Supporting Staff in Stressful Times The Pandemic and Public Health Messaging
CREATING UNBREAKABLE BONDS STEVEN J. MEYER, MD Orthopaedic Surgeon
THE SOUTH DAKOTA REGION’S PREMIER PUBLICATION FOR HEALTHCARE PROFESSIONALS
Recognizing Local ‘COVID Heroes’
VOL. 11 NO. 4
Have You Protected Your FamilY? Thank you for taking care of others. Make sure you take care of yourself and your family too.
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VO LU M E 1 1 , N O. 4 ■ J U N E 2020
Inside This Issue
CONTENTS PAGE 6 | Recognizing COVID Heroes As the COVID-19 pandemic began to impact our region these professionals acted quickly and decisively.
PAGE 9 | Supporting Patients and Providers From a DIstance How a palliative medicine specialist is helping both her patients and her col-
ON THE COVER
Creating Unbreakable Bonds
leagues navigate the challenges of social distancing
PAGE 10 | This Month Online Exclusive online articles, Upcoming Events, & robotic hernia repair
PAGE 14 | News & Notes
Steven J. Meyer, MD, Orthopaedic Surgeon
PAGE 19 | Survey Says . . .
■ By Alex Strauss
A statewide survey shows public trust in
An exclusive interview
News and info you might have missed
doctors is high for COVID-19 information
with the local winner of
PAGE 20 | How to Deal with Potentially
the American Academy
of Orthopaedic Surgeons’
■ By Michael Victoroff
PAGE 22 | The Value of Mindfulness for
■ By Carole South-Winter
Cover story photos: Shane Monahan Photography
f the COVID-19 crisis has given us anything, it is a timely reminder that our medical community is filled with extraordinary providers. In this issue, we are proud to once again be showcasing a few of those providers–some in relation to their work around the virus (“Meet Some COVID Heroes”), others for work they have done for many years (“Creating Unbreakable Bonds”). Do you know someone who has gone above and beyond during this unprecedented time? It’s our job and our privilege here at MED to help lift them up. Reach out to us anytime at info@midwestmedicaledition. com. That’s also the best way to share your own announcements, news, events, schedule changes, and anything else you’d like your medical colleagues to be aware of. MED is your communication partner. Let us know how we can help! —Alex and Steff PS Be sure to join the VIP List at MidestMedicalEdition.com for digital issue access and news updates between issues!
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COVID HEROES JULIE MEYER
MANAGER OF INFECTION PREVENTION AT SANFORD Julie Meyer, Sanford
Manager of Infection Prevention, has been instrumental in developing COVID-19 planning and protocols in addition to surge planning and developing
covered. “So not only am I thinking
been through a pandemic before.
about my own shop. I’m also having
This is new territory. We will have
daily virtual meetings with long
notes after the fact but right now
term care facilities, ambulatory care
we are just living it. “
clinics, funeral homes, etc,” says Turbak. “A pandemic is not hospital-centric, it’s community centered. You are always trying to predict and forecast. We can’t be complacent and think it isn’t going to happen.”
best practices for conserving PPE. She and her team have been on call for COVID-19-related infection prevention calls 24/7 across the Sioux
on the units to ensure all questions are answered and proper protocols
PLHS ER Director
are followed. Julie is a subject matter
Monica Everson has had
expert in infection prevention
to pivot quickly to prepare her
which is vital for keeping our staff,
department for a possible surge in
patients, and visitors safe.”
cases of COVID-19. This has included
“Julie has been tirelessly rounding
instructing staff how to manage the walking-well who are asking for
INFECTION CONTROL NURSE, PRAIRIE LAKES HEALTHCARE SYSTEM PLHS infection
RN, ER DIRECTOR, PRAIRIE LAKES HEALTHCARE SYSTEM
Falls region. According to Sanford,
As the COVID-19 pandemic began to impact our region, everyone in healthcare had to adapt quickly and decisively. We invited organizations across the area to share some of the many ’COVID Heroes’ who stepped up to do what was needed.
virus tests, cross-training other
CHIEF NURSING OFFICER, PRAIRIE LAKES HEALTHCARE SYSTEM
clinical staff how to work in the ER,
of triage. “My job pretty much has
been to reassure staff that what
CNO Shelly Turbak over-
we’re doing is in line with the CDC,”
sees the Healthcare Branch of the
says Everson who created a policy
city/county central command
binder that she updates daily. “There
known as the Watertown Area Task
is so much information out
Force. Healthcare entities through-
there and not all of it is reli-
out the Watertown area report to
able. When I feel like my
her and she collaborates with other
staff is safe and has the
branches, as needed, to make sure
latest information, I feel
everything–from hospital supplies
OK when I leave for the
to daycare for healthcare workers–is
day. None of us have
gathering PPE and making sure it is handy, and managing the logistics
control nurse Shannon Britt oversees infection control policies and procedures. During the pandemic, she started a weekly newsletter focused on infection control policies and procedures. Britt works with directors to implement new protocols and educate staff and sends daily email updates to keep everyone informed. She is also involved with the Watertown Area Task Force and helps coordinate with other healthcare entities in town. “I was prepared in some ways. I knew what infection control was,” she says “But this has become a professional and personal growth situation. It’s been like ‘Here you go. Spread your wings and fly!’”
LAB DIRECTOR, HURON REGIONAL MEDICAL CENTER
DIRECTOR OF MARKETING, PRAIRIE LAKES HEALTHCARE SYSTEM PLHS Director of Marketing, Jennifer Bender, is also the Public Information Officer for the Watertown Area Task Force. Along with two members of the police department, who are also serving as PIOs with Bender, she launched a community Facebook page to serve as an information hub and coordinates a daily live commu-
As lab director at Huron Regional Medical Center, Scarborough “took the bull by the horns” in developing new testing protocols with the State Department of Health. Scarborough helped develop the plan and set up processes for the initial drive-through COVID-19 testing in the hospital’s ambulance bay. Later, she helped the county task force implement off-site testing using the same protocols and processes. Scarborough advocated for adequate supplies for Beadle County, an early hot spot for the virus, and helped the county procure an Abbott Analyzer. “She took the initiative to research the technology and got the unit up and testing within one day of it’s arrival,” HRMC told MED. “She takes accurate testing very seriously and has worked tirelessly to make sure we can provide quick and accurate diagnosis for our providers.”
nity update. Bender worked with a local group to summarize the daily briefing in Spanish and launched a video PSA project for social media. In her role as Director of Marketing, Bender ran the internal communications on COVID-19 protocols and
PURCHASING DIRECTOR, HURON REGIONAL MEDICAL CENTER
developed a #PrairieStrong ad cam-
As the purchasing director for Huron
paign to inspire the staff and the
Regional Medical Center for the last
25 years, Janna Rose has been tenacious at making sure HRMC can get
RONY HERRERA REYES
FLOOR TECHNICIAN & HOUSEKEEPER, HURON REGIONAL MEDICAL CENTER
Rony recently celebrated one year working as a floor technician at Huron Regional Medical Center. During the COVID-19 pandemic, he was asked to change from his regular duties as a floor technician to provide housekeeping for several areas of the hospital campus According to HRMC, he took on these new responsibilities without complaint and with a positive attitude. “As things changed, he again was asked to flex
the supplies they need to prepare for a surge in COVID-19 cases. “In the face of many shortages and delays, she’s reached out to connections far and wide and ‘dogged’ the State to make sure we get our fair share.,” HRMC told MED. “She’s developed backup plans upon backup plans and been very careful about protecting the supplies we do have. This includes not only personal protective equipment, but also cleaning supplies and regularly-needed supplies. She’s bright and not afraid to get right to the point with what she needs for our entire facility and staff to safely care for COVID and nonCOVID patients.”
THE INPATIENT COVID CARE TEAM, HURON REGIONAL MEDICAL CENTER JASON BARNHARD CRNA LINDSEY MCCASKELL RN, ASSISTANT INPATIENT DIRECTOR
DESTINY FINN RN, OB COORDINATOR When Beadle County saw its first cases of COVID-19 in early March, HRMC’s Inpatient COVID Care Team quickly connected with their counterparts elsewhere in the state and the country to develop a plan to conserve and extend the use of N95 respirators, care for COVID patients needing to be intubated in the ICU, and create isolation areas on the
his work environment and said, it is
medical and OB floors. This trio
important for me to keep coming into
led the effort to map out how the
the hospital and working wherever I
COVID ward would operate, how to
am needed – for the patients, and for
separate supplies and medications,
and how staff could support one another in applying PPE and coming in and out of the ward.
CHAPLAIN, ASERACARE HOSPICE, SIOUX FALLS Charles Isaac, a Chaplains at AseraCare Hospice in Sioux Falls, has stepped up to minister to more than the spiritual needs of hospice patients and their families. Like many organizations, AseraCare has been forced to get creative to deliver quality care while also keeping patients, families, and the community safe. “We continue to see our patients in person, but also have expanded into telehealth visits to meet patient’s needs,” AseraCare wrote in a note to MED. “Charles took on this initiative to ensure that we could continue to serve our patients. He trained our staff to be proficient in the use of this technology and has even helped
MD, NEPHROLOGIST AND PRESIDENT OF THE YANKTON MEDICAL CLINIC BOARD OF DIRECTORS Yankton Medical Clinic says nephrologist Byron Nielsen “has not been afraid to make changes at the clinic that keep providers, staff, patients, and visitors safe and healthy. He has taken the lead and set an example for us to follow. We have embraced telemedicine and internal meetings are not held in person but using video conferencing. This is a challenging time and information at first was changing almost as soon as it was released. We are fortunate to have dedicated people like Dr. Nielsen to make sure we are doing what we need to do to
RN, MSN, INFECTION CONTROL COORDINATOR, YANKTON MEDICAL CLINIC Yankton Medical Clinic’s infection control coordinator Kristal Vogt “has been on top of all the changes and latest recommendations communicating all of the information to Dr. Nielsen and our infection control committee and making recommendations for processes,” YMC told MED. “Vogt has stepped up to make sure all staff are educated on the proper procedures for using PPE and she keeps careful track of inventory. She’s been working on creative solutions to replace what we need when supplies are limited or unavailable,” they added. ❖
keep everyone safe and healthy.”
several family members become more equipped in the use of video messaging, allowing them to be in contact with their loved ones.”
❱ You can read extended interviews with some of these COVID Heroes on our website.
We dedicate this issue of
MED to our . . .
Extraordinary Healthcare Facilities & to their employees
who work tirelessly to preserve and protect the health of our communities every day.
Thank you! 8
Supporting Patients and Providers From a Distance
S H E A LT H C A R E workers
of just informational. The whole dynamic
at Yankton Medical Center
learn to cope with the new
Those changing dynamics, coupled with
realities of COVID-19, board
the stress of changes in their personal lives,
certified palliative medicine specialist
has also made this a challenging time for
Amanda Sedlacek, DO, is stepping up
YMC clinic staff.
efforts to support both them and their sickest patients.
To support them, Dr. Sedlacek is leading virtual in-service sessions on topics such
Dr. Sedlacek was featured on the cover
as managing difficult conversations,
of the April/May issue of MED Magazine,
dealing with emotional patients, delivering
which went to print before the pandemic
bad news remotely, embracing new tradi-
had impacted the South
tions with their own
Dakota region. Since then,
families, taking better
Dr. Sedlacek’s work in
care of themselves, and
patient and staff care has
living more mindfully.
become even more rele-
“A lot of people have
vant. She spoke with us
come by my office to say
again in late April to tell
thanks,” says Sedlacek.
us about some of the
“I have had people say, ‘I
didn’t really know how
“Every visit I have now
to manage this before.
is a virtual visit,” Sedlacek
I haven’t ever done self-
told MED. “This includes
care.’ So they appreciate
all of our palliative care
patients, nursing home
Dr. Sedlacek received
patients, everyone. At first,
training in self-care prac-
it was challenging. Even
tices and group therapy
when things are normal, it
during her Palliative &
is difficult to have some of
Hospice Medicine fellow-
these conversations. But to have to do it
ship at Summa Health in Akron, Ohio. YMC
virtually is a definite change.”
staff who take part in these live training
Sedlacek says some dying patients who
sessions work through a workbook and use
would otherwise have distant family with
things like journaling prompts to process
them are having to navigate these strange
complex emotions in a safe and supportive
waters on their own. In some cases, care-
givers who were helping them can no longer come.
EVEN WHEN THINGS ARE NORMAL, IT IS DIFFICULT TO HAVE SOME OF THESE CONVERSATIONS. BUT TO HAVE TO DO IT VIRTUALLY IS A DEFINITE CHANGE.
“I do feel like we are doing a good job of supporting our clinic staff,” says Dr.
“We are touching base with our palli-
Sedlacek. “We play ‘We Are Family’ every
ative care patients weekly now, just trying
day at 4:30 and we are finding new ways
to see what they need for support,” she
to help each other and maintain that con-
says. “Now, we are also having people
nection, even though we have to stay six
asking more emotional questions instead
feet apart.” ❖
THIS MONTH ONLINE Highlighting content and opportunities available exclusively at MidwestMedicalEdition.com
Dr. Michael Brozik, MD, on Robotic Hernia Repair at Surgical Institute of South Dakota UPCOMING
When general surgeon Michael Brozik,
in men because of a natural weak-
MD, joined Surgical Institute of South
ness in this area. Dr. Brozik and his
Dakota in SIoux Falls almost three years
colleagues at SISD typically utilize a
ago, he was ‘not a huge
mesh scaffold to repair
fan’ of robotic surgery.
these hernias. As scar
Like most new sur-
tissue grows into the
geons, Dr. Brozik had
mesh, it strengthens the
experience with the min-
repair. Hernia surgery is
imally invasive robotic
now the second most
common operation Dr.
Make-A-Wish 20th Annual Golf Tournament
surgical residency at St.
Brozik performs, after
Joseph Mercy Hospital in
Ann Arbor, Michigan,
Beyond the fact that
where he also did a surgi-
the robot negates the
cal critical care fellowship.
need for a large abdomi-
SDAHO 4th Annual Rural Health Leaders Virtual Conference
CNOS Foundation Orthopaedic & Sports Medicine Symposium
Learn more about these events, see what’s been cancelled or postponed, and add your own events for free on the website.
But he admits that, at first,
says high-definition 3D visualization
tages of the technology.
allows him to see better than he can
“I changed my tune after groin her-
with his naked eye. As a result, he
nias, though,” says Dr. Brozik. “Before
can handle internal tissues with
I was doing these robotically, many
greater delicacy, reducing trauma to
patients would still be having a lot of
the tissues and cutting pain and
discomfort two weeks later.”
But Brozik noticed that his roboti-
“I would say that the physicians in
cally-repaired groin hernia patients
our group have been early adopters of
had a completely different experience
minimally invasive surgical tech-
from those treated traditionally.
niques,” says Brozik. “Everyone here
“These patients tend to feel like they
was doing robotics before I joined. We
are back to normal in two weeks,” he
are ahead of the curve in this technol-
says. “Some do not even require any
ogy, having seen the advantages.”
pain medication.” About 96% of all groin hernias are inguinal (inner groin), and most occur
nal incision, Dr. Brozik
he did not fully appreciate the advan-
You can read an extended version of this article on our website.
Exclusive online articles Local Companies Adapt Business Model To Respond To Healthcare Needs What do a distillery, a fire apparel company, and a print shop all have in common? In addition to being northwest Iowa businesses, when the pandemic hit, they all changed their production models to help fulfill needs at Spencer Hospital.
What Rural Health Clinics Need To Know About Telehealth Billing The CARES Act authorized rural health clinics to furnish telehealth services and bill as the distant site provider during the COVID-19 Public Health Emergency. The experts at Eide Bailly explain how that works.
A Remote Work Checklist from High Point Networks Is some or all of your staff working from home? Learn some budget- conscious ways to make sure rapid changes to your officeâ€™s IT environments do not lead to increased cyber-threats
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January / February 2019
Steven Meyer, MD HIS MARCH, just as the attention of the world was
MED: What compelled you to start
turning to COVID-19, orthopaedic surgeon Steven
this work and how do you think it
J. Meyer, MD, of the CNOS Clinic in Dakota Dunes became the recipient of the 2020 American Academy
of Orthopaedic Surgeons’ Humanitarian Award. The award came
family? SM: What compelled me initially was the fact that I look around and I see
just three months after his 51st medical mission trip to Tanzania
the dichotomy. In America, we have
as part of Siouxland Tanzania Educational Medical Ministries
so much and appreciate so little. Tan-
(STEMM), the nonprofit organization he founded in 1997. STEMM is dedicated to bringing medical care and educational opportunities
zanians have so little and appreciate so much. It has been such a joy to work alongside and develop relationships
to the East African nation. Dr. Meyer spoke with us in April about
with people who truly understand
the award, STEMM, Tanzania, and pivoting during the pandemic.
what it means to live a life of love and
MED: Were you surprised to
Tanzania. Two years after that, we
receive the Humanitarian Award?
did the first knee replacement. The
SM: Well, yes. The previous 20-some
STEMM mission opened up a new
recipients have all been icons of orthopaedics. People like my friend
avenue of high level ortho surgery for the entire country.
Larry Dorr, who has probably written more books on hip replacement than
MED: Things have really blos-
anyone. It is kind of like the Heisman
somed in the region beyond just
Trophy. You expect that to go to ath-
medical care thanks to STEMM.
letes from Auburn or Ohio State and
What are you most proud of?
suddenly it goes to someone from
SM: What makes me really happy is
some little community college. That’s
that, through the efforts of a lot of
kind of how it feels.
other people, orthopaedic surgery is
MED: You have been travelling to Tanzania regularly since you established STEMM in 1997. How have things changed there since your first trip?
now just a small part of STEMM. We also started the number one rated orphanage in Northern Tanzania with fifty orphans from a poor rural community growing up in family homes. We feed hot lunches to thousands of
SM: When I went for the first time in
kids every day and we have sent 10
1996, they were sterilizing instru-
thousand kids to high school and
ments with a hot plate and a cast iron
university. We have built roads and
pot. I was operating with makeshift
buildings and teacher housing. We
instruments and going to the hard-
built a modern birthing center with
ware store to get screws to put in
oxygen and fetal monitors. There is
people. Through our consistent efforts,
really no area of society that STEMM
eight years later, in that same hospital,
hasn’t touched in some way.
I did the first hip replacement in
has impacted you and your
service. Another big blessing for me has been the opportunity to take my kids, one of whom is now in college and two in high school. They have each been to Tanzania eight times. They don’t complain about things as much as most Western kids. It has given all of us a very different perspective. MED: Do you think your patients in Sioux City have been impacted by your mission work? SM: I think my work in Africa has given me a greater sense of empathy and compassion for people, in general. It has also given me the opportunity to offer my patients a window into a greater world perspective. So many of my patients know about the work we do and they know what our mission is about. So it opens up opportunities for them, too. Of all the places in the world, this is not necessarily where you would expect a phenomenal mission to be born. We are a different culture, a different color, mostly blue collar. But people here have demonstrated a great heart for this mission.
kable Bonds BY ALEX STRAUSS
MED: What role has CNOS
could be a benefit for our patients.
played in this work?
We were on the forefront of same
SM: CNOS has been a huge part.
day hip and knee replacements five
They have been so supportive, financially, logistically, and through
or six year ago, before a lot of people were even talking about it.
encouragement. I am blessed to have world class partners who are
MED: What is next for STEMM?
at the top of their game. They have
SM: We have recently started
afforded me the opportunity to do this by taking call when I am away and sometimes more than that. In 2012, I was gone for three months and my partners at CNOS picked up my practice and took care of it. MED: Switching gears for a moment, any thoughts on how things have had to change at CNOS over the last few months?
doing outreach clinics in some of the Masai villages, providing things like antibiotics and blood pressure medicine. Next, we would like to partner with US colleges and agribusinesses to build an agricultural technology training center. As far as orthopaedics goes, our dream is to find enough orthopaedic surgeons to do trips with STEMM
SM: CNOS has long been on the
that we can establish
leading edge of technology. We had
centers of orthopaedic
telemedicine in place within a
couple of days of realizing that we
Tanzania. There is a
had to implement social distancing.
huge pent up demand
We never had a reason to have this
for people to do some-
in place before, but as soon as we
thing meaningful and
needed it, we had it. Our group is
impactful. Giving them
incredibly innovative and creative.
a place to do that could
We tend to be ahead of the curve,
be an opportunity
as long as the science shows there
us to grow. â?–
A Masai child suffering from fluorosis
ABOVE Dr. Meyer works with a Tanzanian colleague to treat a leg deformity caused by fluorosis. RIGHT Dr. Meyer and his wife Dana with some of the first residents of the orphanage established by STEMM.
Happenings around the region
News & Notes
South Dakota | Southwest Minnesota | Northwest Iowa | Northeast Nebraska
Avera is enhancing access to translation and interpreter services for non-English speaking patients. Avera has created a 14-page toolkit on COVID-19 symptoms, social distancing, home isolation, hand hygiene, face masks, and more. The toolkit has been translated into Arabic, Amharic, Bosnian, Karen, Kunama, Nepali, Spanish and Swahili, with Vietnamese and Korean translations underway. Avera also created informational videos in Spanish and Nepali featuring Avera doctors.
Through its association with Mayo Clinic, Monument Health in Rapid City launched SARSCoV-2 lgG antibody blood testing for COVID-19 in mid-April. Monument began offering the test at drive-through sites. The test costs $100 and results are typically available from Mayo Clinic Laboratories in 3 to 5 days.
Several Avera facilities have started playing “Here Comes the Sun” over the loudspeaker when babies are born or when someone recovers from COVID-19 and is being discharged. The idea came from Dr. Dayna Groskreutz, a pulmonary/ critical care physician. Several Avera hospitals normally play “We’re Caring for Life” or other tunes overhead every time a baby is born at the facility.
Monument is offering antibody testing for Pennington County and Rapid City employees. Those with the antibody in their blood could be good plasma donors to help hospital patients severely affected by COVID-19. “It’s been suggested many of us have already been exposed to COVID-19, but don’t know it because we didn’t have symptoms,” said Pennington County Commission Chair Deb Hadcock. “The antibody test will allow us to know if the disease has already been circulating in our community.”
Lynne Seime, Medical Technologist at the Rapid City Hospital Laboratory, processes samples for COVID-19 testing.
Monument Health began processing its own COVID-19 test samples at its Rapid City laboratory in April, reducing the time it takes to confirm whether a patient has been infected with the virus. The PCR (polymerase chain reaction) test has a 45-minute run time, and 16 tests can be processed at once. Because of the small number of tests kits, initial tests were reserved for hospitalized patients. Tests of non-hospitalized patients were being sent to Mayo Clinic. Monument Health is participating with Mayo Clinic and other healthcare systems in the region in a research project to determine if blood plasma from recovered COVID-19 patients could be an effective treatment for hospital patients with severe infections. Plasma can be frozen for up to a year and could be used to treat severely ill COVID-19 patients locally.
The Monument Health Foundation has launched a COVID-19 Medical Response Fund to support community efforts to fight the coronavirus Tax-deductible gifts to the fund are being used to purchase or help produce medical equipment such as 3D printing supplies for specialized masks created at South Dakota School of Mines & Technology, or locally manufactured face shields.
Monument Health uses innovative UVC light process to sterilize PPE
With supplies of face masks and other personal protective equipment dwindling, Monument Health devised an innovative way to sterilize and reuse N95 respirators. The health system adapted ultraviolet UVC light towers that traditionally are used at Rapid City Hospital to decontaminate patient rooms to sterilize as many as 1,900 N95 masks per day. The UVC towers are placed eight feet apart, and 20 masks are hung on racks midway between them. It takes about 7 1/2 minutes to disinfect a batch. Each respirator mask can be sterilized as many as five times.
SANFORD Three weeks after starting an initiative to help their colleagues facing financial hardship during the pandemic, the Sanford Health Foundation announced that Sanford employees had donated more than $1 million dollars. The money benefits the Foundation’s Enterprise Employee Crisis Fund, which supports Sanford and Good Samaritan Society employees struggling to meet basic needs due to extraordinary and unexpected circumstances. Any employee may apply to receive up to $1,000 in assistance.
Sanford has also joined the national clinical trial of blood plasma therapy for critically ill COVD-19 patients. A Sanford patient in Fargo received a transfusion of plasma from a recovered COVID-19 patient. The use of plasma under this program is for hospitalized patients with severe COVID-19 or those at high risk of progression to life-threatening disease. Studies suggest that antibody-rich convalescent plasma may lessen severity or shorten the length of the illness caused by the virus. The Sanford laboratory in Sioux Falls was the first Sanford facility to start antibody testing for COVID-19 in April. Sanford conducted trial runs before rolling the tests out system-wide. Antibody tests determine previous infection through a blood test. Sanford said it had the capacity to complete up to 1,200 tests daily. Sanford Health Plan announced in April that it would waive all out-ofpocket costs including medical co-pays, deductibles and coinsurance charges for COVID-19 treatment for its members through May 31.The health plan said it would cover all costs for testing and treatment for its members, including outpatient care and inpatient hospital stays across the plan’s footprint in North Dakota, South Dakota, Iowa and Minnesota.
Sanford Health is leading a clinical trial of the antimalarial drug hydroxychloroquine to understand its role in treating and potentially preventing COVID-19. The study will initially include 2,000 exposed outpatients, including frontline healthcare workers and other high-risk patients. The prophylactic treatment trial is designed to determine whether the medication can prevent the illness or minimize symptoms. Infectious disease specialist Susan Hoover, MD, PhD, is Principal Investigator.
At the beginning of April, Sanford Health began utilizing a 90-minute test for COVID-19. The rapid tests were initially reserved for the highest priority patients including those who are hospitalized, healthcare workers, and elderly adults living in long-term care facilities. The rapid tests were initially rolled out in Sioux Falls and Fargo. The addition of the rapid tests increased Sanford’s daily testing abilities by 1,500 tests per week.
SIOUXLAND STACIE WEBNER Stacie Webner, ARNP, has transitioned from UnityPoint Clinic Urgent Care to a family medicine provider at UnityPoint Clinic Family Medicine – Sunnybrook. Webner received a BS in Nursing from Mankato State University and an MS in Nursing from Clarkson College in Omaha. She brings with her over 13 years of experience as a nurse practitioner and is certified by the American Academy of Nurse Practitioners. Prior to joining UnityPoint Clinic Family Medicine, Webner worked at UnityPoint Clinic Urgent Care in Sioux City.
INDEPENDENTS Children’s Hospital & Medical Center and the University of Nebraska Medical Center Munroe-Meyer Institute have announced the signing of a new Institutional Affiliation Agreement to enhance and expand genetics, developmental/behavioral pediatrics, behavioral health, and primary care medical home services in Nebraska and across the region. This IAA is part of a Master Affiliation Agreement between Children’s and UNMC, established in late 2019 to broaden and enhance collaboration between Children’s and various UNMC entities.
• Happenings around the region
News & Notes
Happenings around the region
Former Assistant Administrator Lindsey Hauger is the new CEO of Pioneer Memorial Hospital & Health Services in Viborg. Hauger grew up in Viborg and worked at the hospital as a CNA in high school. She received her MBA in healthcare at the University of Sioux Falls and received her Nursing Home Administration License in 2017. Hauger replaces former CEO, Tom Richter, who retired at the end of April. Amanda Marts, a PT at Pioneer Memorial, recently received the Clinical Instructor of the Year Award from USD School of Health Sciences Department of Physical Therapy. She was chosen by doctoral candidates for her impact on their clinical experiences.
Linda Hofmann, RN, has received the 2020 Award for Nursing Excellence at Yankton Medical Clinic, PC. Hofmann has been a nurse for 40 years and has worked at YMC in multiple departments for 11 1 ⁄2 years. She works in the gynecology and obstetrics department.
SARA PEPPER Dr. Sara Pepper of Yankton Medical Clinic has earned board certification by the American Board of Pediatrics. Pepper is also now listed as a Fellow of the American Academy of Pediatrics. Dr. Pepper has been a pediatrician at YMC since 2018. YMC recently awarded six scholarships to area students as part of a 23-year-old scholarship program to promote healthcare careers. Four scholarships went to high school students, one to a student enrolled in a nursing, radiology, medical lab, or respiratory therapist program, and one to a medical student at the Sanford School of Medicine. Applicants must plan to return to work within 50 miles of Yankton.
Prairie Lakes Healthcare System in Watertown resumed elective surgeries in late April. The hospital said proactive measures implemented in response to COVID-19 would stay in place as a deliberate effort to carefully return to business; including the continued enforcement of PLHS’s No Visitor Policy and screening of temperatures and other symptoms at the entrances. “We welcome the opportunity to return, not to normal but to a new normal as we make a positive difference in the health of our patients and the communities we serve,” said CEO K.C. DeBoer.
CAITLIN BACH Caitlin Bach is the new General Manager of Nutritional and Environmental Services at PLHS. Bach is a native of the Watertown area and a graduate of Lake Area Technical Institute with a degree in marketing and business management. She was most recently the Nutritional Services Manager and brings twelve years experience at PLHS to her new role as General Manager.
SCOTT KINDLE Board certified dermatologist Scott Kindle, MD, has joined Yankton Medical Clinic. Dr. Kindle earned his MD from the University of Nebraska Medical Center in Omaha and completed his residency at Mayo Clinic in Rochester, Minnesota. He joins Dr. James Young in the dermatology department
PLHS has launched a plan to ensure income stability for its staff, guarantee the accrual of employee benefits, protect staff with COVID-19 exposures, and safeguard organizational needs through the pandemic. Under the “Prairie Lakes Cares Plan”, PLHS will redeploy staff with reduced hours and those who cannot be redeployed will be able to access the plan, which will have an allocated number of hours for staff in these situations.
PRASHANTH ANAND Orthopaedic surgeon Prashanth Anand, MD, FACS, has joined the physicians of the CNOS Clinic in Dakota Dunes. Dr. Anand will practice general orthopaedics with an emphasis in sports medicine and arthroplasty at UnityPoint Health – Fort Dodge. Dr. Anand completed fellowships in Foot & Ankle surgery at Duke and in Sports Medicine at Union Memorial Hospital in Baltimore. He comes to CNOS from Carle Richland Memorial Hospital in Olney, Illinois.
OTHER Spencer Hospital nurses Carol Hartig, Dee Hoger, Beth Hopkins, John Lyon and Margaret Molitor have been selected among Iowa’s 100 Great Nurses for 2020. The 100 Great Iowa Nurses program identifies 100 outstanding nurses across the state every year.
The Helmsley Charitable Trust announced in April that several area facilities would receive funding from a multimillion-dollar effort to save the lives of COVID-19 patients and protect the frontline healthcare workers. A total of $4,711,481 in funding will be distributed across five upper-midwestern states to pay for 367 LUCAS mechanical CPR devices to be deployed to hospitals caring for patients during the pandemic and beyond. Prairie Lakes Healthcare System, Sanford Health, Avera and Monument all received funds.
ANGELA GAIKOWSKI Family Medicine Nurse Practitioner Angela Gaikowski of Sisseton, South Dakota has joined Modern Day Health Care in Sioux Falls. Gaikowski has special interest in pediatrics and mental health. Modern Day Health Care (MDHC) is an advanced practice nurse-owned and operated clinic that provides 100 percent of it’s care through telemedicine. They recently expanded their coverage into Minnesota and can now provide telemedicine services to four states including South Dakota, Iowa, and Colorado.
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• Happenings around the region
News & Notes
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SURVEY SAYS . . .
PUBLIC TRUST IN DOCTORS IS HIGH FOR COVID-19 INFORMATION BY ALEX STRAUSS
HEN IT COMES TO informa-
understand where people are getting
tion about COVID-19, the people
COVID-19 information, their most trusted
of South Dakota trust doctors
sources, current behaviors, impact on
and public health officials more
basic needs and mental health, and their
than other sources. Both rank higher
access to healthcare,” says Wesner.
than elected officials or the news media
Seventy-two percent of respondents
in a new statewide public health survey
report that they were self-isolating most
led by faculty in the joint USD-SDSU
of the time and 90 percent were supportive
Master of Public Health program and
of school and business closures. Nine-
USD’s Sanford School of Medicine and
ty-three percent said their most trusted
Department of Psychology.
source of COVID-19 information is public
The group launched the Community Impact Survey on March 24th, relying
health officials. Medical doctors came in second at 68 percent.
primarily on social media to help spread
“I’m hoping that this information is
the word. Within a week, more than 4,000
empowering for doctors and shows them
South Dakotans had responded. By mid-
what an important role they play in public
April, that number had climbed to 6,000
health,” says Wesner. “People value their
with all but a single county represented.
opinion much more than they value elected
“We are hoping that this will help us
officials and the news media. This really
learn how individuals and families are
demonstrates that they can play a much
affected by and reacting to the coronavirus
larger role than they already do in their
pandemic,” says Chelsea Wesner, MPH,
communities in shaping health policy and
MSW, of USD’s School of Health Sciences.
larger public health responses.”
“Our primary goal is to inform public health
The findings are being shared with
responses as this pandemic evolves and
the Great Plains Tribal Epidemiology
when a vaccine becomes available.”
Center and the South Dakota State Health
Wesner says previous health crises
Department with a view toward developing
suggest that the pandemic has the poten-
effective communications both now and
tial to be devastating to rural and tribal
in the future.
communities, where baseline health may
“These findings are informing the
not be as high. They are using the survey
public health response now, but I think
responses to help craft effective messages
we can use the same findings when a vac-
especially for people in underserved
cine is available,” says Wesner. “We need
to be asking what else can we do? How
“If we look back at past outbreaks, the
can we plan ahead for when we have a
number of fatalities is higher in tribal com-
vaccine? Who are people going to trust
munities,” says Wesner. These communities
to share that information and how do we
are also less likely to have easy access to
healthcare when residents do get sick. “In order to develop effective messaging going forward, it is critical that we
I’M HOPING THAT THIS INFORMATION IS EMPOWERING FOR DOCTORS AND SHOWS THEM WHAT AN IMPORTANT ROLE THEY PLAY IN PUBLIC HEALTH
One answer seems to be to involve both public health officials and physicians in the effort. ❖
How to Deal with Potentially Dangerous Patients BY MICHAEL VICTOROFF, MD
policies for managing patients who
to help.”). Unfortunately, there is no
ers regularly deal with
create risks to themselves or those
fixed rule for when to apply one tactic
patients under stress
around them. Some form of this
or the other.
and are exposed to the
advice logically extends to all health-
The practitioners who are most
risk or threat of violence in the
care providers. It must be remembered
talented in this art tend to be those
workplace at higher rates than
that violent patients may themselves
with experience. One important point
most other professions. Unfortu-
be vulnerable to injury or adverse
about verbal confrontation is that
nately, the nature of the profession
health outcomes, and need interven-
high stress levels can generate a state
makes it necessary for providers
tions by behavioral health, social
of “auditory exclusion,” in which any
sometimes to care for, manage, or
services, law enforcement, or the
party might actually not be able to
defend themselves from a person
courts. The organization’s legal advi-
hear questions, instructions, or
who is acting out violently.
sor should be readily available for
Emergency medicine providers,
crisis management for situations such
in particular, often face the challenge
as applying for a restraining order or
of conducting an assessment on a
handling refusal of treatment by an
resistant patient. EMTALA rules that
require a clinical evaluation do not
RISK FACTORS FOR VIOLENCE IN PATIENTS
ableness and reality apply in the ED
CONSIDERATIONS FOR ADDRESSING TENSE SITUATIONS
and everywhere else. No clinician is
A delicate judgment needs to be made
required to put their safety at risk to
sometimes between confronting a
comply with the law. The question is
belligerent person with threats (e.g.,
whether all available means have
“You’re making me very uncomfort-
• Delirium and delusional states
been used to protect staff—and other
able. If you continue to act like this,
patients—as well as the violent
I’m going to call security.”) versus
• Suicidal intent
attempting to bond with them by
make exceptions for difficult cases. However, the standards of reason-
Emergency and some urgent care
being accommodating (e.g., “I defi-
facilities that are subject to EMTALA
nitely get why that’s bothering you.
are obliged to develop resources and
Let me see if I can do something
The strongest risk factor for violence is a history of violence. Other risk factors include: • Intoxication
• Fear, anger, and revenge • Explosive or antisocial personality traits •C ommunication barriers, like language, sensory or intellectual impediments
Do you know the signals of an impending assault? Read them and access OSHA’s guidelines on violence and healthcare workers on our website.
Besides offering training, facilities and practices need to assure adequate staffing for safety. They can support their staff with policies that encourage personnel to take unobtrusive, protective steps at an early stage of discomfort. Some of these include involving chaperones or asking a colleague to join a tense discussion, maintaining interpersonal space, not leaning/reaching across the patient’s body, or not allowing a patient to block the way out of a room. In some cases, it might be better to avoid giving a patient the sense of being physically or emotionally “cornered.” Physical and technological measures are available that can be useful. Some of these are flags in the patient chart about a past history of violence or delirium, a coded flag on the patient’s door or stretcher, colorcoded patient gowns or wristbands, “panic buttons” in patient care areas or even wireless alarms carried as ID badges. Appropriate physical barriers (such as reception desks) and clear pathways within the facility are common sense measures. Visible video cameras may have a deterrent effect (and recordings can help defend
Committed to Making Your Workplace Safer
providers, when their actions are proper.) Finally, it should be remembered that people who have been subjected to violence may carry a bit of latent PTSD. The very training and policy discussions intended to improve safety can be experienced as stressful by some trainees. Some people don’t have the temperament to intervene in a violent encounter, and it is not reasonable to build this duty into everyone’s job requirement. ❖
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Michael Victoroff, MD, COPIC Patient Safety and Risk Management
The Value of Mindfulness for Healthcare Professionals Stress, Self-Esteem, and Job Satisfaction can all be improved by learning to be present BY CAROLE SOUTH-WINTER
HANGES to health delivery
Research supports that mindful-
Fourth, the act of meditation itself
and administration in recent
ness-based interventions such as
is associated with increased parasym-
decades have intensified
sitting meditation, breathing exer-
pathetic tone and related decreases in
levels of stress, burnout, and
cises, guided imagery, relaxation
heart rate, blood pressure, blood cor-
morale among healthcare profession-
methods, yoga, and desensitiza-
tisol, breathing rate, skin conductance,
als. The demands these professionals
tion-relaxation can have significant
and muscle tension. Finally, a number
face include heavy caseloads, limited
positive impacts on job satisfaction,
of mindfulness training studies in
control over the work environment,
relationships with patients, co-work-
patient populations report enhanced
long hours, and even concern over
ers and administration; as well as
immune function as measured by
adequate PPE and moral issues.
increased focus and creativity.
cytokine expression, leukocyte quan-
This is directly linked to increased
First, mindfulness training can
stress and symptoms of burnout.
promote long-standing increases
Miller and McGowen (2000) point to
in positive affect and reductions in
clinical training “culture” to explain
anxiety, emotional reactivity, and
that the goal-oriented approach leads
stress. Second, it is reported to
to neglecting alternative sources of
increase empathy and compassion,
gratification or self-esteem; thus,
and to promote a sense of connected-
after training, physicians may
ness with others. Third, it is viewed
not have a way to find meaningful
as a predictor of health-determining
balance between work and other life
lifestyle choices, including diet, exer-
cise, and substance use.
tities, and antibody titers in response to vaccination. ❖
Carole South-Winter, ND, EdD, is Associate Professor and Health Services Administration Program Director in the Beacom School of Business at USD.
Go online to learn more about “Sass and Science”, a new mindfulness training opportunity for healthcare professionals.
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What’s happening in the world – it makes caring for our community more important than ever. And that’s why we’re here. Because health care lives in all the places you are. The unfamiliar places. The challenging places. The hopeful places.
We’re standing wit h you.
If the COVID-19 crisis has given us anything, it is a timely reminder that our medical community is filled with extraordinary providers. In...
Published on May 18, 2020
If the COVID-19 crisis has given us anything, it is a timely reminder that our medical community is filled with extraordinary providers. In...