I am incredibly proud of everything we’ve accomplished in 2024. This year has been a testament to the dedication, skill and compassion that define our nursing team.
To each of our nurses – thank you. Your hard work, resilience and commitment to excellence drive everything we achieve, from patient care to quality improvements and beyond.
One of our most exciting milestones was reaching a pivotal point in our Magnet® journey. After 20 years of dedication, we were among just 10% of applicants invited directly to a site visit after submitting our application. This achievement was the result of a remarkable team effort, including the submission of 368 documents totaling more than 4,100 pages that demonstrated how we meet Magnet® standards. We are now closer than ever to achieving this prestigious recognition!
Our commitment to clinical quality remains strong. We’ve consistently increased colorectal cancer screening rates, reflecting our ongoing efforts of reaching eligible patients and improving patient outcomes. Targeted infection prevention initiatives have significantly reduced nurse-sensitive indicators (NSIs), and safety milestones across our units highlight the extraordinary impact of teamwork and patient-centered care.
New initiatives, such as Ambulatory-Based Council and the refreshed Wellness Collaborative, are further enhancing how we address challenges, support well-being and build our shared governance structure. Additionally, our onboarding process for internationally educated nurses (IENs) has been a resounding success, achieving an exceptional retention rate and earning national recognition as a best practice.
We’ve also made big strides in partnerships, like our collaboration with the University of Jamestown and Minnesota State Community and Technical College, to support nursing cohorts and launch a new simulation center. These initiatives are shaping the future of nursing and ensuring we have the skilled professionals needed to lead in care.
Beyond our walls, our nurses continue to make a powerful impact in the community, from the Boo to the Flu vaccination event and food pantry initiatives to expanding care access in rural areas. These efforts remind us of the difference we can make – not just for patients at the bedside but for entire communities.
The Sanford Improvement Symposium was another proud moment, showcasing the innovative work happening across our teams. With 73 posters and more than 200 attendees, it was a great opportunity to celebrate and share ideas that are driving care forward.
Looking ahead, we are inspired by this year’s accomplishments and motivated by the lives we touch every day. Together, we are transforming nursing practice and setting the standard for excellence!
To be the premier rural health system in the United States.
VALUES
Service
Doing our best every day to uphold and care for others.
Courage
Having the strength to persevere, problem solve and take action.
Humility
Respecting others and knowing there is more to learn.
Stewardship
Safeguarding the resources that have been entrusted to us.
Family
Honoring the commitment we have to each other through it all.
About Sanford Health
Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland. Headquartered in Sioux Falls, South Dakota, the organization has 53,000 employees and serves over 2 million patients and nearly 425,000 health plan members across the upper Midwest including South Dakota, North Dakota, Minnesota, Wyoming, Iowa, Wisconsin and the Upper Peninsula of Michigan. The integrated nonprofit health system includes a network of 56 hospitals, 288 clinic locations, 147 senior care communities, 4,000 physicians and advanced practice providers and nearly 1,500 active clinical trials and studies. The organization’s transformational virtual care initiative brings patients closer to care with access to 78 specialties.
The integrated nonprofit health system includes:
• 56 medical centers
• 288 clinic locations
• 147 senior care locations
• 425,000 Sanford Health Plan members
• 53,000 employees
• 4,000 physicians and advanced practice providers and 10,000 registered nurses delivering care in more than 78 specialty areas
• Centers of Excellence:
– Cancer
– Children’s
– Heart
– Orthopedics and Sports Medicine
– Women’s Health
Each year, Sanford Health provides:
• 9.7 million outpatient and clinic visits
• 112,512 admissions
• 228,405 surgeries and procedures
• 13,094 births
• 362,428 emergency department visits
Sanford Medical Center Fargo in 2024
• 28,757 admissions
• 141,441 patient days
• 4.95-day average length of stay
• 558,358 outpatient visits
• 6,919 inpatient surgeries
• 20,368 outpatient surgeries
• 65,208 emergency department visits
• 14,363 GI procedures
• 10,035 catheter lab encounters
• 2,851 births
Fargo Health Network in 2024
• 1,796 admissions
• 10,376 patient days
• 156,701 outpatient visits
• 108 inpatient surgeries
• 1,693 outpatient surgeries
• 11,977 emergency department visits
• 1,415 scopes
• 203 births
• 99 clinic locations
Strategic Planning
The overarching aspirational goal for the Fargo market is to provide personalized, worldclass primary, tertiary and advancing quaternary services to the communities and patients we serve. The Sanford Health Fargo Nursing Strategic Plan outlines Sanford Medical Center Fargo’s five-year plan to meet these goals.
Goal: Be the health care employer of choice for nursing in the Fargo market.
Objectives:
• Advance equity and experience initiatives.
• Achieve Magnet® designation.
• Engage and value the workforce through leadership development, retention initiatives, tactics and meaningful recognition.
• Grow the talent pipeline.
• Expand and develop the IEN program.
Goal: Implement alternative ways of care delivery to practice at the top of the nursing scope and promote professional nursing practice.
Objectives:
• Implement and expand virtual nursing and virtual observer initiatives.
• Explore alternative options for care delivery.
• Expand the transition to practice programs such as nurse residency and the IEN fellowship.
• Provide continuing education and professional development opportunities for nurses.
Goal: Grow and enhance nursing research, evidence-based practice and shared governance.
Objectives:
• Develop a plan and structure to optimally enhance nursing research through partnership with our enterprise teams.
• Complete our ongoing research studies and start dissemination.
• Strengthen the shared governance structure by enhancing leadership support and increasing clinical nurse engagement in shared decision-making.
• Expand and strengthen evidence-based practice throughout the organization.
Goal: Advance a culture of accountability to become the industry leader in quality, safety, high reliability and patient experience.
Objectives:
• Advance equity and experience initiatives.
• Achieve Magnet® designation.
• Engage and value the workforce through leadership development, retention initiatives, tactics and meaningful recognition.
• Grow the talent pipeline.
• Expand and develop the IEN program.
Goal: Retain nursing workforce through nursing well-being and workplace violence prevention.
Objectives:
• Implement employee retention and well-being committees.
• Continuing success of the workplace violence prevention program.
• Improve communication on workplace violence prevention strategies.
TRANSFORMATIONAL LEADERSHIP
Journey to Magnet ® Designation
Magnet® designation represents the gold standard for nursing excellence and reflects the outstanding work of our nurses, care teams and support staff. In 2004, the Sanford Medical Center in Fargo began creating the structure needed to become Magnet® designated, which included establishing a standard nurse residency program. Over the years, we have implemented a shared governance structure with the Nursing Senate and have steadily incorporated the required components for Magnet® designation.
In the summer of 2023, Theresa Larson, chief nursing officer, approached the Nursing Senate to seek support pursuing Magnet® designation. The senators supported the decision to recognize the efforts of the nursing staff. In August 2024, the Sanford Medical Center in Fargo submitted its application for Magnet® designation.
Over the next year, team members evaluated data, wrote stories and gathered information to prepare our submission to the Magnet® Program. On August 19, 2024, we submitted:
• 368 documents totaling more than 4,100 pages
• Highlights from 114 departments demonstrating excellence
• Evidence for meeting 102 Magnet® standards
This was a significant milestone for the Sanford Medical Center team in Fargo, as we had never made it this far in our journey before! In November 2024, we were notified that Sanford Medical Center Fargo would move directly to a site visit with a four-appraiser team – an achievement accomplished by fewer than 10% of organizations on their first attempt at Magnet® designation. The site visit will take place February 3 to 6, 2025. We’re proud to welcome our appraiser team and showcase the incredible work our nursing teams do every day.
ANCC National Magnet® & Pathway to Excellence 2024: Educate, Innovate, Celebrate!
The 2024 American Nurses Credentialing Center (ANCC) Magnet® Conference was held in New Orleans, Louisiana, from Oct. 27 to Nov. 1. Representatives from the Nursing Senate, the Ambulatory-Based Council, Leadership team, Education and Development (LEAD) team and the quality team attended the event, joining more than 13,000 nurses from around the world.
Some takeaways included:
• Best practices for ambulatory spaces
• Evidence-based practice strategies
• The role of AI in health care
• Nursing-Sensitive Indicators (NSIs)
• Leadership development
The team heard from keynote speaker Damon West, a best-selling author and criminal justice professor. In 2009, West was sentenced to 65 years in a Texas prison, and during his sentence, he received advice that changed his life. An inmate told him that prison is like a pot of boiling water – you can be a carrot, an egg or a coffee bean. The carrot softens under pressure. The egg hardens. But, the coffee bean transforms its environment. The message: Be the change you want to see and don’t let your circumstances define you.
In addition to learning sessions, the team explored exhibit halls, networked with other nurses at the conference and discovered new health care technology, including snapping a photo with the PureWick® booth!
Leadership Development Day
The annual Leadership Development Day took place on May 30, 2024, at the Armory Event Center in Moorhead, Minnesota. This event brought together managers and directors from the Fargo region to foster connections and strengthen leadership skills.
Guest speaker Mark Willmarth emphasized the importance of leaders engaging with their teams and truly listening. He shared that people forget 75% of what they hear within two months – and of the remaining 25%, only about 60% is remembered accurately.
Willmarth also introduced the concept of personality colors – Red, Blue, Green and Yellow – and led an interactive activity to help leaders better understand and collaborate with colleagues who have different communication and working styles.
He also explored the differences between complex and complicated issues: complicated problems are technical and can often be solved with expertise, while complex problems require adaptive thinking and innovative responses. Leaders walked away with practical tools and strategies to enhance their problem-solving skills and tackle challenges with confidence.
22nd Annual Nursing Symposium: Where Innovation Meets Compassion
The 22nd Annual Sanford Nursing Symposium was held on May 2, 2024, kicking off Nurses Week. Planned by the Fargo LEAD team, the symposium welcomed 610 attendees both in person and virtually – a 14% increase from the previous year. Centered on the theme Where Innovation Meets Compassion, the symposium invited participants to explore the intersection of clinical excellence and empathetic care.
Event highlights included:
• 24 speakers and panelists delivered engaging presentations and discussions.
• 38 poster presentations showcased innovative nursing practice in the Gallery of Nursing Excellence.
• A silent auction benefiting the Sanford Health Foundation raised funds through friendly competition.
• On-demand educational sessions were made available afterward, resulting in 462.25 ANCC contact hours awarded to staff.
The symposium explored the latest innovations in nursing while cultivating a strong sense of community and shared purpose among attendees. The event underscored the Fargo LEAD team’s dedication and the collective commitment of all participants to advancing the field of nursing.
We look forward to continuing this journey of innovation and compassion at the 23rd Annual Sanford Nursing Symposium on May 1, 2025.
Photos from the annual nursing symposium.
Internationally Educated Nurses
In 2024, the Internationally Educated Nurses (IEN) program continued to enhance Sanford Health’s efforts to build a more inclusive culture, improve nurse retention and enrich workforce diversity. As a key recruitment strategy, the program brought skilled nurses from a variety of global backgrounds, strengthening patient care and team collaboration through their unique perspectives and experiences.
The Sanford Health Fargo region welcomed 60 IENs throughout the year, with just one resignation – resulting in a retention rate of 98.3%. This impressive outcome reflected the program’s strong support structure, which included comprehensive orientation, dedicated mentorship and professional development opportunities.
To foster a sense of connection and belonging, IENs gathered for a shared meal and scavenger hunt. In addition, the launch of the International Employee Resource Group (ERG) offered a formal platform for international staff to connect, share experiences and advocate for their needs, further strengthening community and inclusion.
Many IENs stepped into leadership roles this year – serving as preceptors, earning certifications and becoming clinical care leaders. Their contributions not only supported organizational goals but also advanced their own professional growth.
The IEN program continued to be an asset in addressing workforce challenges, while promoting cultural and professional diversity across Sanford Health in Fargo.
Melissa Mohr, clinical learning and development specialist, developed an innovative onboarding process for IENs that was recognized by The Joint Commission as a best practice. This initiative addressed key challenges, including technical difficulties and the need to enhance both physical assessment skills and confidence among IENs.
As part of the onboarding process, concise reference guides were created to aid in task completion and documentation, and hands-on practice sessions were conducted to improve physical, neurological and stroke assessment skills. Recognizing the importance of psycho-social support, the program also integrated resources to address emotional and psychological needs, ensuring a holistic approach for transitioning into their new roles at Sanford Health.
This comprehensive strategy facilitated the successful integration of IENs into the workforce, fostering their professional growth, confidence and readiness to deliver high-quality care.
IEN Fellowship
On October 15, Kimberly Anderson, MS, RN, CEN, CPEN, TCRN; Marissa Manske, MSN, RN, MEDSURG-BC; Kristen Jones, MPH, BSN, RN; Eman Mohammad, BSN, RN; Shelby Maly, JD; and Megan Sneddon were invited to speak at the ND Hospital Association Conference. They presented the innovative work Sanford Health has done to recruit and retain IENs within our organization.
The presentation, titled Empowering Internationally Educated Nurses (IENs) to be Successful in North Dakota: A Highlight of Sanford’s Journey, focused on:
• Exploring strategies to leverage the role of the IEN
• Understanding the complexities involved in recruiting and immigrating IENs
• Navigating the challenges of integrating nurses from diverse health care systems and cultures into North Dakota
• Providing an overview of Sanford Health’s IEN program designed to recruit, retain and support this vital workforce
Launched in 2022 with the arrival of Sanford Medical Center Fargo’s first international nurses, the IEN Fellowship is a dynamic transition-to-practice initiative helping internationally educated nurses adapt to the U.S. health care system. Since then, Sanford Health in Fargo has welcomed hundreds of nurses from around the world, and the program continues to evolve to meet their unique needs.
The fellowship provides a supportive and safe environment where nurses can openly discuss the cultural adjustments they encounter, easing their transition. Participants find comfort and camaraderie in the social aspects of the program, eagerly anticipating monthly meetings where they can connect and share experiences.
Looking ahead to 2025, Sanford Health aims to further grow the program – continuing to inspire and empower IENs to thrive both personally and professionally as they integrate into their new roles.
Fargo Region Equity and Experience Council
Sanford Health celebrated its first year with the Fargo Region Equity and Experience Council, marking significant progress in promoting inclusion, belonging and community engagement.
Community outreach was a key focus, with sponsorship of the Fargo Moorhead West Fargo Chamber of Commerce Breaking the Ice event and participation in the Black to the Future Juneteenth Celebration. During Ramadan and Eid al-Fitr, the council supported cultural observances with resources and shared meals.
Fargo Cultural Celebration Week brought together employees through games, potlucks, volunteer efforts at the Downtown Engagement Center and an essay contest. The council also partnered with organizations like the YWCA and New Life Center to provide basic medical care for those experiencing homelessness.
As a testament to this work, the region – led by the council – was nominated for a humanitarian award.
Department Spotlight: Anesthesia
In 2024, the certified registered nurse anesthetists (CRNAs) at Sanford Health in Fargo remained dedicated to the values of Family and Advancement, prioritizing team support, collaboration and advocacy for their role within the organization. With significant increases in surgical volumes, procedural requests and trauma activations, the CRNA team continued to grow and learn through annual skills fairs that introduced new techniques and facilitated the completion of essential annual check offs.
The team played an important role in mentoring more than 30 student nurse anesthetists across Sanford’s three Fargo hospitals. Recruitment efforts emphasized connection, commitment and the ongoing pursuit of professional growth and development within the department (pictured to the left)
To celebrate their achievements and foster team unity, the CRNA team held the Annual Advanced Practice Provider (APP) Awards, recognizing excellence in categories such as Enrichment, Citizenship and Trailblazer. This year, 17 APPs were nominated, and the winners were honored for their outstanding contributions to the profession.
Beyond professional growth, the CRNAs connected through various social and team-building activities, including attending Red Hawks games, participating in book club meetups, joining the Fargo Marathon and taking part in the Backwards Halloween event at the Sanford Children’s Hospital Fargo. United both inside and outside the hospital, the CRNA team truly embody a strong sense of family and mutual commitment.
To further their advocacy and departmental development, the CRNA team submitted a presentation to the Sanford Improvement Symposium titled Certified Registered Nurse
Anesthetists: Who Are We and What Do We Do?
The submission advocated for greater recognition and inclusion of CRNAs across Sanford Health’s regional and enterprise footprint.
STRUCTURAL EMPOWERMENT
Structural empowerment provides nurses with the ability to have a meaningful say in the way they practice as professionals through councils and input on policies and processes. This develops them professionally to achieve the highest degree of clinical excellence and professional fulfillment.
Shared Governance
Sanford Health continues to strive for excellence in our initiatives to promote collaboration and shared decision-making between nurses and leaders. Our shared governance groups give clinical nurses a voice to participate in the decisions and be “at the table” to influence workflows and nursing practice throughout the organization. Many groups promote growth and development for staff and contribute to activities that have a positive impact on our community. At the heart of our shared governance structure is our Nursing Senate and our Unit-Based and Ambulatory-Based Councils.
Nursing Senate
Throughout 2024, the Nursing Senate led a year of significant progress and growth, driving initiatives that elevated patient care, optimized workflows and empowered nursing practice through collaboration and innovation. Representing both inpatient and ambulatory areas, the senate convenes monthly to review proposals, provide feedback and oversee the work of sub-councils.
Key accomplishments:
• Clinical Improvements: Approved hospital-wide initiatives like Unit-Based Hospitalist (IDT rounding), standardized Bedside Handoff and implemented Fall Tailoring Interventions for Patient Safety (TIPS).
• Documentation and Practice Enhancements: Supported ENFit, medication safety tracers, mobility bundle updates, 12-hour patch assessments and dysphagia screening updates.
• Workflow Advancements: Approved insulin calculator checks and NG tube insertion algorithm standards.
• Communication and Safety Improvements: Incorporated advanced tools like the Language Line Success Center Module, PADIS verbiage updates and alert tone alignment with Rauland Nurse Call Systems.
• Ambulatory Representation: Launched the Ambulatory-Based Council (ABC), giving voice to outpatient clinic nurses and fostering unified practice across settings.
Ambulatory-Based Council
Established in July 2024, the ABC is co-chaired by Courtney Caspers, RN, and Benjamin Nelson, RN. The council brings together ambulatory staff from across the region.
Within its first three months, ABC contributed two agenda items to the Nursing Senate and began addressing longstanding workflow inconsistencies, such as pre-operative medication list standardization and device evaluation.
The council continues to invite broad participation and collaboration from ambulatory care teams.
Wellness Collaborative Council
Formed as a revitalization of the former Healthy Work Environment Council, the Wellness Collaborative Council continues to promote well-being through volunteer opportunities, social events and wellness campaigns.
In 2024, the council supported initiatives such as:
• Feed My Starving Children volunteer day
• A homeless shelter needs drive
• Clay Your Way creative event
• Breakroom toolkits and wellness space advocacy
The council’s quarterly prize drawing helped engage participants and reinforce the importance of staff wellness.
Nursing Professional Development Council
In 2024, the Nursing Professional Development (NPD) Council celebrated professional development by:
• Honoring hundreds of preceptors with handwritten, personalized thank-you cards during Nurses Week and NPD Week.
• Acknowledging certified nurses throughout the year with e-cards that celebrate their hard work and valuable expertise.
• Fostering peer collaboration through monthly Educator Spotlights that highlight the strength, experience and innovative problem-solving of individual team members.
• Expanding access to education by launching several new online resources for staff, including the Preceptor Portal, the Nursing Certification Resource Website and a continuing education section in the Success Center.
• Driving enrollment in mandatory education, achieving approximately 75% participation in two key training rollouts.
One of the year’s most exciting initiatives was the enterprise expansion of the Preceptor Badge Buddy, a tool providing resources and recognition for preceptors. With 5,000 badge buddies set to launch in 2025, the impact of this grassroots effort will be felt system wide.
Department Spotlight: Family Birth Center Unit-Based Council
The Family Birth Center Unit-Based Council brought staff together through monthly team-building activities, including Bark in the Park Day, a Zorbaz lunch event and the Hey Boo Fall Craft event. These events helped nurture relationships and promoted a positive work environment.
Night Shift Council
Thanks to this council’s persistence, all campuses now provide 24/7 soda fountain access for night shift staff as of January 2024. The Night Shift Council also worked to expand micro market food offerings, giving staff a wider variety of overnight food options.
In addition, the council created resources to support mental health and wellness – including a flyer about managing their mental health and learning healthy coping strategies.
Nursing Patient Injury Prevention Committee
In its second year, the Nursing Patient Injury Prevention (NPIP) Committee prioritized fall reduction with the rollout of Fall TIPS across adult inpatient units.
The committee reviewed hospital quality data related to:
This year’s primary focus was developing and implementing a comprehensive fall reduction plan. As part of this effort, the Fall TIPS program launched across all adult inpatient areas. During the rollout, NPIP committee members provided education and support to their respective units to ensure proper implementation. The committee also enhanced fall defect tools in each area to integrate TIPS into post-fall debriefs.
Looking ahead to 2025, the NPIP committee will continue to collaborate and share insights regarding other NSIs, with an emphasis on identifying barriers and addressing challenges. Recently, efforts have shifted toward investigating and addressing trends related to HAPIs.
The team is analyzing data to better target areas for improvement within each space. Fall reduction efforts will continue in collaboration with the Fall Rapid Cycle Improvement Group to support ongoing progress and sustained impact.
Evidence-Based Practice/Nurse Research Council
Over the past year, the AskClinicalQuestions-FGO@sanfordhealth.org initiative helped address real-world challenges faced by nursing staff. We responded to over 11 clinical questions related to various aspects of nursing care across different clinical spaces.
They also supported 18 interdisciplinary graduate students in quality improvement and evidence-based practice (EBP) projects that drove improvements across the Fargo region.
This council is currently supporting the Neck Assessment EBP project, with project implementation expected to begin in late January 2025.
Sanford Fargo conducted two research studies this past year:
• COVID-19 and the Current State of Nurse Wellness in Rural America
• The Experience of Internationally Educated Nurses (IENs) Transition to Nursing Practice at a Rural Healthcare System
Findings from these studies have been published and presented at multiple conferences, most recently in the Journal of Nursing Administration (JONA).
The EBP council is also excited to announce the official launch of the RN EBP Mentorship Program on January 16, 2025. This program will equip nurses with the skills and support needed to lead EBP initiatives.
EXEMPLARY PROFESSIONAL PRACTICE
Professional Practice Model
Exemplary professional practice is nursing practice that represents the best of the best. The Professional Practice Model (PPM), developed by nurses at Sanford Health, guides nurses to achieve this level of nursing practice.
Nursing-Sensitive Indicators
The increase in NSI celebrations from 2021 to 2024 is truly impressive! Let’s take a moment to highlight this remarkable growth:
• 2021: 13 NSI celebrations marked a solid start. The initiative began to make waves, drawing attention to the importance of nursing-sensitive outcomes in patient care.
• 2022: There were 11 celebrations. While slightly fewer, this still reflected a strong commitment to highlighting these critical indicators and their role in improving health care quality.
• 2023: Celebrations surged to 16, signaling a return to growth and an even stronger focus on NSIs. This increase demonstrated a rising recognition in driving patient care improvements.
• 2024: This was our best year yet – with 30 NSI celebrations! That’s more than double last year’s total and nearly triple the number from three years ago.
This upward trend is a clear testament to our shared dedication to recognizing the value NSIs bring to improving outcomes and the quality of care we provide.
2024 NSI Celebrations
10ABCD FBC
2E ICU
100 Days Without a Fall
200 Days Without a Fall 1 Year CAUTI-Free 2 Years CAUTI-Free 1 Year CLABSI-Free 2 Years CLABSI-Free 1 Year HAPI-Free
2 Years HAPI-Free
9B PICU 4W EDU 4C Ortho EDU
2N Hospice CDU
5A Critical Care Neuro 5B Critical Care Trauma 5C Critical Care Cardiac
2N Hospice 5B Critical Care Trauma
7S Oncology 8AB Innovations 5C Rehab 6CD Cardiac
7CD Medical 8CD Med/Surg 5SE Med/Surg
9CD NICU 5D IMC
7CD Medical CDU 9A Peds
9B PICU 9CD NICU 5C Rehab 9A Peds
4C Ortho 5C Rehab
Sanford Improvement Symposium
In October 2024, the Fargo region had the opportunity to recognize and celebrate the wonderful improvement work that our teams have done at the Sanford Improvement Symposium. This year’s event took place at the Avalon Events Center in Fargo.
The intent of the symposium was to provide team members with a platform to network with colleagues and present the innovative work they are leading in their areas. This event also featured keynote speakers and panel discussions focused on high-quality care and the importance of collaboration across interdisciplinary teams.
We had an excellent turnout with 232 attendees and 73 poster presentations. Many of the posters were presented by our Performance Improvement Council – a nurse-led council committed to driving improvements and innovation in patient safety and quality care.
Improvement Symposium Award
CLINICAL CARE
Recipients:
1st Place: Low Tech, No Tech, No Problem!
Jackie Hinrichs, BSN, RN
2nd Place: PICU PANDEMonium
Kacie Dorn, MSN, RN, and Kassy Vettleson, PharmD, BCPS
SAFETY
1st Place: Mitigate to Accelerate – Imagine’-ining a Path to Zero Retained Foreign Objects
2nd Place: Tiny Vessels: Optimizing Pediatric Peripheral Intravenous Site Insertion, Securement, & Management to Reduce Infiltration & Extravasation Rates in Sanford Children’s Hospital
Allison Aberle, BSN, RN, CPN
SANFORD EXPERIENCE
1st Place: Leaving No Patient Behind
Jayden Desai, BAN, RN
2nd Place: Sanford Specialty Pharmacy: Optimizing the Specialty Medication Experience
Erianne Gibson, PharmD, and Beau Sizer, PharmD, CSP
COST
1st Place: Suture Situation Minimization: The Right Thing in the Right Place at the Right Time
Susan Pfeifer, CHL, CRCST, and Rachel Maasjo
EVIDENCE-BASED PRACTICE
1st Place: Port Flushes in Oncology – Does Frequency Matter?
Shabbir Haiderbhai, MD, and Grace Lavandowska
COMMUNICTION
1st Place: Unit-Based Hospitalist Project – Interact and Impact
Dev Mannuru, MD, CPHQ-PHYS-ADV, CPXP, and Clint Rossland, BSIE
QUALITY OF LIFE
1st Place: Continuing the Fight Against Hunger: Year 3 of the Wellness Pantry
Shelly Arneson, ASN, RN
Advanced Nursing Certifications
Patient care is becoming increasingly complex, requiring highly skilled nurses in both acute care and ambulatory settings. Nurses demonstrate their expertise through advanced board certification and recertification, which involves ongoing learning and clinical practice. By voluntarily pursuing specialty certification, nurses show their commitment to professional growth and their dedication to delivering high-quality care.
Sanford Health supports nursing specialty certification by offering free review courses and select study materials. Nurses also have access to a Continuing Education (CE) Direct license, which provides online certification review courses and CE to help maintain certification. Those who pass their certification exam are eligible for exam fee reimbursement through the Education Assistance Process.
Sanford Medical Center Fargo has set a goal for 50% of eligible nurses to achieve advanced certification. Currently, 42.49% of eligible RNs have achieved or are maintaining certification.
Nursing certification affirms a nurse’s knowledge in their specialty of practice and empowers them to continue honing their skills. In the Sanford Health Fargo region, more than 400 nurses are certified in approximately 84 different specialties from 50 different certifying bodies.
This year, National Certified Nurses Day was celebrated with an event recognizing all our certified nurses through speakers, prizes and recognition. The event was held in March at KingPinz in Fargo with more than 200 certified nurses in attendance.
Transition to Practice: Nurse Residency
Sanford’s Nurse Residency Program (NRP) is a 12-month, evidence-based program accredited with distinction by the ANCC Practice Transition Accreditation Program (PTAP). Standardized across Sanford Health in 2019, the program supports newly graduated RNs, RNs with less than one year of hospital experience and transitioning licensed practical nurses (LPNs) in inpatient settings as they adapt to their roles in clinical practice.
As one of only 200 PTAP-accredited programs globally – and the first in North Dakota, Sanford’s NRP helps new nurses navigate the challenges of transitioning from students to competent nurses. Participants are automatically enrolled upon meeting eligibility criteria after hire, without requiring a separate application process.
In 2024, 163 nurses completed the program, achieving an overall retention rate of 90%, compared to 86% in 2023.
• Cohort 15 (started May 2024): 49/51 – 96% retention
• Cohort 16 (started September 2024): 79/81 – 98% retention
Several key changes over the past year have likely contributed to the increased retention rates, though multiple factors undoubtedly played a role.
First, the RN curriculum was updated to better align with the needs of our learners. This enhancement was informed by analyzing pre- and post-program surveys, as well as recommendations from leaders.
Notable improvements included integrating topics like communication and delegation into all seminars as core objectives, rather than addressing them as standalone subjects. Additionally, leadership development courses were introduced to prepare nurses for advanced roles, such as preceptor and charge nurse positions, within their first year of practice.
Finally, we incorporated education on social determinants of health to help nurses reflect on and address personal biases. This resulted in more equitable and compassionate care for diverse patient populations.
These strategic updates reflect Sanford Health’s commitment to supporting professional growth and cultivating a culture of inclusivity and leadership development.
PTAP Accreditation
In 2025, the NRP will reapply for PTAP accreditation. The team is currently preparing the self-study submission, which involves documenting practices and achievements across the system. The Fargo region has been assigned eight exemplar stories to showcase its commitment to excellence in nursing practice.
Department Spotlight: 7S Inpatient Oncology Unit
The 7S Inpatient Oncology Unit increased their nursing certification percentage to 32% overall! The team also had two of their nurses, Amy Hall, BSN, RN, OCN, BMTCN; and Nerline VanDyke, BSN, RN, OCN, BMTCN, become the first bone marrow transplant certified nurses in the organization.
College & University Partnerships
Sanford Student Nurse Intern Program (SSNIP)
Sanford Health in Fargo hosted 101 summer interns, each spending their 10-week internship split between two different departments to foster a diverse and well-rounded learning experience. This unique structure allowed interns to gain insight into various aspects of health care.
For the first time, we included ambulatory locations in their placements to further broaden their learning opportunities. Of the 101 summer interns, 59 extended their internships into the fall, balancing this valuable experience with their return to school.
This opportunity allowed them to continue building confidence and gaining knowledge in the nursing role. Extending internships into the school year also served as an effective recruiting model, potentially leading to a transition from intern to a new-hire RN.
Culture of Caring
Sanford Health in Fargo expanded the Culture of Caring (CoC) program from three units in 2023 to 10 units in 2024, broadening its impact. As part of the updated CoC curriculum, Joy Trees were introduced in each participating unit, providing a space for students and staff to share messages of gratitude and appreciation.
Looking ahead, the program is set to grow even further. Plans are underway to expand to additional units and partner with colleges in the summer of 2025, continuing to foster a culture of support and appreciation.
University of Jamestown
Sanford Health has also strengthened its academic partnership with the University of Jamestown by launching two new accelerated nursing programs:
• Associate of Science in Nursing: This prelicensure program is designed for anyone without prior nursing experience. The first cohort started in August 2024.
• Direct Entry Master of Science in Nursing: This program is tailored for career changers who hold a bachelor’s degree in a non-nursing field. The first cohort begins in January 2025.
For more information, please visit Inside Sanford: https://internal.sanfordhealth.org/news/Pages/Sanford-and-University-of-JamestownNursing-Education-Partnership.aspx.
COMMITMENT TO PATIENTS & COMMUNITY
AirMed Fargo Gives Back to the Community
Every day, AirMed crews serve the tri-state region by delivering lifesaving care to patients in critical situations. In 2024, they extended that care beyond the skies by committing to acts of community service through their unit-based council.
In October, a group of AirMed employees spent the afternoon completing fall yardwork for a fellow Sanford Health employee facing health challenges. Then in November, the team continued a heartfelt tradition by preparing and serving a meal at the Ronald McDonald house – their second year supporting families in need through this effort.
Department Spotlight: Sanford Children’s
Ringing the bell after chemotherapy marks a significant milestone – the completion of a child’s cancer treatment and the beginning of recovery. For patients and families, this moment represents relief, accomplishment and hope for the future – giving them the opportunity to celebrate and acknowledge a positive turning point after enduring a difficult treatment journey.
For young patients, ringing the bell can be a deeply emotional experience. It showcases their resilience and strength, signifying not just the close of a challenging chapter but the start of a new one.
Currently, many chemotherapy regimens require hospital admission. As a result, more and more pediatric patients complete their chemotherapy as inpatients without the opportunity to ring the bell, as they would in the outpatient setting.
The importance of this milestone came to light in a story about Sam Milanovich, MD, a pediatric oncologist, who carried the bell from RMCC to the Children’s Hospital so one of his patients could ring it to mark the end of their chemotherapy.
The moving gesture sparked the creation of a permanent Sanford Children’s Hospital mural and bell wall funded in partnership with the RMCC Pediatric Oncology Foundation.
Completed in mid-October, the wall offers patients and families a place to celebrate strength, perseverance and healing. On October 24, the very first pediatric patient rang the bell.
Kamp KACE
Every summer, Kamp KACE (Kids Against Cancer Everywhere) is a place where magic happens – a place of healing, laughter and connection for children with cancer, childhood cancer survivors and their siblings. Since its founding in 1986, Kamp KACE has offered a week-long camp experience where kids who might feel different because of their medical journeys don’t feel set apart, they feel understood.
The kids get to be kids, surrounded by peers who share similar journeys and by a caring community of volunteers, nurses and medical staff. With Sanford Health’s support, kampers with complex medical needs can safely attend. Nurses and providers are present in every corner of the experience, whether in the health cabin administering medications, providing first aid or working one-on-one with high-risk kampers who require extra support such as mobility assistance, oxygen, IV care or behavioral guidance.
Day staff, including nurses, PCTs and other community volunteers, provide assistance with daily activities and compassionate emotional support. Thanks to the Sanford Health Foundation and Sanford’s Volunteer Paid Time Off program, nurses can serve at the kamp without using their PTO.
Every year, children arrive who may feel isolated or different, but the kamp can instill a renewed sense of confidence, connection and joy in them. At Kamp KACE, wellness isn’t just about medicine, it’s about belonging, recovery and hope.
Nurses in the Community
Social Determinants of Health and Community Immunizations
Pediatric primary care continues to provide opportunities for preventive care efforts through creative ways. In May 2024, department chairs Bonnie Kvistad, MD, and Melissa Horner, MD, and the Children’s nursing team saw 45 students at Fargo South High School for sports physicals and immunizations.
In October 2024, a total of 720 patients were vaccinated at the Boo to the Flu blitz event where both the flu and COVID-19 vaccines were offered to the community.
Pediatric primary care continues to focus on social determinants of health, including collaboration with the Great Plains Food Bank to offer on-site food pantries and food box programs. As of November 30, 2024, the Sanford Southwest Children’s Clinic food pantry supported 299 families, and the Sanford Moorhead Campus food box program supported 171 families.
Expanding Access to Lactation Support in Rural Communities
A group of registered nurses from Sanford Oakes Clinic advocated and achieved certification as lactation consultants, making a major step forward in maternal and infant care for southeastern North Dakota.
Previously, the nearest lactation consultant was located approximately 45 miles away, creating a barrier for many new mothers seeking support. Through the BUILD grant, a program of the Blue Cross Blue Shield of North Dakota (BCBSND) Caring Foundation, the team secured funding for training, certification and essential equipment necessary to make
These certified lactation consultants will now travel to Sanford Health’s rural clinics where lactation services did not previously exist, extending care to the communities of Oakes, Ellendale, Forman, Gwinner, LaMoure, Enderlin, Valley City and Lisbon.
This initiative reflects Sanford Health’s continued commitment to removing barriers to access and supporting families where they are – empowering rural nurses to deliver essential care close to home.
Team Hope: Sanford World Clinic
In 2024, Team HOPE returned to Guatemala with a new group of Sanford Health staff, once again partnering with the International Esperanza Project to provide high-quality care to the community of Santa Apolonia.
Over just four and a half days, the team served 1,091 patients and completed 124 surgeries, offering services in general medicine, pediatrics, dermatology, dentistry, endocrinology and optometry. Every surgery performed and every medication prescribed was free of charge to these patients.
Although there were a few barriers along the way – such as variation in how prescriptions were written – the group was able to provide education to the patients to ensure understanding.
At one point during the trip, the team experienced car trouble. A gentleman who stopped to help had a lazy eye. The team was able see him and perform surgery that same day!
The trip ended with many smiling faces and grateful hearts. The work of Team HOPE reflects the mission of the Sanford World Clinic: to bring high-quality care to underserved communities around the world.
With each journey, the team looks forward to continuing their commitment to improving global health – one patient and one community at a time.
AWARDS & RECOGNITON
Annual Nursing Awards Recognition
The 2024 Nursing Awards Recognition Event was a night to remember! Held at the Delta on May 7, the event saw a record-breaking number of nominations – more than 1,100 submissions, highlighting the incredible work of nurses and nursing supporters across the region!
Attendees enjoyed an evening filled with food, refreshments, interactive activities and the chance to win exciting door prizes. The celebration served as a heartfelt tribute to the dedication and impact of nurses throughout the region.
Evelyn Quigley Spirit of Nursing Award – The Legacy Award
This award recognizes a nurse who has contributed significantly to the art and science of nursing throughout their career. Through strength of character, commitment and competence, this recipient is an individual who “lights a flame” for nursing practice, leaving a legacy for others by elevating professional nursing within Sanford Health and the community.
This award is named in honor of Evelyn Quigley, MSN, RN, Chief Nursing Officer Emeritus.
Award Recipient:
The Exemplary Professional Practice Nurse Award
This award recognizes board-certified, registered nurses who demonstrate excellence in practice, collaboration, communication and professional development. These individuals are committed to providing the highest standard of care across Sanford Health.
Their work illustrates a seamless alignment between their daily nursing practice and the mission, vision, philosophy and values shared by Sanford Health and the nursing profession.
Award Recipients:
• Hannah Pavek, DNP, APRN, CNP
• Jill Eddy, BSN, RN, CCDS
• Suzanne Groth, BSN, RN, CPAN
Darla Dobberstein, MHSA, BSN, RN
Star of Nursing Award
This award recognizes both registered nurses and licensed practical nurses within their first two years of practice. It honors individuals who demonstrate passion for their newly chosen career and embody a spirit of lifelong learning. These individuals exemplify enthusiasm, consistently seek growth and build nursing competencies through participation in unit or organizational activities.
Award Recipients:
• Bella Mae Ann Bergantin, BSN, RN
• Miah Hoff, ADN, RN
• Luke Johnson, BSN, RN
• Jordyn Kack, BSN, RN
• Brita Newman, BSN, RN
• Maggie Oberlander, BSN, RN
Structural Empowerment Award
The award recognizes a registered nurse or licensed practical nurse who demonstrates professional engagement, development and a commitment to community involvement. Through active participation in shared governance and decision‐making structures, this nurse helps shape standards of practice and address key issues, whether by serving on the Nursing Senate, acting as a clinical academic or preceptor, or engaging in professional associations and community initiative. This individual lends their expertise to committees and task forces that promote excellence in patient care and the safe, efficient and effective operation of Sanford Health.
Award Recipient:
Carmen Pederson, BSN, RN
Friend of Nursing Award
The Friend of Nursing Award recognizes individuals who are not nurses but have supported and contributed to the nursing profession and work environment of the health care team.
This award recognizes registered nurses and licensed practical nurses who exemplify the qualities of transformational leadership in nursing. These formal or informal leaders communicate expectations, guide the development of others and help their department evolve to meet current and future needs in alignment with strategic goals. They bring a strong vision, a well-articulated philosophy and a deep commitment to professional practice. Their leadership is grounded in advocacy and support on behalf of patients and staff.
Award Recipients:
• Stephanie Hammers, MSN, RN
• Kelsey Bartness, BSN, RN
• Kristi Baukol, BSN, RN, CNML
• Zachary Jensen, BSN, RN, CRRN
• Emily Mangin, BSN, RN, ONC, PMGT-BC
• Florence Nelson, BSN, RN
The DAISY Award for Extraordinary Nurses
The DAISY Award is a national recognition program that celebrates the extraordinary clinical skill and compassionate care provided by nurses every day.
The award was established in 1999 by the family of J. Patrick Barnes, who died at the age of 33 from complications of idiopathic thrombocytopenic purpura. Deeply moved by the care Patrick received during his hospitalization, the family created the DAISY Foundation to honor nurses who go above and beyond.
Today, the DAISY Award is presented in more than 3,000 health care facilities across all 50 states and 13 countries. At Sanford Health, patients and families touched by the nursing care they receive can submit a nomination to recognize the nurse’s kindness, care and expertise.
Award Recipients:
Lucky Tiongca, MSN, RN
Sam Anderson, BSN, RN, CHPN
Annika Biegler, BSN, RN, CEN
Olivia Ellingson, BSN, RN
Tessie Domingo, BSN, RN, CPN
Greta Florence, BSN, RN
Riley Hoffman, BSN, RN, CCRN
Alissa Godlevsky, BSN, RN, CCRN
Anne Johnson, BSN, RN, SANE
Jordyn Kack, BSN, RN
Kaelyn Kaul, BSN, RN
Marryn Lundeen, BSN, RN
Oakley Martin, BSN, RN
Maggie Oberlander, BSN, RN
Hudson Pung, BSN, RN
Jennifer Richtsmeier, BSN, RN
Adrian Sevigny, BSN, RN
Kristi Ackerman, ADN, RN
Mel Brown, BA, ADN, RN
Meaghan Johnson, ADN, RN
Kayleigh Kulyk, ADN, RN
Kala Larson, ADN, RN, RNC, C-NPT
Josephine Wuo, ADN, RN
Adeline Ness, LPN
DAISY Nurse Leader
The DAISY Nurse Leader Award recognizes nurses who have made an extraordinary contribution to patient care. Honorees can include any nurse leader who has directly influenced patient care, such as nurse managers, directors, supervisors and clinical care leaders.
Award Recipient:
Becky Browning, MBA, BAN, RN, CPN, CNML
DAISY Nurse Educator
The DAISY Nurse Educator Award was created to honor nurse educators for their inspirational influence on the nurses of today and tomorrow.
Award Recipients:
• Breanna Brinkman, BSN, RN, RNC-OB
• April Leiran, BSN, RN
• Chelsea Young, BSN, RN, MEDSURG-BC
Employee of the Year
Each year, Sanford Health recognizes outstanding employees who have contributed to the culture and care provided in the organization. Employees can nominate co-workers who they feel exemplify the values and mission of the organization.
Award Recipient:
Julie Kossan, BSN, RN
Julie is a registered nurse in the ICU at Sanford Medical Center Fargo. She was nominated for her contributions to creating a culture of safety and compassion for both patients and staff. She embodies Sanford Health’s core values and is a wealth of knowledge. Known as the “mom” of the unit, Julie is always willing to help answer her co-worker’s questions. Her nominator shared, “I can only hope that if I were in the hospital, or my family member was, that Julie would be taking care of me. Julie is an invaluable asset to this hospital and needs to be recognized.”
Sunflower Award
The Sunflower Award recognizes and celebrates nursing assistants and patient care technicians who go above and beyond to deliver compassionate and excellent care to those we serve.
Award Recipients:
Kashmir Scalia
Brady Davidson
Alison Hughes
Gordan Walth
Junior Wahkor
Matilda Gartei
Samantha Kubitz
Guardian Angel Award
The Guardian Angel Program provides patients and families with the opportunity to celebrate exceptional care by making a gift in honor of a caregiver.
Award Recipients:
Ashley Benson, DNP, APRN, CNP
Katie Thompson, DNP, APRN, CNP
Danielle Joyce, APRN, CNP
Sara Hansen, Nurse Midwife
Allison Aberle, BSN, RN, CPN
Joseph Dirks, BSN, RN, CCR
Deanna Erickson, BSN, RN
Anna Holen, BSN, RN
Luke Johnson, BSN, RN
Katelyn Kennedy, BSN, RN
Julie Minion, BSN, RN, RNC-OB
Laura Peterson, BSN, RN
Kristine Joy Jarabelo, RN
Leah Moller, RN
Susanne Wood, RN
Jody Lyons, LPN
APP Awards
Every year, Sanford Health’s Fargo region hosts a special recognition dinner to honor its advanced practice providers (APPs). This year’s APP Recognition Dinner was held on September 13 at the Avalon Event Center in Fargo. This event recognizes the achievements and advancements our APPs have accomplished throughout the year.
Recipients:
APP of the Year Award
This award was presented to an APP who exemplifies the values of the profession and is dedicated to the art and science of healing.
Carrie Pfaff, APRN, CNP, Medical Oncology
APP New to Sanford Award
This award was presented to an APP who is within their first five years of employment and has made significant contributions to Sanford Health.
Carly Kaspari, APRN, CNP, Medical Oncology
Enrichment Award
This award was presented to an APP who participates in the education of students, colleagues or others, while maintaining an active clinical practice.
Jeremy Herbrandson, APRN, CRNA, Anesthesiology
Trailblazer Award
This award was presented to an APP who demonstrates exceptional leadership, innovation and forward-thinking contributions in clinical care, technology, research and policy.
This award was presented to an APP who provides a significant contribution to the health care system, is actively involved in leadership committees or councils, promotes professionalism and demonstrates excellent clinical skills.
Brooke Keller, DNAP, APRN, CRNA, Anesthesiology
Hero Awards
Sanford Heroes are chosen each month for demonstrating excellence in one of the Sanford values of calling, courage, family, community, service, resolve and advancement. Sanford employees as well as patients and visitors can nominate employees for a Sanford Hero award. *Award categories have not yet been updated to match new organizational values.
• Kayla Howard, DNP, Nurse Scientist, Office of Nursing Practice – Fargo (May)
• Roxanne May, Kayla Brown, Tayler Leysring and Becky Browning, Pediatric Admission and Recovery Unit – Fargo (October)
Department Spotlight: 7S Inpatient Oncology
Department Spotlight: 5C Inpatient Rehabilitation
Nerline VanDyke, RN, BSN, OCN, BMTCN, was recognized as Red River Valley Oncology Nursing Society’s Nurse of the Year at the November meeting.
On December 3, Sanford Inpatient Rehabilitation was awarded the Triple Crown Award, which recognizes excellence in preventing patient harm. The award is presented to nursing units that go one full year without a CAUTI, CLABSI and HAPI.
This marks the second time our unit has received the award – a testament to the team’s consistent commitment to patient safety and quality care.
The nursing team collaborates closely with the therapy staff to mobilize patients and reduce the risk of pressure injuries. Nurses play a vital role in performing daily care to prevent CLABSIs and CAUTIs, while also educating patients and their families on the importance of continuing these practices after discharge.
We’re proud to be recognized for our dedication to patient safety and helping patients heal and return to living independently.
Network Highlights
Sanford Hillsboro Medical Center, Network
This year marked another great year for Sanford Hillsboro Medical Center. The team hired three internationally educated nurses who are set to begin in 2026!
Hospital nursing staff once again sponsored a local family for Christmas through the Traill County’s Angel Tree Project, providing gifts for an entire household in the community.
Colette Smith received an award from the Good Samaritan (GS) Home Care team for being a helpful partner in referring patients to their service and working with them to meet patient needs.
Kayla Bjornstad served as an LPN apprentice this year at Hillsboro hospital and was honored with a Friend of Nursing Award at the 2024 Nursing Recognition Event.
Alison Frueh, LSW, was also awarded a Friend of Nursing Award at the same event, nominated by the Sanford Hillsboro nursing team.
Sanford Mayville Medical Center, Network
The presentation, titled Empowering Internationally Educated Nurses (IENs) to be The Mayville Medical Center had an eventful year with multiple recognitions
• Sam Fugleberg, NP, and Jessica Foss, RN, received awards from GSS Home Care for their exceptional partnership in caring for patients.
• Pam Bertrand, CNA, received a well-deserved Sunflower Award for her exceptional dedication and service.
• Sanford Mayville Medical Center was named one of the Top 100 Critical Access Hospitals for 2024 by Chartis – a prestigious acknowledgement of excellence in quality care and performance.
Yearly Brand Ambassadors
The Sanford Brand Ambassador Program celebrates employees who go above and beyond in their commitment to the organization’s mission of providing health, healing and comfort to patients, residents and communities.
Each year, executive leadership selects 20 individuals through a nomination process, recognizing those whose dedication and passion truly represent the spirit of Sanford Health.
As part of the honor, the selected ambassadors enjoy a special three-day trip, where they connect with one another, relax and celebrate. They also continue their role as brand advocates for Sanford Health, sharing their stories and inspiring others within the organization and across the communities we serve.
For 2024, ambassadors were rewarded with a trip to Charleston, South Carolina, where they were recognized for their commitment and impact. Among this year’s nursing recipients were Eman Mohammad, BSN, RN, program specialist, Michelle Thomson, LPN, West Fargo Clinic, and Olivia Karzon, patient care technician.
NEW KNOWLEDGE, INNOVATIONS AND IMPROVEMENTS
Unit-based Hospitalist Workflow Project
Sanford Health hospitals in Fargo implemented a unit-based hospitalist workflow initiative aimed at improving patient care and team collaboration across multiple units. The project focuses on enhancing care delivery efficiency with a goal of having 80% to 90% of patients managed by designated physician teams on specific units, including SMCF-6AB, 6CD, 7CD, 8AB and Broadway-5SE.
By optimizing unit-based care, the initiative aims to reduce patient transfers and strengthen unit-based relationships between physicians, case managers and nursing teams. This structure allows physicians to stay on a single unit for the majority of their patient load, improving consistency in care and communication. Each team is supported by a dedicated case manager, and structured communication tools are used to guide discussions, prioritize treatment and address any overnight concerns.
Central to the initiative are interdisciplinary team (IDT) rounds held weekdays at the same time to foster collaboration among hospitalists, case managers and nursing staff. In units like SMCF-6AB and Broadway-5SE, the rounds streamline decision-making and ensure the entire care team is aligned. Nurses are encouraged to ask questions during conversations to minimize interruptions later.
On weekends and holidays, a flexible rounding model engages bedside nurses individually or in collaboration with the charge nurse. This ensures continuity of care and reduces disruptions.
Looking ahead, the unit-based workflow project is a key step in our broader strategy to optimize patient care and improve efficiency. By maintaining a unit-focused approach and enhancing communication, Sanford Health in Fargo can achieve its patient care objectives while reducing staff workload.
from the workflow project.
Photos
On August 4, 2022, our Virtual Window performance improvement project launched in the Clinical Decision Unit (CDU) with the goal of improving patient well-being and reducing delirium. The project features a live outdoor video feed from two local Sanford Health locations, displayed on an 85-inch TV screen. The decision to show the Fargo locations was intentional, as it provides a more realistic, outdoor view, mimicking the experience of looking out a real window.
The inspiration behind this project was to connect patients to the outside world and support their circadian rhythm – especially important for those confined to units without windows, such as the CDU. Research shows that exposure to natural light and outdoor scenery can reduce stress and symptoms of delirium, which is why the virtual window is expected to provide significant benefits for patients in our care.
Since the project went live, feedback from staff and patients has been overwhelmingly positive. Many have expressed appreciation for being able to see outside, check the weather in real time and stay oriented to the time of day and night.
We plan to expand this initiative by installing smaller virtual windows in each CDU room, ensuring that every patient has access to a realistic outdoor view. This project is just one of the many ways we are enhancing the patient experience and improving outcomes in the CDU.
Virtual Window
Nursing Research Studies
Sanford Health Fargo conducted two research studies on supporting and understanding the nursing workforce this past year.
The first study, Navigating Nursing Wellness in Rural America, examined nursing wellness following the COVID-19 pandemic. Led by Anna Ferguson, MSN, MBA, RN; Becky McDaniel, PhD, RN, PMH-BC; Samantha Bartelt, PMHNP, APRN, CNP; and Karen Robinson, PhD, RN, FAAN, this mixed-method study was conducted in two phases:
• The first phase identified barriers to wellness and found that advanced practice registered nurses (APRNs) reported higher wellness scores than nurse leaders.
• The second phase refined intervention strategies, which resulted in improved wellness scores.
Findings from the study have been published and presented at multiple conferences, including:
• The Journal of Nursing Administration
• University of North Dakota for Rural Health Center’s Annual Conference
• The North Dakota Nurses Association
The research has also been accepted for an oral presentation at the 2025 National Evidence-Based Practice Conference, and an abstract has been submitted to the 2025 ANCC National Magnet® Conference.
The second study, The Experience of Internationally Educated Nurses (IENs) Transition to Nursing Practice at a Rural Healthcare System, is an enterprise multi-site qualitative study exploring the experiences of IENs as they transition into the largest rural health system in the U.S.
The Fargo team includes Ashley Lacey, BSN, RN, and Eman Mohammad, BSN, RN, with Karen Robinson serving as a consultant. Fifteen IENs participated in the first round of interviews, and 11 completed the second round 11-12 months post-hire. Data analysis is ongoing.
Department Spotlight: 4C Inpatient Orthopedics
In 2024, Sanford Medical Center Fargo’s orthopedic teams achieved a significant milestone with a notable increase in same-day total joint surgeries – including procedures for the ankle, shoulder, hip and knee. By year’s end, 55% of primary total joint surgery patients were discharged the same day, a substantial improvement from just 9% in October 2023.
A key factor in this success was the pivotal role of RNs in the orthopedic clinic. These nurses prepared patients for surgery through education and personalized support.
In March 2024, Sanford Health launched a new full-time preoperative clinic = Preoperative Assessment Clearance Education (PACE) – to better prepare patients for surgery. The clinic includes an advanced practice registered nurse (APRN) and a team who meets with patients three weeks before their procedure to complete necessary assessments and provide education.
Due to space constraints in the South University PACU/Phase 2 areas, same-day discharge patients are monitored on the orthopedic unit. There, they receive physical therapy evaluations, case management and final education before being discharged just hours after their procedures.
Despite the challenges of adapting workflows typically used in ambulatory surgery centers, the nursing and interdisciplinary teams successfully created a seamless, efficient process that maintains high standards of care and patient satisfaction.
Baxter Customer Experience Center Trip
In December 2024, clinical nurses, leaders and supporting staff from Fargo visited the Baxter Customer Experience Center in Irvine, California. The visit provided an in-depth look at how Hillrom/Baxter solutions are effectively integrated across diverse health care settings.
During the visit, the team had the opportunity to examine cutting-edge technologies designed to enhance patient care, including smart beds, digital whiteboards, Ready Connect and wireless bed connectivity dashboards. Hands-on engagement with these technologies inspired innovative ideas to bring forward to our Innovation Unit.
Attendees also reviewed Hillrom/Baxter’s strategic roadmap, which facilitated the development of valuable partnerships and presented opportunities for future testing and piloting of emerging technologies.
Department Spotlight: 7CD: “Let’s Use our mMINDS.”
The nursing staff on 7CD have proactively initiated a performance improvement project to implement the mMINDS scale for monitoring alcohol withdrawal as an alternative to the currently used CIWA protocol.
To evaluate the project’s effectiveness, the team will track several metrics, including staff surveys, chart reviews comparing mMINDS and CIWA data side by side, length of patient stay, ease of assessment using both scales, medication administration dosing and time efficiency for RNs and LPNs.
The team has successfully obtained Institutional Review Board certification. They are working toward the goal of implementing a practice change at Sanford Health, adopting the mMINDS scale as the new standard for monitoring alcohol withdrawal.
Yearly Organizational Honors
• Sanford Medical Center Fargo was given a 5-star rating from the U.S. Centers for Medicare and Medicaid Services (2024).
• Sanford Medical Center Fargo received the American College of Cardiology’s NCDR Chest Pain – MI Registry Platinum *Performance Achievement Award (2021, 2022, 2023, 2024).
• Sanford Medical Center Fargo was recognized by The Joint Commission with:
- Advanced Comprehensive Stroke Center Certification (2017-present)
- Gold Seal of Approval for hip fracture, knee replacement, hip replacement and shoulder replacement programs (2013-present)
• Sanford Medical Center Fargo received the YWCA Cass Clay Leader in Women’s Empowerment Award (2024).
• Sanford Roger Maris Cancer Center earned a spot on Becker’s Hospital Review’s Top 100 Hospitals and Health Systems with Great Oncology Programs list (2023, 2024).
• Sanford Orthopedics & Sports Medicine was included in Becker’s Healthcare’s Top 100 Hospitals and Health Systems with Great Orthopedic Programs (2024).
• Sanford Fargo Brain & Spine Center was recognized by Becker’s Healthcare as one of the 70 Hospitals and Health Systems with Spine and Neuroscience Programs to Know (2023).
• The Chartis Center for Rural Health named the following facilities to its Top 100 Critical Access Hospitals list:
- Sanford Thief River Falls Medical Center (2023, 2024)
- Sanford Mayville Medical Center (2022, 2023, 2024)
• Sanford Medical Center Fargo was named the best hospital in North Dakota by U.S. News & World Report (2021, 2022, 2023, 2024).
• Sanford Ambulance received the American Heart Association’s Mission: Lifeline EMS Gold recognition (2023, 2024).
• Sanford Medical Center Fargo was named an Own the Bone Star Performer by the American Orthopedic Association (2023, 2024).
• Sanford Medical Center Fargo received the American College of Cardiology’s NCDR Chest Pain – MI Registry Platinum Performance Achievement Award (2024).
• Sanford Medical Center Fargo received American Hospital Association: Get With The Guidelines recognition (2022, 2023, 2024), including:
- Stroke Gold Plus Award
- Stroke Elite Plus Honor Roll
- Type 2 Diabetes Honor Roll
- Stroke Advanced Therapy Honor Roll
Contributors
Special thanks to the individuals and teams who contributed to this report:
• Adam Johnston, BAN, RN, CEN, CPEN, NPD-BC
• Alissa Biever, ADN, RN
• Amanda Price, BSN, RN, MEDSURG-BC
• Anna Ferguson, MSN, MBA, RN
• Anne Heller, PhD, RN
• Ashley Lacey, BSN, RN
• Benjamin Nelson, BSN, RN
• Brianna Thielges, BSN, RN
• Brittany Maher, BSN, RN, CLC
• Courtney Caspers, BSN, RN
• Clint Rossland
• Dev Mannuru, MD
• Diane Bartholomew, BSN, RN
• Dre Blotsky, BSN, RN
• Eman Mohammad, BSN, RN
• Emily Mangin, MSN, MBA, RN, ONC, PMGT-BC
• Frederickson Abdulwahab, ADN, RN
• Gregg Homan, BSN, RN, CIC, CMSRN
• Heather Lundeby, BSN, RN, CFRN
• Heather Perez, MSN, RN, NI-BC
• Jessica Schindeldecker
• Julie Mallett, BSN, RN
• Kayla Howard, DNP, RN
• Karen Robinson, DNP, RN
• Karlie Sitzler, ADN, RN
• Katie Halvorson, BSN, RN, CCRN
• Kelsey Storck, BSN, RN
• Kimberly Anderson, MSN, RN, CEN, CPEN, TCRN
• Kristen Jones, MPH, BSN, RN
• Lyn Telford, MSN, RN, CPHQ
• Marcia Bettenhausen, BAN, RN, CPHON, CNML
• Mariah McCaul, BSN, RN
• Marie Riemer, BSN, RN
• Megan Coon
• Megan Hills, MSN, RN, CNML
• Melissa Mostad, MSN, RN
• Michelle Johnson, BSN, RN, ONC
• Samantha Bartelt, MSN, APRN, PMHNP-BC
• Sam Taylor, BSN, RN
• Sara Harty, BSN, RN
• Sarah Roth, BSN, RN
• Shaunda Krebsbach, BSN, RN, CLC
• Shelly Arneson, ADN, RN
• Stephanie Fugleberg, BSN, RN
• Tansy Wells, MPH, CPHQ, CPH
• Taylor Pfarr
• Theresa Larson, MSN, RN
• Tonya Kellerman, BSN, RN, MEDSURG-BC
• Ty Werven
• Vicki Oberg, BSN, RN
• Zachary Jensen, BSN, RN, CRRN
Visit sanfordhealth.org/nursing-excellence to view this report digitally.
