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Timely Resources for Reopening Your Practice From Shell Space to Surge Space in Record Time

THE YEAR NURSE OF THE

CELEBRATING NURSING IN THE TIME OF COVID

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

JULY AUGUST

‘COVID Heroes’ Help Healthcare Weather the Storm

VOL. 11 NO. 5

2020


Let’s get to the root of the problem As providers, we know that substance misuse and

addiction are often just symptoms of more complex problems. For treatment to be effective, the whole person—their basic needs, mental health, physical conditions, and overall safety must be addressed. Talking with your patients is a great place to start— helping them find a support team is even better. The Resource Hotline can provide your patients with the services and support they need to fully recover including:

• Connecting to housing, transportation, employment, and food assistance • Help accessing treatment and recovery services • Identifying financial assistance opportunities • Parenting education • Follow up services with a personal guide for addiction recovery through the Care Coordination program Your guidance is powerful. Patients are more likely to follow through when you recommend a course of action.

Refer your patients and their families to the

Resource Hotline 1-800-920-4343 It’s FREE, confidential, and available 24/7. Together, we can treat the whole person and set them on the path to recovery. For more: AvoidOpioidSD.com/find-help

AvoidOpioidSD.com


When one number connects you to the region’s best pediatric specialists, Anything can be. 1.855.850.KIDS 1.855.850.KIDS (5437) (5437) is is your your 24-hour 24-hour link link to to pediatric pediatric specialists specialists for for physician-to-physician consults, referrals, admissions and transport. physician-to-physician consults, referrals, admissions and transport.

Education Education

• •

Research Research

• •

Advocacy Advocacy

• •

Care Care


VO LU M E 1 1 , N O. 5 ■ J U LY/AU G U S T 2020

Inside This Issue

CONTENTS PAGE 6 | Resources and Guidance for Reopening Medical Practices ■ By COPIC Ready to reopen? Here is a list of online resources that can help you do it safely.

PAGE 8 | Recognizing COVID Heroes

ON THE COVER

Year of the NURSE THE

Celebrating Nursing in the Time of COVID

PAGE 10 | This Month Online How to find back issues of MED, Exclusive online articles, coronavirus restrictions in SD

PAGE 16 | News & Notes A roundup of medical community news and announcements you might have missed

PAGE 18 | Hurry Up and Wait

■ By Alex Strauss

Two hundred years after the birth of Florence Nightingale, the World Health Organization

Monument Transforms Shell Space in Record Time Ahead of Projected COVD-19 Surge Page 21 | Local Healthcare Professionals at the Heart of Public Information Campaign Familiar —and trusted— faces remind the public not to let their guard down.

designated 2020 the International Year of the Nurse and Midwife. Unfortunately, COVID has largely overshadowed the celebration. PAGE

Meet some of the healthcare professionals who have gone above and beyond to help keep patients, colleagues, and communities safe.

12

Page 22 | Your Medical Practice is Reopened: Now What? ■ By Jackie Coult Eide Bailly's advice for protecting patients, staff, and your bottom line Page 23 | Upcoming Events

W

elcome to the Summer edition of MED Magazine! As South Dakota area healthcare professionals adapt to post-pandemic practice, we asked some regional experts for resources and advice to make it easier. You’ll find these articles at the front and back of this issue. We hope you will find them valuable. Also in this issue, we did not need COVID-19 to highlight the value of nurses in this, the official Year of the Nurse. But it didn’t hurt. We discuss the critical role that nurses play in rural healthcare, both now and in the future, with two of South Dakota’s nursing leaders. We are also proud to feature more COVID Heroes of local healthcare along with a roundup of virus-free news. Don’t forget to join the VIP list at MidwestMedicalEdition.com for free access to the digital version of this magazine and news updates between issues. See you in September! —Alex and Steff

Virtual and live summer and fall events

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STANDING APART

WORKING

Dr. Amanda Young, a family practice physician with Avera Medical Group Spencer (closest to camera), and Laura Manwarren, Spencer Hospital Emergency Services director.

TOGETHER. MED salutes the outstanding local healthcare professionals who work

tirelessly to preserve and protect the health of our communities every day.

THANK YOU


Resources and Guidance for Reopening Medical Practices BY COPIC’S PATIENT SAFETY AND RISK MANAGEMENT DEPARTMENT

H

EALTHCARE IS FACING A CONTINUAL changing environment surrounding COVID19. As medical practices reopen, they are looking for support and information to help

them navigate these changes. Below are some general guidelines and expert resources to provide assistance for physicians and medical practices during this time.

PRACTICE CONSIDERATIONS

PATIENT CONSIDERATIONS The practice should develop a policy for pre-screening patients prior to presentation into the practice, usually through phone triage. The triage call script should include the recommendation for wearing a face mask, information on what the practice is doing to assure social distancing, and limitation of non-patient visitors when appropriate. • The AMA has developed a pre-screening template

Prior to reopening, medical practices should implement

which practices may use. www.ama-assn.org/system/

necessary steps to assure patient and staff safety. Assess-

files/2020-05/physican-guide-reopening-practices

ing current and future PPE needs, sanitizing procedures, modifying schedules, and limiting visitors to minimizing

-covid-19.pdf • The Centers for Disease Control and Prevention (CDC)

contact are important considerations. The following are

guidelines can be used to ensure compliance with face

helpful links to guide a safe return:

covering recommendations. www.cdc.gov/coronavirus

• The American Medical Association’s (AMA) A Physician Practice Guide to Reopening provides an informative checklist of areas to look at and things to

/2019-ncov/prevent-getting-sick/diy-cloth-facecoverings.html. • In addition, providers should have knowledge of

consider as you reopen. www.ama-assn.org/system/

available COVID-19 testing sites in their location using

files/2020-05/physican-guide-reopening-practices

available local and state public health guidance.

-covid-19.pdf. • The AMA also posted a fact sheet that focuses on state

STAFF CONSIDERATIONS

directives ordering a delay in elective procedures and

Education and ongoing communication are integral to

related guidance from the federal government and the

staff knowledge of changing COVID-19 recommendations

American College of Surgeons (ACS). www.ama-assn.

to promote a safe working environment. Staff should be

org/system/files/2020-05/state-elective-procedure

educated on signs and symptoms of COVID-19 and the

-chart.pdf

importance of not presenting to work if signs and symp-

• The Centers for Medicare and Medicaid Services (CMS) has released recommendations related to Phase 1 of reopening for medical facilities that provide non-

toms are present or if they have had direct contact with anyone who has tested positive for COVID-19. Staff should be screened regularly, and screening

emergent, non-COVID-19 care. www.cms.gov/files/

should be kept in a file separate from their employee

document/covid-flexibility-reopen-essential-non-

file. Office administrators should be aware of reporting

covid-services.pdf

requirements and the obligation to protect healthcare

• The Medical Group Management Association (MGMA) published a detailed checklist for reopening practices that covers areas such as financial management,

professionals during a pandemic. www.ama-assn.org/ deliver ing-care /ethics / obligations-protect-health -care-professionals

human resources, and operations. www.mgma.com/ MGMA/media/files/pdf/MGMA-Practice-Reopening -Checklist.pdf?ext=.pdf

6

ID 179734578 © Natalia Gusarova | Dreamstime.com

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OPERATIONAL CHALLENGES Decreased revenue and employee costs during the pandemic has been a challenge to many practices. AMA has developed resources to help navigate workforce reduction, compensation changes, benefit modifications, and legal compliance during COVID-19. www.ama-assn.org/delivering-care/ public-health/making-tough-decisions -managing-practice-s-employee-costs Note: This information was current at the time of submission of this article. Due to the ever-changing guidelines and regulations related to COVID-19 and variations on how different states are approaching this issue, please be sure to review the websites of the resources mentioned above to determine if updated information has been posted. For additional practical considerations, see page 22.

Steven Meyer, MD

CNOS ORTHOPAEDIC SURGEON

CARING FOR US and bringing

miracles

TO TANZANIA

2020 AAOS

Humanitarian

We congratulate Steven J. Meyer, MD, FAAOS, of CNOS on being awarded the American Academy of Orthopaedic Surgeons’ Humanitarian Award for his work with children in Tanzania, Africa where he organizes life-saving surgeries and supports life-changing education.

CNOS.NET | 605-217-2667 IOWA • SOUTH DAKOTA • NEBRASKA

July/August 2020

7


Recognizing

COVID

As the impact of the COVID-19 pandemic started to be felt in our region, everyone in healthcare had to adapt quickly and decisively to keep patients, communities, and their colleagues safe. We invited organizations across the area to share some of the many ‘COVID Heroes’ who have stepped up to do what was needed.

HEROES THE COVID INCIDENT COMMAND TEAM

PIONEER MEMORIAL HOSPITAL & HEALTH SERVICES, VIBORG

The COVID Incident Command Team at Pioneer Memorial Hospital in Viborg spent countless hours preparing the facility and three clinic locations for the COVID pandemic. They were instrumental in planning and developing protocols to keep staff, patients, and residents safe. The team includes (pictured left to right) Holly Jensen, Interim Director of Nursing for LongTerm Care & Performance Improvement Coordinator; Tonya Rudd, Director of Clinic Operations; Lindsey Hauger, Chief Executive Officer; Sharon Jacobsen, Director of Nursing; Anne Christiansen, Chief Financial Officer; and Lori Hisel, Director of Support Services. (Not pictured is Krista Schaeffer, Director of Nursing for Long-Term Care.)

KATHY HANSEN

DIRECTOR OF QUALITY, SAFETY AND EMERGENCY PREPAREDNESS MADISON REGIONAL HEALTH SYSTEM Kathy Hansen has been instrumental in making sure Madison Regional Health System is following, responding to, and implementing the rapidly -evolving COVID-19 guidelines. “Kathy is an integral part of the success of

BRAD HAUPT

VP, SUPPLY CHAIN AND CONTRACT MANAGEMENT MONUMENT HEALTH

MRHS. She has many responsibilities

Brad Haupt is used to getting phone

in the areas of quality, patient satisfac-

calls when something is missing.

tion, infection control and facility

What he wasn’t used to —until about

preparedness,” says Tammy Miller,

three months ago— was having 1,200

CEO of MRHS. “Kathy is adamant about

products on back-order or facing their

preserving quality and safety for all of

allocation limit. Haupt’s team had to

our customers, whether patients or

get creative early on, as manufacturing

employees. Our facility is grateful for

around the globe began facing major

her leadership.”

shortages. The decision to stop elective surgeries gave the supply chain a chance to catch up. “Our contractors and buyers are constantly vetting vendors and bringing in substitute products,” says Haupt.

Read more details and interviews with some of these and other COVID Heroes

8

MidwestMedicalEdition.com


DAVID BASEL, MD,

BUNNY CHRISTIE,

VICE PRESIDENT OF CLINICAL QUALITY AVERA MEDICAL GROUP Dr. Basel has been one of our leaders in the COVID response and lead physician on COVID surge modeling and predictive analytics. He’s worked closely with the State of South Dakota Department of Health and healthcare counterparts across the state to determine surge numbers and surge timelines for both the state and larger communities within the state.

JAWAD NAZIR, MD,

INFECTIOUS DISEASE SPECIALIST AVERA MEDICAL GROUP

MARK ABRAHAM, MD,

MS, INFECTION PREVENTIONIST BROOKINGS HEALTH SYSTEM

Bunny Christie is a microbiologist

GENERAL SURGEON MIDLANDS CLINIC

with a specialization in infectious

Dr. Mark Abraham of Midlands Clinic

disease. When the first case of

has played a major role in planning

COVID-19 was identified in South

and decision making regarding

Dakota on March 10, she became a

COVID-19 as President of the Medical

shining star. From responding to the

Staff at MercyOne Siouxland Medical

first SOS call at the local clinic, to

Center. His hours at the hospital

managing phone calls with the state,

have increased as he has been on the

staff, physicians, and administrators,

frontlines caring for COVID-19 posi-

to training nursing home staff to use

tive patients and interacting with

PPE, to providing middle-of-the-night

them for research protocols, and

training to staff on using PAPR hoods,

because of that he has been self-iso-

Christie has been the rock of Brook-

lating from his wife and three young

ings Health System’s response.

daughters. Dr. Abraham continues to

According to her supervisor, Quality

spread awareness, urging people to

Director Sandra Ruesch, “Bunny has

take the precautions seriously. “Our

been our quarterback in a football

lives will be different and likely a bit

game that is going into perpetual

less convenient for the foreseeable

overtime!”

future. That is much better than the alternative I have seen,” he says.

Dr. Nazir has been Avera’s lead infectious disease physician during this pandemic. He’s helped colleagues and health leaders bridge the knowledge gaps in understanding the virus and provided the professional expertise to establish infection control measures and clinical protocols at

KAREN WEBER, RN,

MEDICAL SURGICAL & ED DIRECTOR

LAWRENCE VOLZ, MD,

GENERAL SURGEON

BROOKINGS HEALTH SYSTEM

MIDLANDS CLINIC

Karen Weber recognized Brookings

Dr. Lawrence Volz, Chief Medical

Health’s traditional disaster pre-

Officer for MercyOne Siouxland

paredness plan, which called for an

Medical Center, has been vital in

off-campus care site if the hospital

decision making and implementa-

exceeded capacity, would not work

tion of the Coronavirus prepared-

with the unique clinical and medical

ness and response. Dr. Volz has had

challenges of COVID-19. Weber spent

an immense presence in caring for

many long nights figuring out how to

COVID patients at MercyOne, includ-

care for up to 63 patients inside the

ing working on treatment plans

main campus by repurposing same-

with the critical care physicians and

day surgery rooms, PACU bays, rooms

nursing staff, working on a hyper-

Dr. Hericks has been leading the

on the old OB unit, the cardiopulmo-

baric oxygen therapy trial, and the

charge preparing staff and clinical

nary rehab gym, and the outreach

use of plasma therapy for COVID

protocols for treating COVID patients

clinic. She also found resources for

patients. He was the driving force

in the inpatient setting. He’s also been

equipment, supplies, additional beds

behind efforts to unite his physician

instrumental in identifying neces-

and IT equipment to supply those

colleagues in sharing a “wear your

sary critical care beds needed for the

additional rooms and worked side-

mask” social media campaign. He

anticipated patient surge.

by-side with physicians to develop

is active in the news answering

treatment protocols.

questions about COVID-19. ❖

multiple levels for both patients and employees.

ANTHONY HERICKS,DO,

PULMONOLOGIST, AVERA MEDICAL GROUP AND MEDICAL DIRECTOR OF CRITICAL CARE SERVICES AVERA MCKENNAN

July/August 2020

9


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

Exclusive

online articles Surgeon Says Daily Meetings are a Vital Part of the Groups’ Success Read our exclusive interview with Michael Bauer, MD, about why he loves daily meetings with his colleagues at Surgical Institute of South Dakota.

South Dakota is the State with the Fewest Coronavirus Restrictions, Study Finds With all states having at least partially reopened (as of this writing) as new COVID-19 cases have seen a slow decline, the personal-finance website WalletHub recently released updated rankings for the States with the Fewest Coronavirus Restrictions, as well as accompanying videos. To identify which states have the fewest coronavirus restrictions, WalletHub compared the 50 states and the District of Columbia across 14 key metrics. The data set ranged from whether childcare programs and restaurants

High-Level Spine Care with a Hometown Touch Fellowship-trained orthopedic surgeon Brent Adams, MD, of Yankton Medical Clinic proves patients don’t have to leave town for state-of-the-art spine care.

have reopened to the presence or absence of a “shelterin-place” order. Below are highlights from South Dakota’s ranking. Coronavirus Restrictions in South Dakota (1=Fewest, 25=Avg.) 1st Requirement to Wear a Face Mask in Public 1st Reopening of Child-Care Programs 1st Travel Restrictions

Does your practice need SOCaaS? If you are not in the business of cybersecurity, it might. In this video, a High Point Networks’ Sr. Security Consultant explains what it is and how it works.

2nd Large Gatherings Restrictions 1st Strictness of “Shelter in Place” Order 1st Reopening of Non-Essential Businesses 1st Reopening of Restaurants and Bars Note: Rankings are based on data available as of 12:30 p.m. ET on Monday, June 8, 2020. Check our website for a link to the full report.

Are you enjoying our COVID Heroes feature? (pages 8 –9) We’ll keep posting them online and sharing on social media as long as we are receiving them. If you know of someone who has gone above and beyond at your facility or practice in recent months, let us help you lift them up! Send a few lines about why you think they should be recognized along with a photo to Alex@MidwestMedicalEdition.com.

10

MidwestMedicalEdition.com


Spring Conferences and Symposiums

Sanford Unveils $200 Million Expansion Plans Coping with COVID-19 as a Medical Professional

VOL. 11 NO. 2

SD Rural Hospitals Dominate the Top 20 List

2020

Recognizing Local ‘COVID Heroes’ Supporting Staff in Stressful Times

VOL. 11 NO. 3

The Pandemic and Public Health Messaging

2020

JUNE

New Local Podcast Offers a Way Through Grief Think You Can’t Be Scammed? Think Again!

VOL. 11 NO. 1

2020

APRIL MAY

Birth Tissue Donation Now Available Locally

MARCH

Interacting with Law Enforcement: What You Need to Know

JANUARY FEBRUARY

Yankton Respiratory Therapist’s eCig Ed Campaign

VOL. 11 NO. 4

2020

CREATING UNBREAKABLE BONDS STEVEN J. MEYER, MD Orthopaedic Surgeon

Reflections on Three Decades in South Dakota Medicine

NEW DECADE, NEW NAME

H. Thomas Hermann, MD

REBRAND REFLECTS MONUMENTAL CHANGES AT REGIONAL HEALTH THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

MED March_Final.indd 1

DELIVERING CARE BEYOND HEALING AMANDA SEDLACEK, DO Palliative Medicine Specialist

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

April / May 2020

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS

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GET THE DIGITAL COPY We often hear from healthcare professionals who want to revisit something they saw in a past issue of MED Magazine but can’t find their hard copy. That’s why we created an easy-to-access Digital Archive. If you’re a MED VIP, you can instantly read any past issue on your phone, desktop, or tablet by clicking the link in your bi-monthly email. No rifling through piles on your desk, no bugging your office staff, no added clutter. If you’re not yet on the VIP list, get the link by clicking on Read a Past Issue on the home page and following the prompts.

THINGS ARE RESTARTING . . . DON’T MISS OUT! As the world gradually returns to normal, MED’s online calendar is, too. You’ll find both in-person and virtual events on the schedule and can easily add any event to your personal calendar with a single click. Check the page often for updates and don’t forget that you can always post your own live or virtual event for FREE right on the page at MidwestMedicalEdition.com/calendar.

DID YOU ENJOY LAST MONTH’S ARTICLE on the benefits of mindfulness for healthcare professionals by USD’s Dr. Carole South-Winter? We go deeper in an exclusive interview with Dr. South-Winter on the website.

January / February 2019

11


YEAR

The

of th e

NURSE

BY ALEX STRAUSS

CELEBRATING NURSING IN THE TIME OF COVID

T

wo hundred years after the birth of Florence Nightingale, the World Health Organization designated 2020 the

International Year of the Nurse and Midwife. But it’s no surprise if you didn’t know. In fact, thanks to Carol Stewart

COVID-19, what was supposed to

Deb Fischer-Clemens

have been a celebratory year has all but slipped by without much

nurses or unlicensed caregivers

celebration. The timing of Certi-

will be critical for navigating the

fied Nurses Day on March 19th was

uncharted waters of South Dakota’s

particularly unfortunate. That was

healthcare future. “The bottom line is that you Avera Mckennan ICU Nurse Abby Hatch in her PPE

have to talk about and support your

the state legislature and other

and Director of the Avera Center for

sure that they can feel safe,” says

nurse-centered events also had to be

Public Policy. “I think more physi-

Fischer-Clemens. “We have to

scrapped. Not that many of the

cians are recognizing how important

demonstrate that we understand

region’s nurses could have attended;

it is to have that nurse at the bedside

how important their role is to all of

they were too busy doing their jobs.

assisting them every way they can.”

us. It is only becoming moreso.”

“If there is anything good that

Fischer-Clemens says the value

has come out of COVID, it is an

of this mutual appreciation goes

improved sense that nurses are so

way beyond fostering a positive

SOUTH DAKOTA’S NURSE “SHORTAGE”

important and that physicians and

working environment. She believes

Despite what some healthcare

nurses have to be a team,” says Deb

that strong relationships between

employers have experienced,

Fischer-Clemens, President of the

nurses and physicians, nurses and

Fischer-Clemens says there is no

South Dakota Nurses Association

administrators, and nurses and other

real shortage of nurses in South

first case of the novel coronavirus. In South Dakota, Nurses Day at

12

nurses, which includes making

MidwestMedicalEdition.com

Photos courtesy Avera Health

the week after South Dakota saw it's


stress has become exponential during this crisis. I worry a lot that some are going to leave the profession.” If the projections are true, she may be right. RegisteredNursing.org puts South Dakota seventh on the list Nurses at Avera Queen of Peace Hospital in Mitchell, South Dakota

Dakota— yet. There were more than 21,000 active LPNs and RNs (about

of states most likely to have a serious nursing shortfall by 2030. If it happens, elderly populations the hardest.

16,200 full-time equivalents) in the state in 2018, which was up by about 4 percent from the previous year. On paper, the numbers are good. What the state does have is a shortage of certain kinds of nurses —nurses willing to work in hospitals, work in rural areas, take overnight shifts, work weekends and holidays, and staff tough departments like ICU and Emergency. “Having the right mix of new and experienced nurses that are working nights, weekends, and holidays is becoming a greater and greater challenge and it’s getting worse,” says Fischer-Clemens. “For ICU and Critical Care and ER

Oncology nurses at Avera McKennan

it will likely hit the state’s rural and

IN SUPPORT OF RURAL NURSES Carol Stewart, Graduate Program Director and Assistant Professor of Nursing at Mount Marty College in Yankton, says convincing new nurses to take jobs in rural areas is an even bigger challenge now than it used to be. “Unless they have family ties there, a lot of younger nurses do not want to come to the middle of nowhere where there is not much action,” says Stewart. Stewart served as Director of Nursing at an Avera facility before moving into academics in 2009. She

I THINK MORE PHYSICIANS ARE RECOGNIZING

HOW IMPORTANT IT IS TO HAVE THAT NURSE AT THE BEDSIDE ASSISTING THEM EVERY WAY THEY CAN.

nurses especially, we really have to emphasize the value that they bring and the satisfaction that comes from having made someone better. We have to emphasize the importance of their role in these challenging situations and we do have to pay for it.” The necessity for competitive compensation is a given. But when that hits its ceiling, appreciation and support become even more essential. And it is magnified in the time of COVID. “It is a tough thing to be caring for COVID patients,” says FischerClemens. “The donning of protective equipment, the concern you have every minute that you could do something wrong and get the virus, the worry every day that you could take something home to your family ... The

July/August 2020

Nurses with Avera Sacred Heart Hospital in Yankton, South Dakota helping out with a Chamber of Commerce “Stay at Home” campaign.

13


Nurses with Avera Sacred Heart Hospital in Yankton, South Dakota wearing donated masks.

Even hospital nurses may find themselves increasingly in front of cameras. As an example, FischerClemens points to the approximately 200 COVID-positive Avera patients receiving virtual care at home with the help of nurses. “Nurses always have to have great communication skills, but the nurses providing virtual care also have to be very technically savvy,” says Fischer-Clemens. “It takes a special skill set to be able to interact with patients in that way.” Monument Health is another example of how hospital-based still practices as an NP part-time

comprehensive onboarding, opportu-

nursing may change in the wake

through a Milbank staffing agency

nities for professional development,

of the pandemic. The Rapid City

and is the recipient of this year’s

and access to education can help keep

Hospital is moving toward a team

Nursing Practice Award from the

them there. But appreciation and a

nursing model, where an RN will

South Dakota Nurses Association.

positive culture may be the biggest

lead a group of nurses, including

Like Fischer-Clemens, Stewart

draw of all. She agrees with Fischer-

unlicensed assistants like CNAs,

believes that support is key for

Clemens that COVID has helped in

who provide the hands-on care.

growing and keeping a nursing staff,

this regard. “Sometimes it takes bad things

with COVID patients first,” says

staffing shortages in these areas, you

to bring people together,” says

Monument’s Chief Nursing and

are usually expected to work long

Stewart. “The camaraderie that I see

Per for ma nce

hours and you have to do more with

now is more like I remember 20

Kerkenbush. “Now that we have

less, which can create burnout.”

years ago. COVID has created that.”

gone through this experience, we

But there are upsides to working in a small town; the trick is to help

O f f icer,

Nicole

see it as a good way to tackle a problem that we have been dealing

students see them. “Often, when stu-

NEW MODELS OF CARE

dents get into rural areas, they find

COVID has also created new ways

our resources to the top of their

that they like it,” says Stewart. “They

for nurses to use their expertise.

license or top of their training.”

become nurse generalists, so they

Fischer-Clemens predicts that the

As the region moves into the

get to do everything. The opportunity

shift toward more telehealth because

post-COVID era, workloads begin to

to use all of your skills is appealing

of the pandemic is likely to have

normalize, and furloughed nurses

to some people.”

long-term implications for nursing

return to work, Fischer-Clemens says

in South Dakota.

one thing that will not change is the

That is one reason that Mount

with for years now. We have to use

Marty’s nursing curriculum now

“Personally, I think families will

includes a rural rotation. Stewart

be more reticent to bring a loved

would like to see more partnerships

one to a long-term care facility and

“It is going to take some very

between rural practices and academic

I think we are going to see a big

special nursing to be a part of this

institutions so that more nurses can

increased need for home care,” she

transition to the new norm,” she says.

experience small-town practice.

says. “Virtual care can work well in

“We are going to have to help people

that setting, and we need nurses who

through that because it’s going to be

are going to be directing that care.”

tough.” ❖

For nurses who do make the leap to rural practice, Stewart says

14

“We started using this model

especially in rural areas. “Because of

need for these critical workers to feel valued.

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July/August 2020

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15


Happenings around the region

News & Notes

South Dakota | Southwest Minnesota | Northwest Iowa | Northeast Nebraska

AVERA

SANFORD JOHN LEE

TOM CLARK Tom Clark will join Avera Health’s executive leadership team as its new Chief Strategy and Growth Officer, effective July 12, 2020. Clark brings more than 30 years of experience in the health care sector. Most recently, he served as a Regional President and CEO of Avera Queen of Peace Hospital in Mitchell where he served since 2011. Prior to Avera, Clark served in various CEO and marketing leadership roles in hospitals in Indiana. His work has included operations, strategic planning, business development, facility management, productivity and other business value creation efforts. The new Chief Strategy and Growth Officer will oversee a broad array of strategic departments across Avera.

❱ 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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John Lee, MD, FACS, has joined Avera Cancer Institute as Clinical Medical Officer for Cancer Research. Dr. Lee will provide leadership and strategic direction of Avera’s cancer research program, and clinical activities for translational research, early phase trials and clinical trials in the delivery of cancer care. Since 2016, Lee has been Chief Medical Officer for ImmunityBio, an immunotherapy company, and Senior VP of Clinical Development for NantKwest, a clinical-stage natural killer cell immunotherapy company. Avera announced in early May that it would resume services put on hold due to COVID-19. This includes in-person clinic visits for primary and specialty care as well as planned surgeries, imaging screening tests such as mammography, and procedures such colonoscopy. Some services were put on hold for a few weeks to allow for surge planning and to preserve valuable personal protective equipment. Now that these plans are in place and adequate PPE is in stock, Avera can move forward with phasing in its full range of services. Avera sports and fitness centers are also reopening. The timeline for resuming services at each Avera location will depend on the readiness of that location.

Sanford Health Plan is now covering the costs of risk assessments and genetic testing for some women enrolled in a breast cancer trial at Sanford. The five-year Women Informed to Screen Depending On Measures of risk (WISDOM) Study, started in 2017 and is focused on determining if more personalized approaches lead to better outcomes than traditional screening methods. In May, Sanford Health Plan started covering the cost of genetic testing, assessments and other expenses associated with the study for its members who are enrolled in the study and are asked to be tested.

SHERYL REMME Sheryl Remme, RN, with Sanford Luverne Medical Center has been recognized with a DAISY award for outstanding nursing. Her nomination details how she used warmth and humor to gently help an ailing patient and his family make the difficult decision to move to a hospice facility when long-term care was needed.

The state-sponsored hydroxychloroquine trial, a collaboration between Sanford Health, Avera Health and Monument Health, has been discontinued following the publication of new research from a large controlled trial that found no efficacy in preventing COVID-19 for people exposed to the virus. In early June, The University of Minnesota published the results of its own hydroxychloroquine study, one of the nation’s first randomized trials with the drug. The study found no benefit of hydroxychloroquine over placebo as a postexposure preventive therapy.

SIOUXLAND LINDA FORNOFF Pediatric Neurosurgeon, Dr. Linden Fornoff from Boys Town National Research Hospital in Omaha has joined the CNOS clinic in Dakota Dunes. She attended UNMC for medical school and residency in neurosurgery before completing her Pediatric Neurosurgery Fellowship at Stanford University. Dr. Fornoff will see patients at CNOS one Wednesday a month beginning June 3.

MidwestMedicalEdition.com


LEA GREATHOUSE Lea Greathouse, Vice President of Mission, Marketing, Foundation for MercyOne Siouxland Medical Center has recertified as a Certified Fund-Raising Executive. Greathouse joins over 6,900 professionals around the world who hold the CFRE designation. CFRE recipients are awarded certification for a three-year period.

OTHER

INDEPENDENTS The Spencer Regional Healthcare Foundation invited community members to donate to the annual Garden of Life Campaign in May. The campaign is a fundraising effort for the Spencer Regional Healthcare Foundation and Hospice of Spencer Hospital. Each donation given in memory of a loved one or in honor of a special caregiver is represented by a blooming plant in the hospital park. In order to follow social distancing guidelines, the hospital decided to forego the usual planting ceremony with donors. Instead, a small group of hospital staff did the planting this year. The public is invited to visit the park. Huron Regional Medical Center has started lifting temporary restrictions on elective surgeries, screening tests, and outpatient treatments for non-high-risk patients. Services resuming include inpatient and same day surgeries, screening radiology exams, respiratory and cardiac testing, physical, occupational and speech therapies, and phase 2 cardiac rehabilitation. Patients who were scheduled but had to delay a test or procedure will be contacted to reschedule.

July/August 2020

Breanne Nelsen is the new Activities Director for Long-Term Care at Pioneer Memorial Hospital and Health Services in Viborg. Prior to joining Pioneer Memorial, Nelsen was the Activities Director at Centerville Care & Rehab. As the new Activities Director, one of her goals is to increase volunteer involvement and implement new volunteer opportunities.

Spencer Hospital reintroduced some health services on June 1 that had been suspended during the initial stages of the COVID-19 emergency. Cardiac and pulmonary rehab were reopened. Based on patient needs, diagnostic imaging, laboratory services, physical, occupational and speech therapy, and respiratory services will be expanded. Home health and wound care services will be offered on a limited basis, based on patient risk considerations. Diabetic education will permit individual in-person sessions but will continue to encourage telemedicine appointments.

ZACHARY BROWN Internal medicine specialist Zachary Brown, DO, has joined Storm Clinic in Sioux Falls. Dr. Brown is a native of Rochester, New York. He graduated from the Global Medicine Honors track at Rocky Vista University College of Osteopathic Medicine, which included clinical rotations in Sri Lanka and Kenya. He also completed his internal medicine residency there.

Physicians Vein Clinics has acquired Minneapolisbased Hogue Vein Institute. Physicians Vein Clinics began seeing patients on June 1, 2020, in Minneapolis assuming all care for former Hogue Vein Institute patients. Physicians Vein Clinics currently has locations in Sioux Falls, Watertown, and Mitchell, South Dakota; Sioux City and Sioux Center, Iowa; and Moorhead, Minnesota. The new acquisition adds Burnsville, Eagan, Chanhassen, Medina, Woodbury, and Maple Grove, Minnesota to its network. Sioux Falls-based SAB Biotherapeutics (SAB), a clinical-stage biopharmaceutical company with a proprietary technology to produce fully human polyclonal antibodies without the need for human plasma donors, says it has in vitro data demonstrating that SAB-185, its COVID-19 therapeutic candidate, has highly-potent neutralizing antibodies to SARS-CoV-2 that are four times higher than the most potent human convalescent plasma serum sample evaluated. The company also announced that they initiated manufacturing of SAB-185 on May 25 to support the next phase of clinical development for its potential COVID-19 therapeutic, which is set to begin human trials in early summer.

MONUMENT Monument Health recently installed active air purification systems within its Rapid City Hospital air handling equipment to neutralize exhaust fumes from medical helicopters landing on its rooftop helipad. The Global Plasma Solutions (GPS) Needlepoint Bi-Polar Ionization technology embedded in these systems also kills pathogens such as the COVID-19 virus. After seeing successful installation of these systems in Rapid City, the team decided to add more GPS purification systems to other locations within Monument Health. To add another layer of protection against COVID-19, Monument Health is installing systems covering all of the patient care areas within the Custer, Lead-Deadwood, Spearfish and Sturgis hospitals.

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• Happenings around the region

News & Notes


Hurry Up and Wait MONUMENT TRANSFORMS SHELL SPACE IN RECORD TIME AHEAD OF EXPECTED COVID-19 SURGE

Ellenbecker

Kerkenbush

Health teams located beds, supplies,

to a surge in hospitalized

and staff. The project added 172

COVID-19 patients in the

dormitory style beds and 17 ED beds,

Midwest, health systems

ready for the sickest patients.

across the region had to scramble to

“Each area had its own limitations

make sure they had enough beds,

and possibilities,” says Chief Nursing

personnel, and equipment for what

Officer Nicole Kerkenbush. “We knew

was projected to be unprecedented

that we would need high flow oxygen

patient numbers.

and ventilators in these spaces. And

For Monument Health, the timing

we tried to make sure we could main-

was good. The health system is in the

tain safety with things like bed rails

final year of a $210 million expansion

and call lights.”

of the main Rapid City Hospital

Some corners did have to be cut for

campus. The recently finished, 32-bed

speed and practicality. The first area

Heart & Vascular Unit was immedi-

to open, called The Foothills, has half-

ately converted to accommodate

walls, shower curtain doors, and no

COVID-19 cases.

windows. The ceilings are unfinished

And in just two weeks —record

and there are no private baths. The

time by any standard— unfinished

Prairie, which will one day be another

shell space on the campus that was

inpatient unit for Monument, is more

earmarked for future growth, was also

open with 8 to 20 beds in a section.

converted into bed space for possible “We had no idea how much time The area Monument calls The Prairie has 152 beds in open units on the fourth floor of the new addition.

we had to get ready,” says Dave Ellen-

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functional but that we can also eventually take out,” says Kerkenbush.

becker, Monument’s VP of Facilities

“This was very unusual for us to

Management. “It was a race to get these

be able to push aside the barriers

built out.”

and get this done so quickly,” says

With the help of a local architect

Ellenbecker who worked closely with

and input from user groups, Monument

the Department of Health to make

had a design concept in just three

sure safety standards were met in

days. Contractors who were already

the build-out. “Between our construc-

working onsite hired local subcontrac-

tion team and our local subcontractors,

tors and redirected their efforts to the

everyone felt so empowered to jump

conversion.

in and fill these spaces.”

“It reminded me of experiences I

As of mid-June, there has been no

have had in the military when you have

surge of COVID-19 cases at Monu-

to mobilize quickly,” says Ellenbecker.

ment. As non-essential services ramp

“We identified the needs, took a look

back up and coronavirus is still with

at what we had to work with, and

us, Kerkenbush says the next chal-

mapped out a simple plan.”

lenge will be to figure out how to care

Workers The Foothills, 20 beds on the hospital addition’s second floor, became available on Jun 2nd.

“We had to look at what we could put in quickly that would be safe and

COVID-19 patients.

hung

drywall

and

for these patients while also meeting

extended water, electricity, and other

the ongoing community healthcare

services to the spaces while Monument

needs. ❖

MidwestMedicalEdition.com

photos courtesy Monument Health

W

ITH MODELS POINTING


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KNEE

MOVING.

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Learn more at monument.health/orthopedics

Zimmer Biomet is a medical device manufacturer that provides products and other services used by health care professionals to create personalized care plans. Zimmer Biomet is not a medical professional and does not practice medicine. Zimmer Biomet is not responsible for the content of Monument Health. The persons in these advertisements are models and not actual recipients of Zimmer Biomet products and services. Results are not necessarily typical and will vary due to health, weight, activity and other human variables. *Not all patients are candidates for joint procedures or ROSA Knee robotic technology. Only a medical professional can determine the treatment appropriate for your specific condition. Talk to your surgeon about whether joint replacement is right for you and the risks of the procedure, including the risk of impact wear, loosening, breakage, failure 19 or 2020 require additional surgery. For general information on joint pain and technology, visit www.zimmerbiomet.com or risk of infection,July/August all of which could call 1.800.447.5633. ©2019 Zimmer Biomet.


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MidwestMedicalEdition.com


LOCAL HEALTHCARE PROFESSIONALS AT THE HEART OF PUBLIC INFORMATION CAMPAIGN

T

“WHETHER IT’S WORK OR PLAY, IT IS IMPORTANT TO TAKE THE NECESSARY STEPS TO PROTECT OTHERS AND YOURSELF. BE CAREFUL, BE SAFE.” Be nj a m in C . Aa ke r, M D Pres i d ent- elec t S o uth Da kota State Med i c a l As s o c i ati o n

HE SOUTH DAKOTA COVID -19 Community S outh Da kota COV I D-1 9 Com m unity I m p a c t Proje c t # Ta keCa reSD # COVI D19 # Res i li ent

Impact Project has launched a compendium of free health communication resources featuring

area healthcare professionals. The campaign was created in the wake of a statewide

survey of 7,000 people showing that South Dakotans trust their doctors and public health officials more than other sources.

“I WEAR MY MASK TO PROTECT EMPLOYEES, PATIENTS, AND OUR COMMUNITIES. THANK YOU TO ALL OF OUR HEALTH CARE HEROES.”

“People value their opinion much more than they value elected officials and the news media,” says Chelsea Wesner, MPH, MSW, of USD’s School of Health Sciences. “This really demonstrates that they can play a much larger role than they already do in their communities in

Bob S u t ton Presi d ent a nd C EO, Aver a Hea l t h Si oux Fa l l s, SD

shaping health policy and larger public health responses.” The survey, which ran from March 24th through

S ou t h Da kot a COVID-1 9 C om m u nit y Im p a c t Proj e c t # Ta keC a reSD # COV ID19 # Resi l i ent

April 30th, was conducted by faculty in the joint USDSDSU Master of Public Health program and USD’s Sanford School of Medicine. Ninety-three percent of respondents said their most trusted source of COVD-19 information is public health officials. Medical doctors came in second at 68 percent. “Our primary goal is to inform public health responses

“Transparent Darth coVider. I am your father, Luke.”

as this pandemic evolves and when a vaccine becomes available,” says Wesner. The new public information campaign features a diverse array of community “ambassadors”, including a

Ma r k Hu nt ing on, M D, PhD Di rec tor, C enter for Fa m i ly Med i c i ne Si oux Fa l l s, SD

number of physicians and administrators. The group hopes to upload new resources each week and is looking for new ambassadors to submit photos. If you are interested in

S ou t h Da kot a COVID-1 9 C om m u nit y Im p a c t Proj e c t # Ta keC a reSD # COV ID19 # Resi l i ent

becoming one, contact Chelsea.Wesner@usd.edu. ❖

“THANKS FOR CONTINUING TO SAVE LIVES BY WEARING A MASK IN PUBLIC AND STAYING 6 FEET APART. YOU ARE THE TRUE HEROES.”

“BE SAFE! BE ENCOURAGED! BE HEALTHY! LET’S GET THROUGH THIS.”

S o uth D akota COVI D -1 9 Commun ity I mpact Project # TakeCareS D # COVI D 19 # Res ilient

S ou t h Da kot a COVID-1 9 C om m u nit y Im p a c t Proj e c t # Ta keC a reSD # COV ID19 # Resi l i ent

Me gh an Curry O’Con n e l l , MD, MPH Fa mily Medicin e Phys ician an d U S D Clin ical Facul ty El k Point, S D * P i c tu re taken wh ile h elpin g with th e COVI D - 19 response in New York City.

July/August 2020

Rob e r t S u m m e re r DO, FACOS G ener a l Surg eon, Ma d i son Reg i ona l Hea l t h System Presi d ent , Sout h Da kot a St ate Med i c a l Assoc i at i on Ma d i son, Sout h Da kot a

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YOUR MEDICAL PRACTICE IS REOPENED

NOW WHAT? BY JACKIE COULT

There is a lot to consider for the “new norm” for medical practice. Top priority should be the health and well-being of your patients and staff. Look for ways you can control costs and enhance or maintain revenue. Here are a few things to consider:

PATIENT AND STAFF CONSIDERATIONS 1. Develop Safety Protocols. Universal precautions

FINANCIAL CONSIDERATIONS As medical practices reopen, your revenue and patient volume may increase slowly and unevenly. Physicians should carefully consider their capital needs and use of funds received, both private (bank loans) and public (such as SBA loans or government grants).

1. Increase Patient Volume

are a good starting point for your policies.

a. Expand appointment options

2. Communicate with patients that their safety

b. Recall all canceled appointments

c. Reschedule all cancelled or postponed cases

d. Inform referral providers that you are open and

is your top priority! Whether it is face mask requirements, or COVID testing prior to surgeries, or sanitization after every encounter, or

providing safety measures

asking them to wait in their cars for appointments, let them know you have their health and safety as your top priority.

2. Enhance Revenue Cycle Hygiene

3. Give extra care and attention to the emotional

insurance plan, eligibility and benefits since plans,

and physical needs of staff. The pandemic has required physicians and many other healthcare workers to work long hours in dangerous conditions. Watch for signs of exhaustion, depression, stress and other issues.

a. Take daily temperatures on a non-discriminatory basis

benefits, copays and deductibles, may have changed.

4. Consider scheduling employees and providers in rotating shifts, so if one team experiences a COVID infection, there are still employees able to carry out practice operations.

d. Tackle accounts receivables slowly by implementing an internal process to follow up on outstanding claims.

e. Monitor insurance payments that telehealth

c. Work with employees with unique childcare arrangements.

c. Complete and submit claims within 24 hours from Date-of-Service (DOS)

to be made for staff members over 60 or with underlying health conditions to minimize risk.

b. Collect outstanding balances prior to visit; copay/ coinsurance at the time of visit

b. P  rotect vulnerable staff. Adaptations may need

a. Verify patient demographic information, including

and all other visits are being paid properly.

f. Self-pay may be the new norm, determine and collect self-pay rates that ensure practice is covering costs (must be above Medicare allowable)  

3. Plan to Meet Existing Obligations Maintain open lines of communication with vendors on payments due that you may need to defer. Also. see what they are offering to help you as you ramp back up.

4. Develop a Monthly Budget As you adjust to the new normal, review your monthly expenses. Practices can identify what costs the most Jackie Coult, CHBC, is Senior Healthcare Consultant with Eide Bailly

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on a monthly basis and adjust as necessary. ❖

MidwestMedicalEdition.com


July, August, September

UPCOMING EVENTS JULY 20

SEPTEMBER 11

SEPTEMBER 15

8:00 am

9:00 am - 12:00 pm

8:30 am – 4:00 pm

Make-A-Wish 20th Annual Golf Tournament

Sanford Imagenetics Genomic Medicine Symposium

Avera Rural Medicine and Nursing Conference

Location: Minnehaha Country Club

Location: Webinar, Sioux Falls

Location: O’Neill Community

Information and Reservations:

Information: sanfordhealth.org/

Center, O’Neill, Nebraska

Southdakota.wish.org/

classes-and-events, (605) 404-4212

Information: https://avera.cloud-cme.com/

news-and-events

SEPTEMBER 11 8:00 am – 4:00 pm CNOS Foundation Orthopaedic & Sports Medicine Symposium

SEPTEMBER 15 – NOVEMBER 3 Mindfulness: Stress Reduction 8-Week Course Location: The Good Samaritan

Location: Holiday Inn Express,

Society

Dakota Dunes

Information: sandfordhealth.org/

Information and Reservations:

classes-and-events, ellie.schell-

https://www.cnos.net/events/

inger@sanfordhealth.org

cnos-foundation-orthopaedic-sports-medicine-symposium

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.

Family Medicine Physician Opening for a family medicine physician at a thriving, physican-owned clinic. Learn more about Vermillion and this opportunity on our website. 101 S. Plum Street, Vermillion, SD 57069 www.YanktonMedicalClinic.com/careers

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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 • Anesthesiology

• Neonatal intensive care

• Cardiology

• Perinatal medicine

• Child abuse

• Nephrology

and neglect • Child and adolescent psychiatry • Clinical pharmacy • Developmental pediatrics

• Neurology • Neurosurgery • Ophthalmology and optometry • Orthopedic surgery • Palliative medicine

• Ear, nose and throat

• Pulmonology

• Emergency medicine

• Radiology

• Endocrinology

• Rehabilitation

• Gastroenterology

• Rheumatology

• Genetics

• Sleep medicine

• Hematology

• Surgery

and oncology

• Therapy

• Hospital medicine

• Trauma

• Infectious disease

• Urology

• Intensive care

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

012000-00747 6/20

Profile for MED- (Midwest Medical Edition)

July/August 2020 MED Magazine  

July/August 2020 MED Magazine