‘Virtual Infusions’ for Rural Cancer Patients Inside Rock Rapids’ New Hospital
ON A MISSION TO RESTORE
JUNE
Managing the Risks of “Curbside Consults”
VOL. 10 NO. 4
2019
HEALTH, HOPE, AND DIGNITY UROLOGIST LAUREN WOOD THUM, MD
THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS
MEET OUR UROLOGY TEAM
BRADLEY ANDERSON, M.D., FACS MEDICAL DIRECTOR
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Our team provides treatment and surgery options, including minimally invasive robotic surgery, for many conditions: • Catheter placement/ changes • Erectile dysfunction and abnormal penile curvature
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• Prostate enlargement
• Prolapse
• Routine urologic visits and post urological surgical care • Urinary incontinence or leakage
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VO LU M E 1 0, N O. 4 ■ J U N E 2019
Inside This Issue
CONTENTS
FROM US TO YOU
O
PAGE 6 | NAVIGATING THE RISKS OF CURBSIDE CONSULTS ■ By Dennis Boyle, MD PAGE 8 | THIS MONTH ONLINE How to Recognize a ‘Phishing’ Email, MED Now Accepting Job Postings, Photos from the ACS ‘Magic of Hope’ Gala, What is a MED Digital Partner? PAGE 12 | NEWS & NOTES New positions, promotions, awards, & more
ON THE COVER
LAUREN WOOD THUM, MD
This Sioux Falls urologist is on a Mission to restore health, hope, and dIgnity to women and girls in Uganda. PAGE
10
PAGE 17 | [Sponsored Feature] Journey Construction’s Healthcare Expertise Showcased in New Rock Rapids Hospital PAGE 18 | Virtual Infuions A novel Sanford program offers peace-ofmind to rural nurses and patients when high risk chemotherapy medications are needed. PAGE 19 | SFSH Remodel Relieves Overnight Stay “Bottleneck” PAGE 22 | Hot Springs Doctor Hopes to Mix Medicine & Ministry As he wraps up his seminary work, this family medicine physician is keenly aware of the connection between body and spirit PAGE 23 | Upcoming Events Conferences, Symposiums and Summer CME events
NE OF THE JOYS OF working with so many remarkable healthcare
professionals in the South Dakota region is coming across stories like Dr. Lauren Wood Thum’s. Our cover feature focuses on this young Sioux Falls urologist’s extraordinary efforts to restore health, hope and dignity to people in Africa. In our ongoing dedication to your success, we also bring you expert advice on navigating the risks of so-called “curbside consults” or casual requests for medical advice. Is it possible to be helpful and still stay safe? If your business or practice is collecting data to improve your operation (and whose isn’t?), be sure to check out “Driving Strategy with Data Analytics”. As always, we have also packed this issue with all of the latest news and some features we think you’ll enjoy. Don’t forget to send us yours any time at Info@MidwestMedicalEdition.com. All the best! —Alex & Steff
Photo Above Dr. Tom Margolis (far left), Dr. Wood, Dr. Musa Kayondo, Department chair of OB/GYN at the Ugandan hospital,, and Dr. Joseph Njagi of Kenya, a former resident of Dr. Kayondo's who is now a fistula surgeon in his home country of Kenya.
4
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✦ How complex is the advice being sought? Low-risk consults would include general informational requests, no request for a diagnosis or testing, and non-specific advice. A question such as “how long should you be off of an anti-platelet drug pre-scope?” would be considered a simple, informational question. Whereas “when would you do surgery on this patient?” would require
Navigating the Risks of Curbside Consults
more details than a simple phone discussion. ✦ How much is the asking physician relying on the advice of the physician who is consulted? An “implied” physician-patient relationship may be established when a physician pro-
KEY CONSIDERATIONS FOR THOSE BEING ASKED FOR (OR SEEKING) ADVICE
vides advice that changes a patient’s
BY DENNIS BOYLE, MD
✦ An implied physician-patient relation-
I
ship does exist if you are covering a
N SIMPLE TERMS, a curbside consult is an informal solicitation of another physician’s advice or opinion. It is generally characterized by the following:
treatment plan, even if it is via another medical provider.
patient for a colleague. This also applies for physicians who are supervising allied health professionals when the physician is responsible for making a
✦ Typically limited in scope. ✦ The physician being consulted doesn’t review the patient’s chart, talk to the patient, or examine the patient.
✦ Often times, it involves physician colleagues who know each other. ✦ The physician being consulted does not charge for his or her service or have a financial relationship for the consultation. ✦ The consults can occur on the phone, in person, or via email.
IS THERE A PHYSICIAN-PATIENT RELATIONSHIP?
patient care decision. The more a physician being consulted provides advice specific to a patient, like ordering tests or adjusting medication, the more likely the physician may be exposed to liability or may be viewed as part of the care team.
This is the core question in terms of
✦ Is there a financial relationship
CLARITY IN COMMUNICATION IS IMPORTANT
liability with curbside consults. Here
(i.e., is your group paid to be on call
The requesting provider should be very
are some factors that are examined
or do you bill to answer the ques-
clear and keep questions concise and
in order to answer this:
tion)? Any financial remuneration is
general. They should also ask them-
✦ Does the consultant physician have
a key factor in establishing a physi-
selves if an official consult is warranted.
a formal contract or agreement with
cian-patient relationship, and if a
Make sure you provide adequate infor-
the treating physician or the hospital/
court finds a monetary relationship
mation that is not colored by the
facility where the treating physician
with the consultant, there will likely
answer you want. If you are asking for
works?
be liability.
specific advice, offer the consultant a
WEB EXTRA
Read More
❱ Read the extended version of this article, including example scenarios and specific approaches to curbside consults, on our website.
6
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chance to officially see the patient. On the part of the informal consultant, clarify whether your discussion is going to be documented in the medical record. If you believe the case warrants you officially seeing the patient, then say so. If the requestor is going to document your discussion, review the wording that they will be using. â?–
Dennis Boyle, MD, is an academic rheumatologist at Denver Health and a risk manager at COPIC who speaks on communication and medical liability issues.
June 2019
7
THIS MONTH ONLINE Highlighting content and opportunities available exclusively at MidwestMedicalEdition.com
Would You Really Recognize a “Phishing” Email? Email has become the de facto method for office communication, and the bad guys know it too. This has led to a common threat called phishing emails. A phishing email is an email that appears to come from someone you recognize, but really isn’t. The email might prompt you to reset your password by clicking on a link, contain an attachment that you’re supposed to open or may be just asking for a quick favor. In either case, it’s usually a scam and the bad guys may be trying to get you to download malware, give up your password or provide sensitive information. In this exclusive online article, MED Digital Partner High Point Networks uses actual examples of customer emails to illustrate how sneaky and dangerous these kinds of messages can be. You’ll also find four
must-have tips to help you
identify phishing emails before it’s too late. To read the article, click here in your digital issue or on the High Point Networks logo on any page of MED’s website.
BECAUSE D... YOU ASKE
“ 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. Includes content marketing opportunities and even custom content generation at the Pro level. Intrigued? Only a few spots are left. Contact Steff@MidwestMedicalEdition.com to learn more.
Make your business or practice easy to find by thousands of monthly website visitors. Claim your FREE business directory listing at MidwestMedicalEdition.com/businesses
MED NOW ACCEPTING JOB POSTINGS
MED is now accepting postings for our new online job board. For a small fee, businesses looking to fill healthcare positions can take advantage of MEDs growing online audience to get the word out. Job listings are available in groups of up to five or ten. Contact Steff at Steff@MidwestMedicalEdition.com to learn more.
Never miss an event! Check out MED’s online calendar for a complete listing of Spring conferences and symposiums. MidwestMedicalEdition.com
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AMERICAN CANCER SOCIETY RAISES MORE THAN $100,000 AT 3RD ANNUAL ‘MAGIC OF HOPE’ GALA
Magic of Hope attendees (l to r) MED’s Steffanie Liston -Holtrop, Kasey Gauthier, RN, of Sanford’s Hematology/ Oncology Specialty Clinic, Mitchell Jackson (father of a pediatric cancer patient treated at Sanford), Sanford Pediatric Hematology/Oncology nurse Ashlee Blumhoff, APRN-CNP, and Sanford Pediatric Oncologist KayeLyn Wagner, MD.
Digital Partners
The American Cancer Society raised more than $100,000 at its 3rd Annual Magic of Hope Gala on April 6th. This year’s event benefited Pediatric Cancer Research Grants. The evening included casino-style gaming, live & silent auctions, as well as live entertainment from the White Keys. MED was once again a media sponsor of the event and we enjoyed seeing many friends among the 375 guests in attendance. Other sponsors included Avera, Sanford Health, First Premier Bank, Midco, Reliabank, and First Bank. The American Cancer Society is the largest private funder of cancer research and has played
Yankton physiatrist Judith Peterson, MD, and her husband, radiation oncology Michael Peterson, MD, of Avera Cancer Institute Yankton.
a role in nearly every major cancer research breakthrough. The organization has invested more than $4.6 billion in cancer research since 1946, with the goal of saving lives and freeing the world from the
SEE OUR WEBSITE FOR MORE GALA PHOTOS
pain and suffering of cancer.
Exclusive online articles Hey H2M, What’s With the Cowboy Mural?
Healthcare Hiring is Slipping Healthcare hiring is
Credentialing Tips Regarding Government Entities
Strategic healthcare
down 3.2% since 2018
By Lavonne McKee
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but it’s doing pretty well
The government is
digital partner H2M
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January / February 2019
9
"This was the first time we ever used a cystoscope at the hospital," says Wood, explaining this photo. "We routinely lack standard instruments necessary for surgery and I was ecstatic to find we had access to one."
Lauren Wood Thum, MD On a Mission to Restore Health, Hope, and Dignity
“
IN ONE WEEK IN AFRICA, YOU DO MORE COMPLEX CASES THAN YOU MIGHT SEE IN A YEAR BACK HOME.
”
L
BY ALEX STRAUSS
ONG BEFORE SHE BECAME A DOCTOR , urologist Lauren Wood Thum, MD, of Urology Specialists of Sioux Falls, was drawn to medicine’s ability to change lives. In high school, she started a club to raise money for cleft lip and palate repair. In college at the University of Virginia, she established a new major in global health policy. By the time she was a fellow in female pelvic medicine and reconstructive surgery at UCLA in 2017, she jumped at the chance to apply her skills to some of the world’s most
complex urological cases on a medical mission trip to Uganda with California-based MedLend. “You don’t see nearly the breadth of pathology here that you do there,” says Wood, who made
the trip again in March, this time as an attending physician with internationally recognized fistula expert and Bay Area pelvic surgeon Tom Margolis, MD, who leads the MedLend Uganda missions. Besides surgeons, the approximately 15-person team includes anesthesiologists, nurses, anesthesia techs, ObGyn physicians, nurses, and residents, and a few volunteers. “When I first went there, I struggled,” says Dr. Wood. “I thought ‘Why are we doing complex pelvic surgeries when most people here don’t even have access to basic things like clean water?’” But, as she understood the Ugandan culture and healthcare landscape better, Wood realized that she and her colleagues were doing more than repairing fistulas; they were also restoring lives. “Many girls there are very young when they first have kids and android or narrow pelvis is also more common,” says Dr. Wood. “After obstructive labor, they might have 3rd or 4th degree vaginal tears that go unrepaired. These poor girls are totally ostracized. Their husbands will kick them out. They lose everything. After surgery, they can often reintegrate.”
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Dr. Wood and her colleague Dr. Joseph Njagi of Kenya teaching Ugandan residents.
These are complex cases. Many require repair of a rectovaginal fistula, perineorraphy, and anal sphincter repair. In one case, a woman with a urethrovaginal fistula underwent distal urethral reconstruction utilizing vaginal flaps to recreate the distal urethra. In another case, a patient with a ureteral injury and a failed Boari flap was leaking urine through her skin. “We contemplated an ileal ureter,” Dr. Wood explained to MED in an email. “But due to devascularization of the proximal ureter and patient becoming unstable intraoperatively, we were forced to ligate the ureter and allow her to have a functionally solitary kidney. However, she is dry and happy.” The team has repaired many vesicovaginal fistulas, some of them
“The Ugandan doctors routinely
close to the cervix. Other surgeries
work without so many things that
include neovagina creation (from a split
we take for granted in the US–a
thickness abdominal skin graft), recon-
ventilator, retractors, a Bovie cautery
struction of the urethra, ureteral
unit, suction, staplers,” says Wood. “You
implants, cystocele and rectocele repairs, and prolapse repairs such as transvaginal hysterectomy with vault suspension. Wood says congenital problems are also more common in this population and often go untreated or even undiagnosed for
“ YOU LEARN A LOT OF
TRICKS ON HOW TO MANAGE BECAUSE YOU ARE BASICALLY MACGYVER FOR A WEEK
”
learn a lot of tricks on how to manage because you are basically MacGyver for a week. You have to problem solve and you learn to be a little less demanding.” “It’s almost like going to surgery camp.” Wood is married to her Urology Specialists colleague Dr. Joseph Thum, whom she met during res-
years. One 11-year-old patient with an
idency at Cedars-Sinai Medical Center
ectopic ureter to the vagina (something
in Los Angeles. She has been in Sioux
rarely seen in the US) had never been
Falls since August and says she expects
able to attend school because of urine
overseas medical missions will continue
leakage. Ureteral reimplantation saved
to be a big part of her life.
more than just her dignity; it gave her a future.
“It would be selfish not to do it,” she says. “We go through so much special-
“The week I spend in Uganda is the
ized training and we have so many
most tiring but also the most rewarding
skills. We probably use 10 percent of
week of the year,” says Dr. Wood. “In one
what we could do.”
week in Africa, you do more complex
“It is also medicine at its purest.
cases than you might see in a year back
It is how I imagine it must have been
home.”
in the early days of medicine. You
But it is not only the volume and
just do what needs to be done and
complexity of cases that makes the trip
patients are appreciative. It is incredibly
so challenging.
rewarding.” ❖
June 2019
Dr. Wood with two of the Ob/Gyn residents that she worked with and helped train on this year's trip.
11
Happenings around the region
News & Notes
South Dakota | Southwest Minnesota | Northwest Iowa | Northeast Nebraska
AVERA Avera has ranked first out of the top 20 organizations that earned a 2019 Customer Approved Award from Lincoln, Nebraska–based healthcare-intelligence firm NRC Health. Only 20 Independent Living, Assisted Living, or Skilled Nursing organizations earned this distinction. To qualify, organizations must have a high percentage of respondents willing to recommend their locations to friends and family, a measure which strongly correlates with customer satisfaction and loyalty. Avera Health has been named one of the nation’s 15 Top Health Systems by IBM Watson Health. The study spotlights the best-performing health systems in the US, based on a scorecard of publicly available clinical, operational and patient satisfaction metrics and data. This year’s 15 Top Health Systems study evaluated 337 health systems and 2,961 member hospitals. This is the first time Avera Health has been recognized
12
AMY ELLIOTT Last month, Pediatrics published the first findings from the NIH-funded PASS ECHO study. Avera Research Institute’s Center for Pediatric & Community Research is a cohort and grantee in the study, which focuses on life satisfaction in children with chronic illnesses. “While they face more health concerns, they do not report lower life-satisfaction scores,” says Amy Elliott, PhD, Chief ClInical Research Officer with the Center for Pediatric & Community Research. The new Avera Merrill Pioneer Hospital and Avera Medical Group Rock Rapids campus is now open. Under a partnership arrangement, Avera will lease operations of the $28.9 million dollar 11-bed hospital and clinic. The clinic includes 12 exam rooms and one procedure room to accommodate two physicians and two advanced practice providers.Chemotherapy and infusions will be offered for the first time in the community. Avera St. Mary’s Hospital in Pierre was recently named one of the Top 20 Rural Community Hospitals in the country. The National Rural Health Association (NRHA) has announced the 20 highest-ranked hospitals based on an evaluation by The Chartis Center for Rural Health using iVantage Health Analytics’ Hospital Strength Index. These winners were recognized in Atlanta in May.
BLACK HILLS SHAWN POWERS CFRE International has announced that Shawn Powers, Development Coordinator at the Regional Health Foundation,is now a Certified Fund Raising Executive. Powers had to meet a series of standards set by CFRE International and pass a rigorous written exam. Powers joins over 6,300 professionals around the world who hold the CFRE designation.
WENDY JENSENBENDER Regional Health Pharmacist Wendy Jensen-Bender has been named Pharmacist of the Year by the South Dakota Society of Health System Pharmacists. Originally from Brookings, she graduated from the SDSU College of Pharmacy and did her pediatric residency at Children’s Hospital in St. Paul. Jensen-Bender is a member of the clinical faculty at Rapid City Hospital and Professor of Pharmacy Practice for SDSU. She has worked for both since 1996. Regional Health has been named winner of the Silver Star of Excellence Award, presented by the American Technical Education Association (ATEA) and the National Technical Honor Society (NTHS). The award recognizes Regional Health’s support and commitment to postsecondary technical education. Regional Health is a major employer of Western Dakota Tech graduates. Nearly 10 percent of the class of 2017 joined Regional Health after graduation.
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The Regional Health Behavioral Health Center on Mountain View Road in Rapid City will increase its capacity, allowing the center to serve eight more adult patients. The addition means that the facility will be able to care for approximately 730 more patients per year. To support the growth, Regional Health has hired four additional nurses and a full-time psychiatrist.
JOHN FALCONE John Falcone, BSN, a Registered Nurse in the Progressive Care Unit at Regional Health Rapid City Hospital, has received the hospital’s prestigious DAISY Award. According to the patient who nominated him, Falcone “goes out of his way to assist with patient comfort, both physically and emotionally by explaining how and why the process is taking place.”
SANFORD Sanford Health is hosting the National Institutes of Health’s ‘All of Us Journey,’ a traveling, hands-on exhibit to raise awareness for research.The exhibit aims to gather genetic, biological, environmental, health and lifestyle data from more than a million volunteer participants living in the United States. The exhibit is at the Imagenetics building through the end of May, moves to the Sanford Center June 3 to 7, and on to the Sanford Southpointe Clinic in Fargo June 11 to 14.
EXPERTS
in Neurology.
Schedule an appointment today. CNOS.net | 605-217-2667 IOWA • SOUTH DAKOTA • NEBRASKA
June 2019
13
• Happenings around the region
News & Notes
Happenings around the region
SANFORD CONTINUED Sanford opened a new clinic in Rock Rapids, Iowa on May 1. The $5.15 million clinic is 9,600 square feet and is equipped with 10 exam rooms, two procedure rooms, and two rehabilitation treatment rooms. Sanford has provided care in the community since the 1990s. The new building will increase access to services by providing larger lab and physical therapy areas as well as centralized scheduling and registration and an on-site pharmacy.
WHITNEY FERGUSON Whitney Ferguson, RN, of the Ortho/Neuro unit at Sanford USD Medical Center has received a DAISY award for extraordinary nursing. Ferguson is described as compassionate, caring, respectful, professional, kind and empathetic.
INDEPENDENTS Two independent South Dakota Hospitals - Brookings Health System in Brookings and Prairie Lakes Healthcare System in Watertown - have been recognized as Top 20 Rural Community Hospitals by the National Rural Health Association. This is the second time in three years for Brookings Health and the third time for PLHS. (Look for profiles of these two outstanding community hospitals in an upcoming issue)
AMANDA THOMS Amanda Thoms, CNP, of Parker Medical Clinic was named the April Employee of the Month by Pioneer Memorial Hospital & Health Services in Viborg. Thoms received her MS from Briar Cliff University in Sioux City and her BS from USD. She is American Academy of Nurse Practitioners board certified and has worked with Pioneer Memorial since last September.
SIOUXLAND SHERI ALLEN Sheri Allen, RN, BSN, MSN, has joined UnityPoint Health - St. Luke’s as Director of Surgical Services. Allen has spent the last 37 years in various roles at St. Luke’s, including the last 18 in leadership roles. Most recently, she served as the Nurse Manager of Outpatient Services overseeing Same Day Surgery, Post-Acute Care Unit, and the Infusion Center. In her new role, Allen will focus on overall patient experience.
14
GARY W. JORDAN Gary W. Jordan, FACHE, became President and Chief Executive Officer (CEO) of Cherokee Regional Medical Center in Cherokee, Iowa in March. Jordan earned his MBA from Missouri State University and is a Fellow of the American College of Healthcare Executives. He brings with him 28 years of senior management and healthcare administration experience.
Pioneer Memorial is upgrading its digital radiology equipment thanks to a $284,213 grant from the Helmsley Charitable Trust. The money will pay for a new digital X-ray room and a Mobile X-ray System. The mobile system provides clearer, more effective images that are easier to share and store with 75% less radiation exposure for patients and staff. Thomas Flesher, MD, has joined the team of outreach specialists at Pioneer Memorial. He graduated from the University of Oklahoma College of Medicine and completed his orthopedic surgery residency at Johns Hopkins. Dr. Flesher affiliates with many hospitals including Sanford Luverne Medical Center, Sanford Vermillion Hospital, Sanford CantonInwood Medical Center, and Sanford Canby Medical Center. Visions Therapy Center in Sioux Falls has started the Athletic Edge Academy to help optimize sports performance for area athletes. The focus of Athletic Edge Academy is the link between vision and sports performance. Up to 80% of perceptual input in sports comes from the eyes. Athletic Edge Academy stresses eye tracking, eye focusing, peripheral awareness, depth perception and eye-hand coordination in an individualized program.
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WILL HURLEY Will Hurley, MD, who provides cardiology services at Yankton Medical Clinic, is now a Fellow of the American College of Physicians. He is a Fellow of the American College of Cardiology and an Associate Fellow of the American College of Chest Physicians. He has been a cardiologist with YMC since 2001.
LINDA REESE YMC respiratory therapist Linda Reese, has been certified by the National Asthma Educator Certification Board. Reese also serves on the South Dakota Society of Respiratory Care as a senior director at large.
ALYSSA MRSNY Alyssa Mrsny, MPAS, PA-C, has joined Yankton Medical Clinic. Mrsny received her undergraduate degree from Wayne State College and did her graduate work at Union College in Lincoln, Nebraska. She holds certifications with the ACLS, BLS and NRP.
EXPERIENCED IN HEALTH CARE LAW Boyce Law Firm has decades of experience in providing counsel to hospitals, health systems, health care providers, in-house counsel, and health care insurers across South Dakota. Over the years, our attorneys have been involved with shaping the health care law landscape in South Dakota. This wealth of experience helps us to provide effective and efficient legal counsel to help clients with whatever health care related issues that arise. • Malpractice Defense • Licensing, Credentialing, and Employment • HIPAA/Privacy and Security • Fraud and Abuse/Stark • Corporate Compliance
Yankton Medical Clinic has a new 40 slice CT scanner. The new machine provides exceptional .5mm images in less time while simultaneously reducing radiation exposure for patients. The new scanner uses body size to determine radiation dose and is equipped to handle both larger patients and children. The new CT also uses Single Energy Metal Artifact Reduction to detect things like artificial joins or metals to reduce image distortion.
June 2019
• Roger A. Sudbeck • Lisa K. Marso • Matthew D. Murphy • Tommy L. Johnson
(605) 336-2424 • www.boycelaw.com 300 S. Main Ave, Sioux Falls, SD 57104
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• Happenings around the region
News & Notes
Happenings around the region
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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
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INDEPENDENTS CONTINUED Dakota Lions Sight and Health announced a new partnership with LifeSource in April. The partnership is focused on expanding opportunities for corneal donation and transplantation. Minneapolis-based LifeSource provides organ, eye and tissue donation services in Minnesota, South Dakota, North Dakota and Western Wisconsin. Under the new partnership, LifeSource will provide donated ocular tissue to DLSH which will process the tissue and make it available to surgeons for transplantation. Sioux Falls Specialty Hospital has been recognized as the 2019 Foodservice Department of the Year by the Nutrition and Foodservice Education Foundation. The award recognizes innovative practices or excellence in foodservice management and evaluates nominees in teamwork, innovation, customer service, and operational contribution. SFSH foodservices is one of 37 five-star rated hospitals in the country. Children’s Physicians in Omaha now offers new mothers the opportunity to get breastfeeding instruction and support in the comfort of their own home through a virtual visit with a certified lactation consultant. Any breastfeeding mom can call 402-955-MILK to schedule an in-person or virtual visit. Research shows that mothers have more success and longer duration of breastfeeding when there is early lactation support. For the second straight year, a South Dakota Board of Nursing report ranks the University of Sioux Falls School of Nursing’s NCLEX pass rate as No. 1 among nursing programs in South Dakota. USF’s pass rate is an impressive 10% above the national average. The USF School of Nursing consistently maintains a 100% placement rate for undergraduate Bachelor of Science in Nursing students.
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[ SPONSORED FE ATURE ]
Merrill Pioneer Community Hospital
Journey Construction’s Healthcare Expertise Showcased in New Rock Rapids Hospital
A
MONG THE MOST NOTICEABLE FEATURES of the new Merrill Pioneer Community Hospital, a 52,000 square foot critical access hospital in Rock Rapids, Iowa, is the artful use of healing elements like natural light, wood, and stone to create a welcoming flow.
“Natural light and natural elements are a big part of a healing environ-
ment,” says Hospital Administrator Craig Hohn. “With the light in the entry and the wood and stone, the feeling as you walk in is this natural wave that extends back into the waiting area. We heard a lot of comments about this during our open house, Our patients and visitors love it.” What is less noticeable, but probably even more critical, is the extensive healthcare expertise that Sioux Falls-based Journey Construction brought to the $28.9 million project. “This project was unique in that Merrill Pioneer was switching from one health system to another to run the hospital, communication and planning in the beginning was really critical,” explains Superintendent Kevin Brockmueller. That meant that Journey was largely responsible for making sure that the new facility, which includes 11 patient rooms, emergency services, therapy space, a surgical suite, a GI procedure room, outpatient clinical services, radiology, laboratory, pharmacy and a kitchen/cafe, was precisely managed throughout the entire process from preconstruction to move in. “The coordination of all of the equipment is one thing that makes healthcare construction so unique,” says Brockmueller. “Understanding what goes in each area and how to install it properly is really important. The fact that we knew how to do this and have done it many times, reduced a lot of stress and time.” In the last eight years, more than 60 percent of Journey Construction’s revenue has come from healthcare projects. “We are fortunate to have worked on many new, addition and remodel healthcare projects, the experience and relationships really pay off,” says Brockmueller, who has done three area hospital projects, back to back. “It’s a great feeling to hear so many positive remarks from the staff and locals. We are really proud of this project and what it will bring to the community of Rock Rapids.” The hospital opened at midnight on May 1 and welcomed its first patient at 12:01 a.m. To see more of Journey Construction’s area healthcare projects, visit JourneyConstruction.com and click on “Healthcare”. ❖
June 2019
17
Virtual Infusions NOVEL SANFORD PROGRAM OFFERS PEACE-OF-MIND TO RURAL NURSES & PATIENTS
A
DMINISTERING CHEMOTHERAPY CAN BE challenging for even the most experienced providers. Some high risk agents require a level of expertise that may be hard to come by in lower volume rural cancer centers.
In the past, complex patients who needed high risk chemotherapy
drugs were often sent to Sioux Falls for treatment. But since 2016, Sanford has been running a program designed to make it safer for more of these patients get treatment in their home communities. They call the concept ‘virtual infusions’. “The idea is that an oncology professional who is managing a cancer infusion center in the tertiary care setting also helps manage rural infusions virtually using telemedicine, the telephone and the Electronic Medical Record,” Susan Halbritter, CNP, of Sanford Hematology/Oncology in Sioux Falls told MED. Halbritter says nurses in small rural infusion centers are often good generalists but are not necessarily oncology specialists. Providing direct access to a specialist like herself or another CNP in the Sioux Falls infusion center can help these nurses manage patient symptoms, get questions
“
answered quickly, and confidently give high risk medications. Not only
WE HAVE
does the approach improve patient safety, but it can also save time.
INCREASED THE
“Prior to this program, the nurse in the rural center does the assess-
VOLUME IN THESE
ment, then if they have a question they call the clinic and get the
RURAL CENTERS, KEPT MORE PATIENTS CLOSER TO HOME, AND ELEVATED THE BAR EVERYWHERE.
”
receptionist,” says Halbritter. “The receptionist forwards the call to the nurse and then the nurse has to try to catch the physician between patients, relay the question, then reverse the process.” “Meanwhile, the patient is sitting in a rural infusion center waiting to find out if they are even going to get treatment that day.” If a patient has a reaction during infusion in a rural center, the treatment is usually stopped and the patient may only end up getting a partial dose. Virtual infusions give rural nurses the tools they need to manage symptoms as they arise, often allowing treatment to continue so the patient gets the full recommended dose. In Sioux Falls, Halbritter or another CNP is always on hand in the infusion center. That person carries a dedicated internal phone at all times, giving any nurse with a question immediate access to an answer. Sanford spent a year standardizing policies and procedures between Sioux Falls and centers in Vermillion, Armour, and Worthington, Minnesota where the program is offered. The result is a streamlined process that has increased confidence for everyone involved. “There used to be a short list of medications that doctors would allow to be administered outside of the tertiary care center,” says Halbritter. “Thanks to this process, we have increased the volume in these rural centers, kept more patients closer to home, and elevated the bar everywhere.” ❖
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SFSH REMODEL RELIEVES OVERNIGHT STAY “BOTTLENECK” the existing building, relocating 2nd floor administrative offices off site and converting the space into 11 more patient rooms. Chief Nursing Officer Kelly King says, while the new rooms are laid out just like those on the 3rd floor, the decor has a “modern flare”. “We also labeled the rooms with suite numbers instead of room numbers because we wanted patients to feel more at home,” says King. “All of the medical equipment is behind cabinetry so it is not a constant reminder that you are in a medical facility. Hopefully, that contributes
N
to healing, too.”
OT LONG AGO, Sioux Falls
suites, we added three new rooms,”
“When I first came, we used to
Specialty
faced
says Development & Marketing
joke that 25 patients a day was a busy
a dilemma. The number of
Director Jon Crow. “We also made
day,” says Crow. “Now we are averag-
patients requiring an over-
some of them bigger, so we were able
ing 40 a day and growing. I think
night stay after surgery was rising.
to accommodate more total joints
we have done a good job of meeting
But with only 22 patient rooms,
and bigger cases that required over-
what the market needs.”
the hospital was being forced to
night stays. The new ORs improved
Patients seem to agree. Sioux
schedule these surgeries farther
throughput but they also created a
Falls Specialty Hospital has a consis-
and farther out.
bottleneck for overnight stays.”
tent 5-star HCAHPS rate for patient
Hospital
“When we remodeled our OR
Their solution was to renovate
satisfaction. ❖
July 11-13, 2019
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June 2019
5/13/2019 3:14:23 PM
19
DRIVING STRATEGY WITH DATA ANALYTICS BY CHIRAG SHUKLA
S
“
TRATEGIC PLANNING is a core func-
to report progress. Organizations gain significant
tion in most growing healthcare compa-
value and accountability with such engag ement.
nies. Data analysis drives strategic
Technology is a gamechanger in healthcare.
change by winning debates. Process,
Visualization tools such as Qlik Sense, SiSense,
people, and technology are core elements of
and even Excel allow analytics teams to build
the data analytics journey.
compelling dashboards within minutes. These
The book The 4 Disciplines of Execution by Sean
quick-hit dashboards aid in quality control by
Covey addresses goal achievement through
exposing bad data, missing data, and busting
identifying the goal, knowing how to achieve it,
myths/gut feelings.
keeping a scorecard, and holding everyone
Demand for such scorecards quickly increases
accountable. Process drives the first and last
with every group wanting their own viewpoint
discipline. Data drives the middle two. Data can
represented. But building more dashboards with-
tell what happened after the fact (lag measure)
out a plan leads to multiple definitions of truth.
or it can tell what is happening (lead measure).
If process mapping defined number of walk-in
We can influence the end result by watching the
patients as “patients the hospital served”, that
lead measure. A compelling scorecard showing
definition should not be changed to “number of
lead measures and key performance indicators
people who walked in the door”. Make decisions
(KPI) makes accountability a breeze.
based on one or two well-curated, high-quality
The data analytics journey begins with iden-
scorecards so that everyone is speaking the same
PEOPLE ARE
tifying the goal. Process mapping can uncover
THE MOST
and document areas where data collection is
Finally – accountability is everyone’s job. Set
required. For example: if the intent is to serve
expectations up and down the chain of com-
20% more patients in the next 365 days, process
mand and create a feedback cycle to reinforce
mapping will list areas, people, and systems that
expectations. Make accountability a habit. A
provide data, such as front desk to measure
5-minute weekly standup with key team mem-
patient volume, marketing that identifies ways
bers to review lead and lag measures can bring
to reach patients, systems that calculate wait
significant accountability towards meeting
times, etc. SharePoint, Confluence, and even
strategic objectives.
IMPORTANT ELEMENT IN THE JOURNEY SINCE THEY DRIVE PROCESS AND TECHNOLOGY.
”
Word documents on a shared network are good tools for documentation.
language and looking at the same data.
While the journey of data analytics will take turns as business requirements change, the
Beginning data analysis in parallel with pro-
process, people, and technology investments in
cess mapping saves valuable time and generates
healthcare will provide dividends for years to
engagement. Task management tools like Jira,
come. ❖
Pivotal Tracker, and Asana can help with process mapping and task management. People are the most important element in the journey since they drive process and technology. Build an analytics team of tech-savvy, engaged individuals who understand the business. Create a communication channel between the analytics team and stakeholders with a weekly meeting
WEB EXTRA
Read More
Chirag Shukla has worked in the technology field since the 1990s in a variety of businesses, including petroleum, food service, manufacturing, healthcare, and public safety. He is the Chief IT Officer at RAS.
❱ Read the extended version of this article on our website
20
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Compassion . Experience . Trust  � � � �   605.334.1930 6301 S. Minnesota Ave., Suite 300 www.plasticsurgerysiouxfalls.com
June 2019
21
HOT SPRINGS DOCTOR HOPES TO MIX MEDICINE & MINISTRY
G
ROWING UP IN MONTANA,
practice to devote his time to completing
Hot Springs family doctor David
his seminary work. But he is quick to add
Steele, MD, thought for a time
that he sees this as a change in approach,
about becoming a minister. “I
rather than a move away from medicine.
contemplated it, but I didn’t feel the call,” he said. Instead, he became a doctor.
“I don’t think I’m leaving medicine,” he says. “I just don’t know that I’m going to
Steele graduated from the University
continue to be a ‘traditional’ family practice
of South Dakota School of Medicine in 1997
doctor. I think there may be a way to com-
and completed his family practice residency
bine them both but I’m just not sure yet how
in Marquette, Michigan. He practiced
that’s going to happen.”
medicine in the Black Hills,
In the meantime, Dr.
purchasing his Hot Springs
Steele will remain Medical
medical clinic in 2007. Ten
Director of Grace of the
years later, the clinic became
Pines Hospice and the State
part of Regional Health.
Veterans Home, both in
But a few years ago the
Hot Springs. He has also
call to the ministry returned
considered hospital chap-
and
Steele
laincy. He will complete his
answered. “I think it is
required clinical pastoral
important to keep thinking
education, which is akin
about what you want to do
to an internship, in VA
with your life and not to be
facilities in Hot Springs and
afraid to change directions,”
Fort Meade. After that,
t his
t ime
he says. About that time,
he hopes to have a clearer
he was talking with his wife about what his
picture of how medicine and ministry might
life would be like if he had not become a
mix.
doctor. “She told me I would make a good
“These two areas do not overlap, they
pastor. She didn’t know I had been thinking
are integrated,” says Steele, who says he
about it,” he recalled.
still feels “called” to medicine. “There is a
Dr. Steele, 58, is now in his third year at
huge spiritual component to health. We
Lutheran Seminary in St. Paul. He’s been
are spiritual beings. In family medicine,
taking classes online, with intense, one-
we are taught the body-mind-spirit model.
week onsite sessions twice a year. At the end
If one is ill, the others are going to be
of July, Steele will leave his Hot Springs
impacted.” ❖
“
I THINK IT IS IMPORTANT TO KEEP THINKING ABOUT WHAT YOU WANT TO DO WITH YOUR LIFE AND NOT TO BE AFRAID TO CHANGE DIRECTIONS.
22
”
MidwestMedicalEdition.com
SUMMER 2019
UPCOMING EVENTS JUNE 6 – JUNE 7 3:30 pm Thursday – 5:00 pm Friday
Avera Sports Medicine Symposium Location: Ramkota Hotel, Sioux Falls Information and Registration: avera.cloud-cme.com
JUNE 12 – 13
JULY 25 – 26
8:00 am – 5:30 pm 4th Northern Great Plains Lipids Conference Location: Sanford Center Dakota Room Information: kevin.francis@ sanfordhealth.org, 605-312-6422 Registration: sanfordhealth.org/ classes-and-events
12:00 pm – 8:00 pm, 8:30 am – 12:30 pm
AUGUST 23
SDAHO 3rd Annual Rural Health Leaders Conference
Regional Health Foundation Gala
Location: Holiday Inn CIty Center, Sioux Falls Information: 605-361-2281 Registration: sdaho.org
Location: Rushmore Plaza Civic Center Information: 605-755-9194
JUNE 19 – 20
8:am – 6:00 pm, 8:30 am – 11:45 am South Dakota Work Comp Summit Location: Sioux Falls Convention Center Information and Registration: saferhealthierbetter.com
JULY 12 – 13
7:00 am – 4:30 pm, 7:15 am – 12:15 pm 41st Annual Sanford Black Hills Pediatric Symposium
5:30 pm
SEPTEMBER 7 9:00 am – 1:00 pm
Grand Opening of Regional Health New ED and Heart & Vascular Unit
OCTOBER 7 – 8 1:00 pm – 5:00 pm, 7:45 am – 4:30 pm
Annual Trauma Symposium 2019 & Air Transport Symposium Location: Sanford Center Dakota Room Information: jonathan.bohlen@ sanfordhelath.org Registration: sanfordhealth.org/classes-and-events
SAVE THE DATE:
October 29 – 30 8:00 am Oct. 29 – 12:00 pm Oct. 30 The Many Faces of Addiction: Hope and Healing Location: Sioux Falls Convention Center Information: averacontinuingeducation@avera.org, 605-322-7879
Information: 605-755-9179
SEPTEMBER 19 – 20 8:00 am – 5:00 pm SDAHO 93rd Annual Convention Location: Sioux Falls Convention Center Information and Registration: sdaho.org, 605-361-2281
Location: The Lodge at Deadwood Information: sanfordhealth.org/ classes-and-events
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.
YOUR WORLD IN OUR HANDS
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