the bottom of every page of MidwestMedicalEdition.com. And you have likely read their articles on the website. But exactly what are these MED Digital Partners who seem to be everywhere? MED Digital Partners are advertisers who pay a small monthly fee to be in front of MED’s audience, wherever they are. Digital Partnership includes content marketing opportunities and even custom content generation at the Pro level. Intrigued? These spots are limited. Contact Steff@MidwestMedicalEdition.com to learn more.

NEVER MISS AN EVENT! Check out MED’s online calendar for a complete listing of Upcoming 8

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SISD Surgeons Now Offering Robotic Whipple Procedure

I

Digital Partners

N THE TREATMENT of advanced cancers of the foregut, chemotherapy and surgery are typically used in tandem for optimal outcomes. Unfortunately, complex open surgery with a

lengthy recovery period can delay a patient’s ability

to either initiate or resume chemotherapy. That, says surgeon Mike Person, MD, FACS, of Surgical Institute of South Dakota, is a critical factor in cancer treatment. “Our goal is always to remove as much of the cancer as possible and then get them well enough for chemotherapy as quickly as possible,” says Dr. Person. The Whipple procedure for advanced pancreatic cancer is a prime example. Whipple (pancreaticoduodenectomy) is a large and complex 4- to 5-hour operation involving the removal of the proximal portion of the pancreas along with some of the surrounding intestine and a portion of the bile duct. Person is one of only a few surgeons to perform the Whipple procedure in the Sioux Falls area. He is the only physician in the area now offering the procedure robotically. “To progress the care of pancreas cancer patient’s survivability, it’s about chemotherapy,” says Dr. Person. “So we want to see how we can improve this surgery to get them into or resume chemotherapy as quickly as possible. The robotic surgery gives us a tool to try to do that. We are trying to optimize patient recovery by moving to a minimally invasive approach when possible.”

To read the full article on Whipple and other minimally invasive cancer procedures at SISD on our website, click here in your digital issue.

Does your clinic, hospital, or company do business in North Dakota? MED is expanding

our digital news distribution service into the North Dakota region and we want your news! Send announcements and events to be shared with a North Dakota audience to Info@MidwestMedicalEdition.com and put “North Dakota” in the subject line. Then watch for the chance to join the new North Dakota email list!

conferences and symposiums. MidwestMedicalEdition.com/calendar April / May 2020

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[ INTERVIEW ]

Clarissa Barnes, MD Coping with COVID-19

A

S THE COVID-19 PANDEMIC continues to evolve, healthcare workers are on the front lines of the battle against it. Clarissa Barnes, MD, is an Internist and hospitalist at Avera McKennan and medical director of Avera’s Light Program, which addresses

things like physician stress and burnout. We spoke with her in mid-March on how the crisis is impacting people working in medicine in our area. MED: We still have only a handful

I do think there are physicians who

of COVID-19 cases in our area right

have worsening stress right now,

now. Have you felt any effects yet?

especially those who had more stress

CB: In some ways, things are clearly

at baseline. But, in general, I think it

happening already. I’ve had partners come back from travelling and be told they can’t work for 14 days. So some of us are already taking on extra shifts. In other ways, it really does feel like the bigger impact is still coming.

helps to know what to expect. It is not the patient care aspect that drives us crazy. It is all the other stuff, the unknowns and the logistics. But taking care of patients is aligned with our jobs. This is what we do and, in many ways, it is mentally recentering to focus on that.

MED: How do you cope with that knowledge that things are likely to get a lot worse before they get better?

CB: I think we are all doing what we need to do to prepare mentally. There are a lot of online groups for doctors so many of us are talking to physicians in other markets, getting a sense of what they are seeing and how they are handling it. There is a lot of sharing happening right now. MED: Do you think it creates or alleviates stress to hear about what is happening in other

MED: Have you ever been through a stressful situation like this before?

is what we trained for. We have always known that something like

CB: When I was a senior resident at

this could happen. And physicians

Johns Hopkins, one of our surgeons

in general have a better understand-

was shot. It feels like that. We didn’t

ing than the general public of what

panic. We knew we just had to get

this could look like. As physicians,

the work done. I’m always amazed

we are inherently more comfortable

at how focused and calm physicians

with levels of uncertainty than other

and other healthcare workers are

people are. A lot of decisions we make

when things are in a bad place. Even

every day have a level of uncertainty

when things seem chaotic, people

about them. This level of discomfort

tend to get really focused. I haven’t

is not unusual.

gotten many questions from people worried about their own health.

markets?

MED: Why do you think that is?

CB: As medical director for Light,

After all, physicians are human.

physician stress is part of my job.

CB: I think there is a sense that this

That said, it is important to remember that confidential services are available if you do start to feel overwhelmed. If you are wondering if you need some help, the answer is probably yes. ❖

“I think there is a sense that this is what we trained for. We have always known that something like this could happen.” 10

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April / May 2020

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care

Delivering

Amanda Sedlacek, DO, Palliative Medicine Specialist

A

MANDA SEDLACEK’S PASSION for palliative medicine has its roots in her childhood on a farm in Tabor, South Dakota. “It is a place where people tend to take care of family as they age,” she says. As a child, Sedlacek spent time helping to care

for her aging grandmother who passed away when she was in first grade. “I stayed home with my grandmother sometimes. I did things like help

comb her hair,” remembers Sedlacek, whose mother was a nurse. “My family had to deal with some really hard end-of-life issues and I remember watching how my grandmother changed as a person as she became ill.” The experience ultimately drew Dr. Sedlacek to internal medicine where she saw a chance to care for “the whole person and the whole body”, both in and out of the hospital. She earned her DO from Des Moines University of Osteopathic Medicine and completed her residency in Internal Medicine at St. Joseph Warren Hospital in Youngstown, Ohio. “After my first year of training, one of our program directors told me he thought I would enjoy hospice medicine,” she says. Within a month of working with hospice inpatients in Youngstown, Sedlacek’s mind was made up. She completed a fellowship in Palliative and Hospice Medicine at Summa Health in Akron, Ohio and moved back to South Dakota last summer with her growing family. She now works at Yankton Medical Clinic where palliative medicine makes up about half of her internal medicine practice. “I feel like it is the greatest blessing to take care of people at the end of life,” she says. “It is a time of very raw human emotions. Not just grief and sadness, but also a lot of love. I feel fortunate that I can help people go through this.”

UNDERSTANDING PALLIATIVE MEDICINE As a board-certified palliative medicine specialist, one of Dr. Sedlacek’s first duties was to help other professionals understand the nuances of her role and exactly how she can support them in the care of their sickest patients. “Palliative and Hospice Medicine works alongside the specialty team to focus on the patient’s and family’s understanding of the disease process, their prognosis, and their course Dr. Sedlacek consults with a nurse at Yankton Medical Clinic where she started work this summer.

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bey

g n i l a e h d on BY ALEX STRAUSS

of treatment,” explains Sedlacek.

to live. Part of Sedlacek’s job is to

This can include helping to

help her colleagues navigate this

be guided through a memory-making

complex territory.

process such as making a mold of

manage symptoms such as pain, nausea, dyspnea, depression,

“As a person declines, their

Parents who are losing a child may

the patient’s hand to help them

anxiety, constipation, or diarrhea.

need for an opioid may increase or

But it can also extend to advanced

decrease and 72 hours may be too

care planning, lining up home

long,” she says. “In a case like that, I

are not the only ones who can benefit

services, providing medication

would transition to something more

from Dr. Sedlacek’s expertise. She is

review and recommendations and

short-acting.”

also trained to help other healthcare

assisting with bereavement and psychosocial support. Upon referral, Dr. Sedlacek

Issues such as a patient’s

own stress and anxiety as they care for dying patients.

get a sense for what she calls “The

pads to alleviate musculoskeletal

Three W’s”–what they are wishing

pain may increase the chance of

for, what they are worried about,

accidental overdose through

and what they are wondering.

increased absorption. “Dying isn’t as simple a process

talk about all of these things,” she

as people think,” says Sedlacek.

says. “Dying is something people

“Metabolically, emotionally, even

don’t talk about, so it is something

spirituality, it changes everything.”

to have a provider looking at the

SUPPORTING PATIENTS AND CAREGIVERS

whole trajectory of their illness and

One of the many ways Dr. Sedlacek

addressing their concerns. It is a

helps dying patients and their

really intimate part of their lives.”

families is through processes such

about. It can make a huge difference

as dignity therapy and life review.

THE COMPLEXITIES OF DYING

professionals work through their

drug absorption. Even something as simple as the application of heating

people tend to be very worried

But patients and their caregivers

fluctuating BMI may also impact

consults with patients for an hour to

“During our time together, we

through their grief later.

“Some people feel like they have

“Taking care of very ill patients and their psychosocial issues can be exhausting,” says Dr. Selacek. “Burnout is common, especially among those who are dealing with complex patients who may be coming in multiple times a week. They are dealing with emotions and trauma and grief. Even administrators have to deal with this and it does impact them.” Support can take the form of journaling, intentional self-care, group work, or even creating art or poetry. Dr. Sedlacek says this kind of caregiver support work will be

Caring for dying patients is not easy

lost purpose in their lives when they

especially important when the new

for any provider. Emotions, stress,

are dying,” she says. “We take time

Maternal Fetal Loss program, a

and confusion may be high and

to recap the important moments of

collaboration between YMC and

there may be worried family

their life and what they mean to

Avera Sacred Heart Hospital,

members in the picture, as well. In

them. This can be used with anyone,

launches later this year.

addition, Sedlacek says, a dying

but it is often helpful with a dying

person may not respond to medica-

person who might have younger

work can help us grow personally,

tion as expected. Whereas a fentanyl

children. We talk through gifts like

professionally, and even academi-

patch might make sense for another

notes or videos they could leave for

cally,” she says. “This is how people

patient in pain, the fact that the drug

their children, ways that they can

find great gratitude and love for their

lasts for 72 hours can be a problem

continue to be a part of other

work.” ❖

for patients who may have less time

people’s lives when they are gone.”

April / May 2020

“With the right support, this

13


Happenings around the region

News & Notes

South Dakota | Southwest Minnesota | Northwest Iowa | Northeast Nebraska

AVERA CASEY WILLIAMS Casey Williams, PharmD, Chief Scientific Officer and Executive Director of Cancer Research at Avera Cancer Institute in Sioux Falls is the co-author of a new study on the survivability of colorectal cancer. Williams and his research colleagues at Kiel University in Germany found that patients treated with a combination of medicines based on the unique genetic and molecular profile of their tumor lived longer than those who had standard treatment. In American patients, the survival advantage was a year-and-a-half with precision medicine. “We’re excited because this emphasizes our belief that precision oncology is the future of medicine,” says Williams. The study appears in a recent issue of Cancers. The South Dakota Dental Association, through Professional Insurors, has struck an agreement to endorse Avera Health Plans to its members, the first step toward a goal of creating an SDDA association health plan. “If enough of our members subscribe to the Avera plan, this endorsement will turn into the creation of a fully-insured SDDA association health plan,” says Paul Knecht, Executive Director of the SDDA. The relationship officially began on March 1.

BLACK HILLS

SIOUX LAND In March, the June E. Nylen Cancer Center celebrated 25 years of providing comprehensive cancer care to the Sioux City region. The center officially opened its doors March 27, 1995 as Siouxland Regional Cancer Center. The project was several years in development and was a result of partnerships between MercyOne Siouxland Medical Center, UnityPoint Health St. Luke’s, Siouxland Hematology Oncology Associates, McNealy Radiation Oncology, and Washburn Radiology Oncology Services. The name was changed in 2005 after a gift from Mark Nylen in honor of his mother. The center’s eight providers and staff of more than 100 care for an average of 125 patients each day.

MATTHEW HUMPAL Matthew Humpal, MD, has joined MercyOne South Sioux City Family Medicine as a primary care physician. Dr. Humpal, who recently practiced in Spencer, Iowa, did his residency at Clarkson Family Medicine in Omaha, Nebraska. He attended medical school at the University of Texas Medical Branch in Galveston, Texas and received his bachelor’s degree from Texas A&MCorpus Christi.

Black Hills Surgical Hospital has been recognized as one of America’s Best Hospitals for Orthopedics by the Women’s Choice Award. The award also signifies that Black Hills Surgical Hospital is in the top 1% of 4,910 US hospitals offering orthopedic and spine services. To be considered for the award, a hospital must have arthroscopy, joint replacement and spine surgery orthopedic services, onsite physical therapy, and an MRI. This distinction recognizes excellence in orthopedics based on robust criteria that consider patient satisfaction and clinical excellence.

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INDEPENDENTS & OTHERS LISA DAHL K.C. DEBOER Prairie Lakes Healthcare System recently earned a four out of five star facility rating from Hospital Compare, a service of the Centers for Medicare and Medicaid Services. Staff, volunteers, and board members gathered with PLHS President & CEO K.C. DeBoer for a celebratory event in February. PLHS was also named a Top 20 Rural Community Hospital by the National Rural Health Association (NRHA).

Lisa Dahl is the new Executive Director of the Prairie Lakes Healthcare Foundation. Dahl holds a BS and has more than twenty years of experience in Development and Human Services. Her most recent position was Executive Director for the Watertown United Way. Dahl is a Watertown native and a member of the Rotary Club, Mount Marty Watertown Advisory Committee, Codington County Area Non-Profit Group, and Prairie Lakes Healthcare Foundation’s Susan Jacobson Memorial Fund Committee. Spencer Hospital has again been recognized as one of the Top 100 Rural & Community Hospitals in the US, earning the designation for the fifth consecutive year. Spencer Hospital is the only mid-sized Iowa hospital to have earned this distinction every year it has been awarded. The nation’s top rural hospitals are recognized annually by the Chartis Center for Rural Health, which also recognizes the country’s Top 100 Critical Access Hospitals.

Spencer Hospital’s Wound Healing & Hyperbaric Medicine center received two hyperbaric oxygen therapy (HBOT) chambers in early March. The hospital is renovating a portion of the third floor for the new wound healing center which is anticipated to open this summer. The new Wound Healing & Hyperbaric Medicine services will incorporate the use of HBOT to treat a variety of medical conditions including diabetic foot ulcers, radiation injuries to tissue and bone, necrotizing infections, compromised skin grafts and skin flaps, some types of arterial insufficiency, and ischemia.

HALEY ELLIS PLHS Cardiac Cath Lab Nurse Haley Ellis has advanced her education to Certified Nurse Practitioner. Ellis graduated with her Master’s Degree in Family Nurse Practitioner from South University. She has 13 years of experience as a registered nurse. She spent six of those years caring for patients in the Prairie Lakes Cath Lab. Prior to that, she spent seven years in the Critical Care Unit. Ellis joins Dr. Garcia, Dr. Maaliki, Dr. Miller, and Nurse Practitioner Jacklyn Karli.

April / May 2020

15


Happenings around the region

CHARLES HARPER

KELLY JUEDEN Yankton Medical Clinic, PC, recently welcomed board-certified internal medicine specialist Charles Harper, Jr., MD, and Kelly Jueden, CNP, to the clinic’s Norfolk, Nebraska location inside the Fountain Point Medical Community facility. Harper earned his MD and completed his internal medicine residency at the University of Nebraska Medical Center. Jueden is a family medicine certified nurse practitioner. She earned her Master of Science in nursing from Clarkson College, in Omaha.

Yankton Medical Clinic, PC, laboratory has met all criteria for accreditation by the Commission on Office Laboratory Accreditation (COLA), a national healthcare accreditation organization. COLA is a nonprofit, physiciandirected organization promoting quality and excellence in medicine and patient care through programs of voluntary education, achievement and accreditation. The COLA certification is valid for two years. Watertown’s Brown Clinic has again received the Patient-Centered Medical Home recognition from the National Committee for Quality Assurance (NCQA). The award recognizes primary care teams that coordinate and communicate with other care professionals and specialists in a structured and timely manner. To earn recognition, which is valid for one year, Brown Clinic earned the necessary scores across five standards. In addition to connecting with secondary and specialty care providers, the standards include identifying patient needs, patient care and support, system capabilities, and performance measurement and improvement.

Hospitalist Catherine Leadabrand, MD, collaborates on patient care with Inpatient Care Nurse Erica Sanderson at Brookings Health System. Brookings Health System was recently named a Top 20 Rural Community Hospital and one of the 2020 Top 100 Rural & Community Hospitals in the US. Nationally, Brookings Health ranks in the top one percent of all rural and community hospitals. This is the third time in four years that the National Rural Health Association (NRHA) has named Brookings Health to the elite Top 20 list. It is the fifth consecutive year that the hospital has been included by The Chartis Center for Rural Health on the Top 100 Rural & Community Hospitals list.

Mikala Simon, DPT, is now offering physical therapy through telehealth at Modern Day Health Care. Dr. Simon earned her BS at the University of South Dakota and received her Doctorate of Physical Therapy from Rockhurst University in Kansas City. She has practiced physical therapy for nearly 6 years and lives in the Aberdeen area. Through telehealth, Dr. Simon can check patient progress, address issues, and assist with exercises and other treatments. Modern Day Health Care is an advanced practice nurse owned and operated virtual clinic based in Sioux Falls.

❱ Intrigued by something you’ve read here in News & Notes? Want to know more? You can always read the full versions of these and other recent news items on our website. New articles are added every week!

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30 30+

PROVIDERS

Our team of providers is part of the region’s first hospital dedicated to the treatment of heart disease. Our providers at North Central Heart, a division of Avera Heart Hospital, continue to develop innovative ways to treat our patients with the largest, most experienced network of providers in the area.

17


Giving Kids a Helping Hand Constraint-Induced Movement Therapy at LifeScape

an approach called Constraint-Induced Movement Therapy. CIMT is a scientifically-supported therapy that involves temporarily restraining the unaffected limb while offering intensive daily therapy to encourage use of the affected one. According to Cleveland Clinic, which also offers CIMT, the method “is emerging as a best practice for children with hemiplegia.” “There is such great research on this,” says Conway. “We have been doing pre- and post-CIMT tests with our own kids here at LifeScape and we are seeing great improvements in grip strength and the ability to pick things up and move them.” CIMT can be highly effective but is not necessarily easy–on children or their families. First, the unaffected limb is constrained with a cast. This alone can be frustrating for a child, who may need extra help at home doing basic tasks like dressing or feeding. The cast complicates bath time. And children who find it uncomfortable may have trouble sleeping. The second aspect of CIMT is intense daily therapy. For about three hours each day, a LifeScape therapist works with the child to facilitate use of the affected arm. “Ideally, we want to do this for at least two weeks and usually more like three, depending on the age of the child,” says Conway. “So it is a big commitment for families.” Conway says younger children tend to get the most benefit from CIMT. LifeScape has seen patients as young as one or two years old. “Ideally, we want to see them within the year of their injury, so we can really work on those skills,” she says. “If we don’t get Jessyca Conway, OT, using CIMT with a young patient at LifeScape.

C

them until they are six or seven years old, a lot of

HILDREN WHO SUFFER A BRAIN injury,

things have already occurred that are harder to

infection, tumor, stroke, or other type of

reverse.”

head trauma can be left with the lingering

After two or three weeks, the cast is removed and

effects of one-sided paralysis or hemiplegia.

the child is encouraged to use their new skills at home

Hemiplegia in an arm causes it to be weak, stiff,

for a few months. Conway says parents are sometimes

and lacking in muscle control. Not surprisingly, a

sent home with small splints or other instructions to

child’s natural response is to stop using the

help keep the child from regressing. CIMT may be

affected limb in favor of the stronger, healthy arm.

repeated several times throughout the year with a

“A lot of parents come in and say their child will not use that arm at all,” says LifeScape occupational therapist Jessyca Conway. Conway provides upper extremity rehabilitation for children with neuromotor impairments through

18

break of two or three months in between sessions. “We are often able to go from the child not using the arm at all to them using it all the time,” says Conway. “It is never going to be their dominant hand, but it can be their helper hand.”❖

MidwestMedicalEdition.com


SANFORD UNVEILS PLANS FOR CLINIC EXPANSION AND NEW ORTHOPEDIC HOSPITAL

S

ANFORD HEALTH SAYS IT WILL INVEST $209.5 million into a three-year plan of new projects beginning this year in Minnehaha and Lincoln counties.

THE NEW PROJECTS INCLUDE SANFORD HEART HOSPITAL: The hospital will add 26,058 square feet, including 16 additional patient rooms

57th Street and Veterans Parkway. It will house family

and supporting spaces. That began in March and will be

medicine, pediatrics, obstetrics, allergy, acute care and

done by year’s end.

include 3-D mammography.

SANFORD HARRISBURG CLINIC: Construction on the

SANFORD VAN DEMARK BUILDING EXPANSION:

16,000-square foot clinic begins this spring and should

The 33,000-square foot expansion will also begin this

take about a year. The clinic will house family medicine,

fall and be completed in spring 2022. It will include 23

pediatrics, and obstetrics and will include walk-in

exam rooms, space for eight additional surgeons, and

availability. The clinic on the northwest corner of Cliff

12 advanced practice providers.

Avenue and Willow Street will have a Lewis Drug attached.

SANFORD ORTHOPEDIC HOSPITAL: Construction on the 163,000-square foot building will begin next summer

SANFORD 57TH & VETERANS PARKWAY CLINIC:

and the building will open in 2023. It will include 12

Construction on the 42,000-square foot clinic begins this

operating rooms with space for four more, a Sanford

fall and will be completed in 2021. The clinic, with a

Home Medical Equipment center, and easy access to the

Lewis Drug attached, will be at the northeast corner of

orthopedic walk-in clinic. ❖

Have an INFANT PATIENT IN NEED OF A DIAGNOSTIC HEARING TEST with a pediatric audiologist but CANNOT TRAVEL to one of the EXISTING LOCATIONS? 2 NEW TELEAUDIOLOGY LOCATIONS AVAILABLE: Regional Healthcare Center | Winner St. Luke’s Hospital | Aberdeen

Please make new and expecting parents aware of the EHDI 1-3-6 web application.

SCHEDULE AN APPOINTMENT: The University of South Dakota Scottish Rite Speech Language & Hearing Clinic 605-677-5474

ehdi136.com April / May 2020

19


SOUTH DAKOTA HAS MORE TOP 20 RURAL COMMUNITY HOSPITALS THAN ANY OTHER STATE

S

OUTH DAKOTA HAS MORE

drive the quality of rural hospitals.

hospitals on this year’s National

“There is a culture of self-sufficiency

Rural Health Association Top

in South Dakota, of wanting to do certain

20 Rural Community Hospitals

things and working hard to make sure

list than any other state. Five of the

we can,” says Senne.

20 hospitals are South Dakota-based.

“Communities can feel like they are

The list includes the 20 highest-ranked

losing a part of their identity if they lose

prospective payment system hospitals

their local hospital. So there is a strong

in the country based on an evaluation

desire in smaller communities to main-

by the Chartis Center for Rural Health

tain independence and continue to be

using iVantage Health Analytics’ Hos-

self-sufficient so that they can continue

pital Strength Index.

to take care of their babies and their

The determining factors for the top

grandmas and grandpas.”

20 rural and community hospitals were

Hospitals like Prairie Lakes keep

based on eight indices: inpatient market

investing in improvements that will

PLHS nurses at a recent

share, outpatient market share,

keep them on the NRHA’s radar.

event celebrating the

quality, outcomes, patient

Senne says receiving recognition

hospital's recent awards.

perspective, cost, charge, and

for high quality builds on itself,

financial efficiency.

driving winning hospitals like PLHS to invest in people and

The more confidence you have, the more risk you are willing to assume.

South Dakota hospitals on

technologies that will keep their

this year’s list include:

name on the Top 20 list. And the

•P  rairie Lakes Healthcare System in Watertown •B  rookings Health System in Brookings •A  vera Sacred Heart Hospital in Yankton •A  vera St. Luke’s Hospital in Aberdeen •A  vera St. Mary’s Hospital in Pierre

“For me, it gives me pride and confidence that we are doing what we need to be doing,” says Senne. “The more confidence you have, the more risk you are willing to assume. You have to innovate to stay relevant. Doing good gives you the confidence to keep doing good.” As an example, Senne points to the fact that PLHS was willing to invest in

Avera Sacred Heart and Avera St.

endobronchial ultrasound bronchoscopy

Luke’s both joined the list since 2019.

(EBUS)–diagnostic technology that

For Prairie Lakes, an independent health

has only been available in larger mar-

system in Watertown, this was the

kets–when he requested it. Senne says

fourth time on the Top 20 list. PLHS

the availability of this kind of high

Pulmonologist Svien Senne says there

level diagnostics helps keep patients

is a unique culture in many of South

at PLHS for treatment.

Dakota’s small towns that helps to

20

cycle continues.

“When we are able to make these

MidwestMedicalEdition.com


Committed to Making Your Workplace Safer

diagnoses here in our health system, we are much more likely to keep them here for surgery or medical or radiation oncology. It creates an entrance to our system that can really open things up for us.” With a service area that extends from just east of Pierre into central Minnesota and includes more than 90,000 people, the ability to keep newly diagnosed patients in Water-

We're more than a workers' compensation insurance provider. We're your partner in driving injury prevention.

town has significant value for PLHS. “Even if people have to travel an hour to get to us, they are still saving an hour and a half that it would have taken to drive to Sioux Falls,” says

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Dr. Senne. “It’s good for them

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21


SPRING/SUMMER 2020

UPCOMING EVENTS Note: To mitigate the spread of COVID-19, many area conferences and events have been cancelled or rescheduled. Where possible, we have attempted to note those events which are no longer happening. This information was correct at press time; however, due to the changing nature of the pandemic, we advise you to confirm events in which you are interested.

APRIL 8

APRIL 29–30

JUNE 15–16

CANCELLED

CANCELLED

7:00 am–5:00 pm

28th Annual Avera Trauma Symposium

APRIL 15–16 CANCELLED

1st Annual Heartland Healthcare Preparedness & Cybersecurity Conference

APRIL 17 CANCELLED

Avera Research Integrity Conference

APRIL 23 CANCELLED

2020 Sanford Nursing Symposium

APRIL 24 CANCELLED

Avera McKennan Diabetes Conference 2020

Post-Acute Partners in Care Conference (SDAHO)

42nd Annual Sanford Black Hills Pediatric Symposium

Sanford Kidney Symposium

Location: The Lodge at Deadwood, Deadwood, SD Information: 605-312-1062 Registration: sanford.org/ classes-and-events

MAY 1–2

JULY 20

APRIL 30 CANCELLED

CANCELLED

14th Annual Sanford Sports Medicine Symposium

MAY 5–6 CANCELLED

1st Annual Heartland Healthcare Preparedness & Cybersecurity Conference

8:00 am Make-A-Wish 20th Annual Golf Tournament Location: Minnehaha Country Club, Sioux Falls Information: 605-335-8000, jclark@southdakota.wish.org. Registration: southdakota.wish.org/ news-and-events

SAVE THE DATE:

JUNE 2–3 CANCELLED

2020 Healthcare Symposium (HVAC Elements)

SEPTEMBER 11 8:00 AM–4:00 PM CNOS Foundation Orthopaedic & Sports Medicine Symposium Location: Holiday Inn, Dakota Dunes, SD

VISIT THE ONLINE CALENDAR at MidwestMedicalEdition.com to find more information on these and other upcoming events between issues. You can also add your own event to the calendar for free.


Access to 35 specialties and 135 experts

just one call away When your patients need services that go beyond general care, turn to Sanford Health. We are here to provide you with expert pediatric specialty care including: • Allergy

• Neonatal intensive care

• Anesthesiology

• Perinatal medicine

• Cardiology

• Nephrology

• Child abuse

• Neurology

and neglect • Child and adolescent psychiatry

• Neurosurgery • Ophthalmology and optometry

• Clinical pharmacy

• Orthopedic surgery

• Developmental

• Palliative medicine

pediatrics

• Pulmonology

• Ear, nose and throat

• Radiology

• Emergency medicine

• Rehabilitation

• Endocrinology

• Rheumatology

• Gastroenterology

• Sleep medicine

• Genetics

• Surgery

• Hematology and

• Therapy

oncology • Hospital medicine

• Trauma • Urology

• Infectious disease • Intensive care

Call (844) 851-1515 to refer a patient today.

012000-00742 3/20

Profile for MED- (Midwest Medical Edition)

MED Magazine April/May 2020  

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