med-midwest medical edition-december 2010

O R T H O P E D I C S

Medical Group

In RevIew Nudge: Improving Decisions

about Health, Wealth and Happiness by Richard H Thaler and Cass R Sunstein

House Calls and Hitching Posts: Stories from Dr. Elton Lehman’s

Career Among the Amish As told to Dorcas Sharp Hoover

A Season in Review

Cover Feature

Just in case you missed it . . .Midwest Medical Edition (MED) Magazine came on the scene in 2010 with a mission to inform and educate area healthcare providers on the extraordinary people and programs advancing medicine in the upper Midwest. In our Cover Feature this month, we review our first year’s Top Stories. We hope that these excerpts will inspire you, not only to respect the indi-viduals featured, but to nominate others you think would make a great cover or feature story in 2011. Fill out and fax the Nomina-tion Form in this issue, or email the publisher at [email protected].

By Alex Strauss

ContentsDecember 2010

Midwest Medical Edition

Regular Features

2 | Publisher’s/Editor’s Page

20 | Grape Expectations Adding Sparkle to Your Holiday By Heather Taylor Boysen

31 | News & Notes News from around the region

32 | Learning Opportunities Upcoming Symposiums, Conferences and CME Courses

In This Issue

3 | Using Social Media: Guidelines for Physicians

5 | Midwifery and Home Birthing: A Perennial State Legislative Issue By Dave Hewett

12 | Strategic Focus: Planning Your Health IT TeamBy Jamie Husher

13 | Sanford Opens Simulation Training Center

19 | Kapaska Named CEO of Avera McKennan

Hospital & University Health Center

26 | Slips, Trips and Falls in the WorkplaceBy Lori Berdahl

30 | AHA ‘Go Red’ Conference Set for February page 25

page 6

In RevIew Nudge: Improving Decisions

about Health, Wealth and Happiness by Richard H Thaler and Cass R Sunstein

House Calls and Hitching Posts: Stories from Dr. Elton Lehman’s

Career Among the Amish As told to Dorcas Sharp Hoover

Top Stories2010

2

Happy Holidays from all of us at MED. As we close out our first

year of publication, we want to extend our heartfelt thanks to

all of you who have helped to make this dream a reality. We

appreciate all of the marketing directors, advertisers, advisors,

consultants, and – especially – you, our readers. Without your continued

support, feedback and contributions, this magazine could not continue to

exist and grow.

In addition to our wrap-up of cover feature stories this month, we once

again bring you columns from experts around the region. SDAHO’s president

discusses the highly charged politics behind lay midwifery. We have tips for

running a more technically savvy practice from a healthcare IT specialist.

There are news items from hospitals and health systems from around the

region, tips for buying sparkling wine, once again, reader reviews of books

you may want on your own shelf.

As always, we welcome your contributions, whether it be your thoughts

on a book, your memories for our Then & Now column, an event or news

item you’d like to publicize, or something else. Our mission is to be a premium

communication tool for this wide and diverse medical market. Put us to work

for you and let us know how we’re doing!

Finally, we enjoyed seeing so many of you at the opening events for the

Avera Cancer Institute last month. It is always gratifying to celebrate this type

of milestone event in our medical community. We look forward to many

more in the months and years to come.

Our best wishes for a happy and health holiday season for you and yours,

—Alex & Steff

Steffanie Liston-Holtrop Alex Strauss

From Us to YouStaying in Touch with MED


CONTACT INFORMATION

Steffanie Liston-Holtrop, Publisher 605-366-1479 [email protected]

Alex Strauss, Editor in Chief 336-295-3017 [email protected]

Fax 605-271-5486

MAILING ADDrESS PO Box 90646 Sioux Falls, SD 57109

WEBSITE MidwestMedicalEdition.com

Jan/Feb Issue Dec 5th

March Issue Feb. 5th

April/May Issue March 5th

June Issue May 5th

July/August Issue June 5th

Sept/Oct Issue August 5th

November Issue October 5th

2010/11 AD / Editorial Deadlines

Reproduction or use of the contents of this magazine is prohibited.

©2010 Midwest Medical Edition, LLCMidwest Medical Edition (MED Magazine) is committed to bringing our readership of 3500 South Dakota area physi-cians and healthcare professionals the very latest in regional medical news and information to enhance their lives and practices. MED is published 8 times a year by MED Magazine, LLC and strives to publish only accurate information, however Midwest Medical Edition, LLC cannot be held responsible for consequences resulting from errors or omissions. All material in this magazine is the property of MED Magazine, LLC and cannot be reproduced without permission of the publisher. We welcome article proposals, story suggestions and unsolicited articles and will consider all submissions for publication. Please send your thoughts, ideas and submissions to [email protected]. Magazine feedback and advertising and marketing inquiries, subscription requests and address changes can be sent to [email protected].

MED is produced eight times a year by MED Magazine, LLC which owns the rights to all content.

Publisher Steffanie Liston-Holtrop Editor in Chief Alex Strauss

Cover Design Darrel Fickbohm Design/Art Direction Corbo Design Web Design 5j Design Contributing Writers Charlotte Hofer Kenneth Scott, MD Heather Boysen Dave Hewett Lori Berdahl Jeff Boonstra Jamie Husher Paul Krueger Patty Peters, MD Advisory Board John Berdahl, MD Mary Berg, MD Michelle L. Daffer, MD James M. Keegan, MD Timothy Metz, MD Patty Peters, MD Juliann reiland-Smith, MD Luis A. rojas, MD Daniel W. Todd, MD

Published by MED Magazine, LLC Sioux Falls, South Dakota

MED is looking for reader contributions to our In review and Then & Now

columns. If you have thoughts on a book or movie that you think would

interest your colleagues, please take some time to share them. Then & Now

welcomes contributions from readers who can share insights on the many

ways things have changed in our medical community over the years. Send

your ideas and articles to [email protected].

December 2010 3MidwestMedicalEdition.com

USIng SoCIAl MedIA guidelines for PhysiciansMillionsofAMericAnsusesocialnetworksandblogstocommunicate,butwhen those users are physicians, challenges to the patient-physician relationshipcanarise.TheAmericanMedicalAssociationhasadoptedanewpolicyaimedathelpingphysicianstomaintainapositiveonlinepresenceandpreservetheintegrityofthepatient-physicianrelationship.

AMA urges physiciansto take action against inaccurate insurance claimsTheAMericAnMedicAlAssoci-ation (AMA) is urging physicians totakeactionthisfallagainst inaccuratepaymentsfromprivatehealthinsurers.The AMA designated november asheal thatclaim™month and is sup-plying physicians with tools to fightflawed and inefficient claims pro-cessingbyhealthinsurers.

oneinfivemedicalclaimsispro-cessed inaccurately by commercialhealthinsurers,accordingtotheAMA’snationalhealthinsurerreportcard.A20percenterrorratecostsanestimated$15.5billionannually.Theadministra-tivecostsofensuringproperinsurancepaymentstakesaheavyfinancial tollonphysicians,andcanconsumeupto14percentoftheirearnedrevenue.

“TheAMA’sgoalistosignificantlyreducetheadministrativecostsofpro-cessingclaimsfrom14percenttoonepercentandallowdoctorstofocusoncaringforpatients,insteadofbattlinghealthinsurersoverdelayed,deniedorshortchangedmedical claims,” saidAMAPresidentcecilB.Wilson,M.d..

fallisanidealtimeforphysicianstobolstertheireffortsatappealinginap-propriatelydeniedclaimssincehealthinsurersoften increase claimdenialsduringthelastquarteroftheyear.TheAMAishelpingphysiciansovercomeclaims obstacles by offering onlineresources to help prepare, track andappealclaims.Theseresourcesincludetemplate appeal letters, printablechecklistsandlogsthathelpphysicianssimplify their claims managementsystem.MoreinformationisavailableontheAMA’swebsite.■

The new policy encourages physicians to:

•Useprivacysettingstosafeguardpersonalinformationandcontenttothefullestextentpossibleonsocialnetworkingsites.

•routinelymonitortheirowninternetpresencetoensurethatthepersonalandprofessionalinformationontheirownsitesandcontentpostedaboutthembyothers,isaccurateandappropriate.

•Maintainappropriateboundariesofthepatient-physicianrelationshipwheninteractingwithpatientsonlineandensurepatientprivacyandconfidentialityismaintained.

•considerseparatingpersonalandprofessionalcontentonline.•recognizethatactionsonlineandcontentpostedcannegativelyaffecttheirreputationsamongpatientsandcolleagues,andmayevenhaveconsequencesfortheirmedicalcareers.

Midwest Medical Edition 44

Please fill out the form and fax or email to:

Steffanie Liston-Holtrop, Publisher


4609 S. Baha Ave #201

Sioux Falls, SD 57106

Phone: 605-366-1479 Fax: 605-271-5486

[email protected]

MED Magazine is seeking Nominations for Cover Article topics for 2011. MED is committed to focusing on pioneering physicians, institutions, programs and technologies that are paving the way for the future of healthcare in our region. If you know of a person or program that deserves a closer look, please let us know.

NOMINee:

Title: ___________________________________________________________________________

Location of Practice: ____________________________________________________________

City: ___________________________________________________________________________

State: ___________________________________________________ Zip ___________________

Phone__________________________________________________________________________

Email: __________________________________________________________________________

reason for Nomination: _________________________________________________________

Your Name: ____________________________________________________________________

Title: ___________________________________________________________________________

Phone: _________________________________________________________________________

Email: __________________________________________________________________________

Call for NomiNatioNs

The Med Magazine Advisory Board

Michelle L. Daffer, MD, Dermatology

Midlands Clinic, PC, Dakota Dunes

John Berdahl, MD, Ophthalmology Vance Thompson Vision, Sioux Falls

Mary Berg, MD, Family Practice

Sanford Clinic Family Medicine, Sioux Falls

James M. Keegan, MD, Infectious Disease

Regional Health System, Rapid City

Luis A. Rojas, MD, Gynecologic OncologyAvera Women’s Center for Gynecologic Cancer, Avera Cancer Institute,

Sioux Falls

Juliann Reiland-Smith, MD, Breast Surgery

Comprehensive Breast Care, Sioux Falls

Patty Peters, MD, Family Practice

Avera McGreevy Clinic, Sioux Falls

Timothy Metz, MD, Anesthesiology

Anesthesiology and Pain Management,

Sioux Falls

Daniel W. Todd, MD, Otolaryngology

Midwest Ear, Nose & Throat, P.C.

The less cancer there is, the more birthdays there will be. Patients count on you to remind them of what they can do to prevent cancer. Remind your patients of appropriate screenings and healthy lifestyle choices.

You can help create a world with more birthdays. Visit morebirthdays.com.Or call 1-800-227-2345. Together we’ll stay well,get well, fi nd cures and fi ght back.

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deadlinedecember31,2010

December 2010 5MidwestMedicalEdition.com 5

When south dakota’s86th legislative sessionconvenes this comingJanuary 11, physicians

andtherestofthehealthcarecommu-nitycanexpectthelaymidwiferyissuewill,onceagain,bepartof the“issuemix” in Pierre. The issue has beenaround for years, and by all accountsthosewho favor legislation proposingthestatelicensureorcertificationoflaymidwiveshavebeengettingfartherinthelegislativeprocess.

Typically,themyriadofhealthcareprovidergroupsopposingthelegislationwaituntilsomemidwiferybillisintro-ducedandreacttoit.Thatapproachhasproven sufficient…until now. But itneedstobeunderstoodthatthepropo-nentsofthislegislationareadvocatingonthisissuethroughouttheyearanditistheonlyissuetheyaretalkingtoleg-islatorsaboutwhetherit’sduringsessionorsometimeinJuly.

for those of us who oppose thislegislation,theissueboilsdowntoonething–ensuringthepublicsafety.AJuly editorial fromThe lancet.comprobably summed up our concernsthebestwhenitsaid:

A recent meta-analysis published in the American Journal of Obstetrics & Gynecology provides the strongest evidence so far that home birth can, after all, be harmful to newborn babies . . . The data show that planned home births to healthy and low-risk mothers compared with planned hospital births in the same group of women doubled the risk of neonatal deaths.

But statistics and studies alonewon’tbeenough thiscoming legisla-tivesession.Theclinicalknowledge,personal experiences, and genuineprestigethatsouthdakotaphysiciansbringtothisdebateisthemosteffec-tivewaytopresentthisissue.

Birthingoutcomeshaveimprovedsomuchovertheyearsthatthepublicgen-erally assumes that all outcomes aregood. We know that despite all theadvancementsthatisn’talwaysthecase.our outcomes are better because ofbetterresearch,training,facilitiesandequipment.That cannot be taken forgranted. That is the message south

dakota’sstatelegislatorsneedtohearfromtheirphysiciansastheybeginthis86thlegislativesession.■

Midwifery and Home Birthing A Perennial State legislative IssueBy Dave Hewett, President/CEO, SDAHO

Top Stories2010

66

Med Magazine takes pride in bringing our readers a wide range of stories each year, from the largest health systems, to the most progressive inde-pendent practices and exceptional individual providers. The people and programs featured on our Cover have been nominated by their peers and rep-resent some of the best and brightest in their respective specialty areas, working to further the cause of high-quality healthcare in our region (and sometimes outside our region). This month, we take another look at those Top Stories – as well as some of the more noteworthy news items –from our first year. Following are excerpts from the pages of this year’s Med Magazine.

By Alex Strauss

Top Stories2010A Season

In Review

7

WhileMosTdocTorstodaywouldnotseriouslyconsiderforgoingthetechnologyandotheradvantagesintheirmodernofficesforthechancetopracticeinamoreprimitiveway,somedogetthatopportunitybyvolunteeringtopracticewithchari-

tableorganizationsthatputtheirskillstouseinsomeofthemostimpoverishedpartsoftheworld.Medtalkedtoseveralareaphysicianswhohavemademedi-calmissionsworkapartoftheirprofessionallives.

dr.JohnBerdahl,ophthalmologist,VanceThompsonVisionhasdevotedaportionofhismedicalcareertoperformingcataractsurgeryandothereyecareinsuchexoticlocalesasMexicoandBurma,thepoorestcountryinAsia.

“Wealwayshavepeoplewhodon’trecognizethemselvesinamirrorbecausetheyhadbeenblindforsolong.Wehavepeoplewhohaveneverseenthefaceofagrandchildordidn’trecognizeaspouse.notonlydoesthissurgeryquicklyrestoretheirsight,butitoffersapermanentsolution,”saysdr.Berdahl.

dr.Adamstysanddr.Tomstys,cardiologists,sanfordhearthospital,brotherswhogrewupoutsidetheU.s.,haveworkedinanAfricanleprosyhospital,deliveringbasiccareinexchangeforroomandboard.

“subspecialtymedicinesuchascardiologyisalmostnon-existentintheseremotemissionaryplaces,soweenduptreatingabroadspectrumofconditions,”saysdr.Tom.“Wesawtraumaticinjuries,infections,fractures.Yousometimeshavetoapproachverycomplexconditions,verysimply.”

dr.PattyPeters,familyPractice,AveraMcGreevyclinichasbeenactiveinmedicalmissionssincethemid1990’s.fourofhertripshavebeentoJeremie,haiti.“You’rediagnosingonyourbackgroundwithoutthebenefitofthingslikeX-raysorlabtests,”sheexplains.“sometimespatientsdie,despiteourbestefforts.soitisfrustratingwhenAmericanpatientsthinktheyshouldbeentitledtoeverytestimmediatelyorgetangryifthedoctorisrunningafewminuteslate.inthesepoorcountries,peoplearejustsogratefulandappreciative.”

dr.TerryGraber,familyPractice,custerregionalMedicalclinichastrav-elledextensivelyservingindigenouschurch-basedprograms.hehappenedtobeinhaitiwhentherecentearthquakestruckandwasabletoofferimmediateemergencycare.

“Youcouldsay,whatgoodcoulditdoforanAmericandoctortogoallthewayoverthereandpassoutalittlebitofmedicine?”saysdr.Graber.“Butithinkwearesendingamessagewhenwedothis,thatthereisanon-materialrealmtolife,arightwaytolive,andthatservicecomesoutofthat.”■

Dr. John Berdahl in Burma

Dr. Terry Graber in Haiti

Caring for a Needy WorldLocal Doctors Travel the Globe to Give Back

News flashAvera McKennan Hospital & University Health Center and Sanford USD Medical Center have again been named among the nation’s 100 Top Hospitals® by Thomson Reuters. This is the eighth time Sanford has been recognized with this honor and the fourth consecutive year for Avera McKennan.

Midwest Medical Edition 8 Midwest Medical Edition 88

cdcsTUdies PUT The rATe of fetal AlcoholsyndromeintheU.s.between0.2and1.5casesforevery1000livebirths.otherstudiesusingdifferentmethodshavefoundittobeevenmorecommon–as

many as 1 case out of every 500 live births. And scientistsbelievethatthereareatleastthreetimesasmanycasesoffAsdastherearecasesoffAs.

fewphysicianshaveseenasmanycasesoffetalAlcoholspectrumdisordersasdr.eugenehoyme.heisthechiefMedi-cal officer of sanford children’s hospital, senior VP forchildren’s services at sanfordclinic in siouxfalls, and arenownedclinicalresearcherintothemysteriesofthesesometimesbafflingdisorders.

Althoughthereisstillmuchthatisnotfullyunderstoodabouttheprenataleffectsofalcoholuse,muchofwhatisknownhasbeenuncoveredbydr.hoymeandtheotherthreeclinicalgeneti-cistswhoformthedysmorphologycoreofthenationalinstituteonAlcoholAbuseandAlcoholism(niAAA)ofthenih.heandhiscolleagueshavehelpedtomoreclearlydefinefAsandrelateddisordersthroughyearsofresearcharoundtheworld.

“oneofthemostinterestingthingswehavecometounderstandisthatmostofthesebabiesarenotborntowomenwhodrinkdaily,”saysdr.hoyme.inthecourseofhisresearch,dr.hoymehaspersonallyexaminedmorethan3000childrenwhohavebeenexposedtoalcoholinuteroandnearly400withfull-blownfAsinthelast15years.“MostchildrenwithfAsareborntomotherswhoarebingedrinkers,thatis,theydon’tdrinkduringtheweek,butontheweekendmayconsumeacaseofbeer,forexample.Thatisahugeamountofalcoholforafetustobeexposedto.”

recognizingthatthefirststeptowardpossiblelife-changinginterventionforfAsdpatientsisaccuratediagnosis,dr.hoymeandhisresearchcolleaguesdevelopedasetofdiagnosticcatego-riesforusebyprimarycarephysicians.

“iwouldlovenothingmorethan,bythetimeiretire,tohavehadsomeimpactonreducingtheincidenceofthisconditionaroundtheworld.”■

News flashThe American College of Surgeons Committee on Trauma has verified Sanford USD Medical Center as a Level II Pediatric Trauma Center – the first and only one in the region. The verification means trauma patients have access to a team of board certified pediatric surgeons, specially trained emergency physicians, a pediatric trauma flight team and state-of-the-art operating rooms.

Dr. Eugene Hoyme

News flashThe Sanford School of Medicine is now offering for the first time an accredited pediatrics residency program. Starting in the summer of 2011, the program will accept six residents per year for the three-year training program.

Eugene Hoyme, MD, and Fetal Alcohol SyndromeSanford Researcher has Devoted Career to Understanding and Preventing FAS and Related Disorders

Top Stories 2010

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When iT oPenedit’sdoorsin1985,thesioux falls surgicalcenterwas a single-

storybuildingintheshadowofwhatwasthenMcKennanhospital.Abouttwo dozen doctors and staff per-formedahandfulofprocedureseveryweek in the facility’s six operatingrooms.

Today, the sioux falls surgicalhospitalisaneye-catchingmulti-storybuildingwith 13modern operatingroomsand35privatepatientrooms.Twohundredandfortysurgeonsandstaffmembersfromindependentprac-tices as well as both area health

systemsnowperformeverythingfromtotal joint replacements topediatricsurgery,delicateneurologicalproce-dures and cancer surgery. With avolumeofmorethan800procedurespermonth–about10,000ayear–thisphysician-ownedfacilityhascarvedoutasignificantplaceforitselfamongtheregion’ssurgicaloptions.

Thesiouxfallssurgicalhospital(sfsh)adopteditsnewnameinJanu-aryof2009,inthemidstofitsbiggestexpansionprojecttodate.Thisprojectadded two floors to the hospital,increased the number of overnightbedsandincludedarenovationofthelobbyandreceptionarea,stafflounge,

preoperative admission rooms, andpostanesthesiaunit(PAcU).

sfsh can accommodate a widerangeofsurgeries,includingthosethatrequirespecializedequipmentsuchasballoonsinuplasty,orhipsurgeryfromananteriorapproach, forwhich thehospitaljustacquiredaspecialoperat-ing table. The facility hasmultiplelasersavailableandisconsideringtheadditionof robotic technology.ThehospitalisaccreditedbytheAccredita-tion Association for Ambulatoryhealthcare(AAAhc)andBecker’shospitalreviewnamedsfshoneofthe32bestphysician-ownedhospitalsinthecountry.■

The newly renovated Sioux Falls Surgical Hospital

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FSH

Opening New DoorsSioux Falls Surgical Hospital Builds on its Strengths

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MenliVinGonPineridGeindianreserva-tionhaveanaverage lifeexpectancyof just48years old. for women, it’s 52. in theWesternhemisphere,theonlypopulationwithcompa-

rablylowlifeexpectanciesisthepoverty-andAids-strickencountryofhaiti.

“Almosteverychronicconditionyoucannameis200,300,even500timeshigheronPineridgethanitisnationally,”sayssandraogunremi,dhA,directorofGrantservicesatregionalhealthwhoiswellversedinthehealthcarechallengesofnativeAmericans.“endstagerenaldisease,diabetesanditscomplica-tions,heartdisease–theseareallmuchmorecommoninthispopulation.”

inanefforttoaddressthespiralingproblemsassociatedwithchronicdiseaseaswellasalleviatesomeofthepressureonareahospitals,thesouthdakotadepartmentofsocialservicesin2008approvedagranttofundauniquenewcollaborativeeffort.housedwithinthePineridgeihshospitalandstaffedbyregionalhealthphysiciansandspecialtyproviders,thePineridgeregionalMedi-calclinicisdedicatedtodiagnosis,treatment,educationandongoingmanagementofthemostprevalentchronicconditionsonPineridge.Asajointeffortwithastategovernmentandahealthcaresystem,theclinicisuniquewithintheihs.

ThePineridgeregionalMedicalclinicfocusesonfourhealthconcernsthatarerampantamongthenativeAmericanpopulationonPineridge:congestiveheartfailure,chronicobstructivePulmonarydisease(coPd),diabetes,andthemanagementofbloodthinnermedicationssuchasWarfarin.Theclinic,whichisopentwodaysaweek,isstaffedbyphysiciansormidlevelpractitionerswithexpertiseincardiology,pulmonology,endo-crinologyandpharmacology.

“diabetesissocommonhereandthepeoplereallyseemtoappreciate the timeweareable tospendwith them,helpingthemsortout theirsugar levels,etc.,”saysendocrinologiststephenhaas,Md.“Thiskindoftimeinvestmentissoimportantnotonlyforteachingpeoplewhattheyneedtoknowaboutself-care,butalsoforsendingthemessagethatitisimportant.Whentheyseeustreatingitseriously,theyaremorelikelytotakeitseriously,too.”■

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newS FlASHAvera has been recognized as one of the nation’s ‘Most Wired’ and ‘Most Wireless’ health systems according to Hospitals & Health Networks magazine. This is Avera’s 12th consecutive ‘Most Wired’ and seventh consecutive “Most Wireless” Award.

Sanford Health & Fargo-based MeritCare further unified their two organizations under a single brand name and wordmark. The organization is now encompassed under the Sanford Health brand.

The Pine Ridge Regional Medical ClinicFighting a Legacy of Chronic Disease

Top Stories 2010

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AVerAMcKennAnhAsoPenedthedoorsofitsmostfar-reachingcancercareefforttodate–a260,000 square foot, 5-story, $93million cancercenter.The largestbuildingproject in thehospi-

tal’s history, the newAveracancer institute unites clinical,diagnostic, treatmentandsupport services inabuilding thatwasdesignedtobeasaestheticallypleasingasitistechnologi-cally advanced. Aci gathered under one roof cancer careservicesthathadbeenspreadacrossthecampus.Thegoalwastoimproveaccesstocareforfasterdiagnosisandtreatment.

inadditiontotheAveraWomen’scenterforGynecologiconcology,thenewcenterhousesAverahematologyandTrans-plant,AveraradiationoncologyandAveraMedicaloncologyandhematology.likeotherAveraclinics,theseclinicareasweredesignedaccordingtoleAnprinciplestomaximizepatientprivacyandstaffefficiency.

otherclinicalfeaturesincludeadedicatedimagingsuiteandaseparateareaforbreasthealthandimaging,lead-reinforcedradiationvaults,infusioncenters,apharmacy,andablooddrawstation.inte-grativeMedicineservicessuchasmassageandnutritionalcounselingarealsoavailableonsite.ThefourthfloorhousestheAverasurgerycenter’seightoperatingsuitesand28pre-andpost-operativeroomsandthefifthfloorremainsfreeforexpansion.

Morethanjusta‘prettyface’,theAveracancerinstituteisalsohometosomeofthearea’smostadvancedcancertechnology.ThecenterwillbeoneofonlyahandfulofintheU.s.toownsiemens’newestlinearaccelerator,theArTisTe.ThemachineoffersadvancedtreatmentdeliverytoolsthatenableclinicianstomakecriticaladjustmentsinstantlyanddeliverindividualizedAdaptiveradiationTherapy(ArT)withthehighestspeedandprecision.Aciisalsoutilizinganewintra-operativeelectron-beamradiationtherapy(iorT),madepossiblebya$2.5milliongrantfromthehelmsleycharitableTrust.

“iwouldventuretosaythatitisoneofthenicestcancerbuild-ingsintheUnitedstates,”sayshematologistKellyMccaul,Md,ofAverahematologyandTransplant.“Wehaveincorporatedpositivedesignfeaturesfromalloverthecountrytocreateanidealcancercareenvironment.”

ifyouknowofaperson, institution,orprogramthatyouwouldliketoseefeaturedinMed,pleaseshareyourideaswithus.filloutthenominationforminthisissueandmailorfaxittousanytime.■

Siemens’ newest linear accelerator, the ARTISTE, at ACI

Kri

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The Avera Cancer InstituteA New Home for Cancer Care in South Dakota


PeoPle And Process arecriticalfactorsinasuccessfulimplementation of an elec-tronic health record (ehr)

system.Purchasingand installingnewhardwareandsoftwareareonlypartoftheequation.Providersneedtoconsiderthe people power necessary for a suc-cessfulehrinstallation.conductingagap analysis to identify staff needsduringanehrimplementationiscriti-cal.Willcurrentstaffneednewtraining?Will new staff members be needed?Willexternalresourcesbyutilized?itislikelymostproviderswilluseacombi-nationoftrainingcurrentstaff,addingnew staff along with external supportfromtheehrsystemvendorandlocalhealthiTregionalextensioncenter.

inamessageissuedbydr.davidBlumenthal,thenationalhealthinfor-mationTechnologycoordinator,trainedhealth iT professionals can helpphysicians:

•Assessworkflows•selecthardwareandsoftware•Workwithvendors•installandtestsystems•diagnoseiTproblems•Trainpracticestaffonsystems

Theofficeofthenationalcoordinatorfor health information Technology(onc)fundedhealthiTtrainingprogramsto prepare six health iT workforceroles.WhilesixseparatehealthiTrolesareidentified,providersmaynotneces-sarily have six different or new roleswithintheirsetting.Theimportantpoint

is that the skills of the six roles arenecessaryatvarioustimesintheehrimplementation cycle. All roles arefocusedonimprovingpatientcareandachievingmeaningfulusecriteriatoallowforMedicareorMedicaidincentivepay-ments to eligible hospitals andprofessionals.

eHR implementation CycleAssess>Prepare>select>implement>evaluate>improve

Mobile SupportfourhealthiTrolesarecategorizedasmobile adoption support positions –workingatonesiteforaspecificperiodoftime–thenmovingontothenextimplementationsite.

Practice workflow and Information Management Redesign SpecialistAssisthealthcareprovidersreorganizeworkflowtotakefulladvantageofehrfeatures.

Clinician/Practitioner Consultantsimilartothe“redesignspecialist,”thisrolebringstobearthebackgroundandexperienceoflicensedclinicalorpublichealthprofessional.

Implementation Support SpecialistProvideon-siteusersupportbeforeandduringimplementationofehrsystemsincludingprovidingsupport servicesaboveandbeyondvendorservices.spe-cialistsensuretheehrsystemfunctionsproperlyandisconfiguredtomeettheredesignedpracticeworkflow.

Implementation ManagerManagersprovideon-sitemanagementof the mobile implementation teamsduringtheimplementationphase.

PeRMAnenT STAFFThe remaining two health iT

roles provide ongoing support ofehrsystemsimplemented inofficepractices, hospitals, health centers,long-termcarefacilities,health infor-mation exchange organizations andpublichealthagencies.

Technical/Software Support StaffKeyfunctionsincludesupportingandmaintaining theehr system on anongoing basis including patchingandupgradingsoftwareandprovidingone-on-one support in a traditionalhelp-deskmodel.

TrainerUsingadultlearningprinciples,trainersdesignanddelivertrainingprogramstoemployeesinclinicalandpublichealthsettings.

Theimportant,hardworkofadopt-ing and optimizing anehr systembeginsaftertheinitialimplementationand“golive”concludes.Providersneedtostrategicallyplanwhowillbecapa-ble of performing the various tasksrequiredduringandpost-ehrsystemimplementation.■

Jamie Husher, MS, RHIA, CHPS is an HIT

Educational Specialist with Dakota State

University’s HIT Workforce Development

Training Program.

Strategic Focus Planning Your Health IT Team

By Jamie L. Husher, MS, rHIA, CHPS

Editor’s Note: This article expands on the six health information technology (IT) workforce roles discussed in the November issue.


ThoMAs rePAs, d.o., of rapidcitywasrecentlyawardedthetitleofcertifiedPhysicianinvestigator(cPi).

heisthefirstphysiciantoreceivethiscertificationinsouthdakota.

Aphysicianinvestigatorisaphysi-cianwhoservesasaprimary,sub-orcoinvestigatorwhomonitors, super-vises,and/ordesignsclinicalresearchtrials.Aphysicianinvestigatoracceptsresponsibilityfor thesafeandethicalconductofaclinicaltrial,definedasasystematic experiment designed toevaluatethepharmacokinetics,pharma-codynamics, pharmacoeconomics,safety, efficacy, and effectiveness ofa drug, biological, medical device(therapeuticordiagnostic),procedureor

other intervention involving humansubjects.

certificationisgrantedbytheAcad-emyofPharmaceuticalPhysiciansandinvestigators(APPi)inrecognitionofa physician’s education, training andexperience as a primary, sub- or co-investigator,monitor,supervisor,and/ordesigner of clinical trials and isbasedupontrainingandexperienceaswellassuccessfulcompletionofthewrit-tencPiexamination.

AccordingtoAPPi,asof2009,925physicians were certified Physicianinvestigators.■

(sioUX fAlls, sd) –sAnfordheAlTh has opened a new trainingcenterforemployeesthatfeaturesanewmethodofsimulation-basedlearninginhealthcarefortheregion.

Thenewsanfordsimulationcenterwillallowsanfordemployeestousethenewest high-tech methods to receivehands-ontraininginasafe,no-riskenvi-ronment.Byutilizingacombinationoftasktrainers,mannequinsimulatorsandstandardizedpatients,sanfordemployeeswillhaveachancetolearnnewskillsandimprovetheprocess,accuracyanddeliv-eryofeveryaspectofpatientcare.

“Thecenterwillhelppreparesanfordstafftoofferexceptionalcarebyprovid-ing practice in the latest techniques,treatments and collaborative problemsolvingmethods,”saidBeckynelson,sanfordhealthseniorVicePresidentandchiefoperatingofficer.“Thisstate-of-thearttrainingfacilitywillalsobeusedforcutting-edgeresearchintohowsimu-lation-basedlearningcanimpactclinicaljudgment,interdisciplinarycollaborationandpatientoutcomes.”

Twosimulationsuites,twohigh-tech

debriefingroomsandamulti-facetedtasktrainerroommakeupthe2,400square-footfacilitylocatedatthesanfordhealthcenter for learning in the sanfordstevenscenter.

Thesanfordsimulationcenterwill

alsobemadeavailableinthefuturetocommunitymembers,suchasfirefighters,emergencymedicaltechniciansandfirstrespondersaswellasotherorganizationsand companies that have simulatedlearningneeds.■

Thomas Repas, D.O., First Physician to Receive CPI Certification in South Dakota

Sanford opens Simulation Training Center

Inpatient Medically Complex Program

The 18-bed specialty hospital at Children’s Care offers cost-effective care for children through age 21 who need 24-hour medical monitoring. Services include:

• IV Medication Delivery • Suctioning, Oxygen Administration

• Tracheostomy Care • Ventilator Use & Weaning

• Skilled Nursing Observation following casting or surgeries

• Nutritional therapy via gastrostomy, jeujostomy, NG or NJ

Call Rebecca Weeldreyer, RN, for details: (605) 782-2475

Our specialty hospital provides excellent 24-hour nursing care for your pediatric patients!

CHILDREN’S CARE HOSPITAL & SCHOOLFor Children with Special Needs and Their Families

2501 W. 26th St., Sioux Falls, SD 57105-2498 (605) 782-2300 www.cchs.org

James Wallace, MD Medical Director of Respiratory Care Services

Julie Johnson, MD Medical Director of Rehabilitation Services

The AVerA TrAnsPlAnT insti-tuteinsiouxfallsiscollaboratingwithAurora st. luke’s Medical center ofMilwaukeetoprovidelivertransplantscomplementedby local pre- andpost-transplant care. This program savespatients in the sioux falls area fromhaving tospendup tosixmonthsatatransplantcenterinanotherstate.

The Avera Transplant institute atAveraMcKennanhospital&Universityhealthcenteriscurrentlydevelopingitsownlivertransplantprogramtoaddtoitskidney,pancreasandbonemarrowtransplantprograms.inits17-yearhis-tory,theAveraTransplantinstitutehasprovidedmorethan800solidorganandbonemarrowtransplants.

Averahastwotransplantsurgeonsandtwohepatologists.inaddition,sur-geonsrotatebetweenAveraandAurora

transplantprograms,increasingdepthandbreadthoftransplantsurgeryexperi-enceandcoverage.

“Wehavethespecialistsandexper-tise inplace tocareforvirtuallyanydisease of the liver or hepatobiliarysystem,”saiddr.TariqKhan,hepatobili-arysurgeonwithAveraTransplant&hepatobiliarysurgery.Allhepatobiliarycasesarereviewedataweeklyconfer-ence by a multidisciplinary team,including hepatologists, oncologists,pathologists,interventionalradiologistsandsurgeons.

“Manycasescanbecaredforentirelyinsiouxfalls,becausenoteverypatientwithliverdiseaseneedsalivertrans-plant.Andforthosepatientswhodoneedalivertransplant,wenowhaveapro-gramincollaborationwithMilwaukee,”dr.Khansaid.

dr.heshamelgouhari,hepatologistwiththeAveracenterforliverdisease,saidtherearemanystagesintransplantcare.Theprocessbeginswithpre-trans-plant evaluation and testing by amultidisciplinaryteaminsiouxfalls.if thepatient isdeemedtobea livertransplantcandidate,heorsheisaddedtoawaiting list,basedona scoringsystemwhichdetermineshowurgenttheneedis.

Afterapatientislistedfortransplant,medicalstaffinMilwaukeedeterminewhen the patient needs to come toMilwaukeeinadvanceofsurgery,andtemporaryhousingisarranged.Aftersurgery,patientsarehospitalizeduntiltheyarewellenoughtobedischarged.


Hospital collaboration brings liver transplant care closer to home

Dr Elgouhari Dr. Khan


DOUG BURGC O M M E R C I A L P H O T O G R A P H Y

P E O P L E 9 P R O D U C T S ; T E C H N O L O G Y 9 A R C H I T E C T U R E ; L I F E S T Y L E 9 F O O D ; M E D I C A L

d o u g @ b u r g s t u d i o s . c o m7 1 2 / 2 5 1 / 6 0 0 0 • b u r g s t u d i o s . c o m

N O W O F F E R I N G P H O T O G R A P H Y W O R K S H O P Si n t e n s i v e f u l l - d a y a n d h a l f - d a y o n e - o n - o n e p h o t o w o r k s h o p s • y o u r s c h e d u l e , y o u r l e v e l

g e t f r o m w h e r e y o u a r e t o w h e r e y o u w a n t t o b e3 0 y e a r s c o m m e r c i a l a n d f i n e a r t e x p e r i e n c e • 3 y e a r s t e a c h i n g c o l l e g e p h o t o c l a s s e s

MED ad Doug June 2010:Layout 1 7/12/10 10:45 AM Page 1

Patientscanreceive theirpost-trans-plant care in sioux falls, with anyneededpost-transplanthospitalizationatAveraMcKennan.

dr.elgouharisaysthecooperativearrangement withMilwaukee bringsAveraMcKennanastepclosertooffer-ingitsownlivertransplantprogram,andishelpingtopreparetheAveraTrans-plantinstituteteamforthatday.■

FDA Approves Oral Anticoagulant Tested by Regional Heart DoctorsreGionAlheArTdocTors andareapatientshelpedpavethewayforanimportant new advance in heart care,

announced last month. The fdArecently approved the first new oralanticoagulant medication in 50 years.Pradaxa has been approved for theprevention of stroke and blood clotsin patients with atrial fibrillation.regional heart doctors Black hillscardiovascular research was thefourthlargesttestsiteinthenationforthe trial of Pradaxa®,with 74 patientparticipants.

AccordingtothefdA,atrialfibril-lation affects more than 2 millionAmericans and is one of the mostcommon types of abnormal heartrhythm.Peoplewithatrialfibrillationhave an increased riskofdevelopingbloodclots,whichcancauseadisablingstrokeiftheclotstraveltothebrain.

The re-lY® clinical drug studycompared Pradaxa® with the long-prescribed anticoagulant warfarin(alsoknownbybrandnamescoumadin,Jantoven,Marevan,lawarin,andWar-farin).inanoct.19newsrelease,thefdAstatedpatients takingPradaxa®

hadfewerstrokesthanthosewhotookwarfarin. Additionally, patients onPradaxadonotneedtoundergoperiodicblood monitoring as they do withwarfarin.

“regionalheartdoctorsandourpatientsareproudtohaveparticipatedinadrugstudythatwillmakeadiffer-encein the livesofsomanypeople,”saidrogerderaad,regionalheartdoctorsresearchdirector.“Warfarin,alsoknownascoumadin,hasbeentheonlybloodclotpreventingdrugoptionfor many years. its side effects arenumerousandtherearemanypeoplewhocouldnotbeprescribedthedrugduetoriskofthosecomplications.ourlocalparticipationcontributedsignifi-cantlytowardtheapprovalofasafeandeffectivealternativetowarfarin.Thisissubstantialnewsandweareexcitedtohaveplayedapartinit.”

regionalheartdoctorsandBlackhills cardiovascular research arecurrently participating in more than30clinicaltrials.■

December 2010 17MidwestMedicalEdition.comDecember 2010 17

An esTiMATed 3,600 PeoPleattended the Building hope Gala onfriday, oct. 29, celebrating the grandopeningof theAveracancer instituteand Avera surgery center, located inthePrairiecenteronthemaincampusof AveraMcKennan hospital & Uni-versityhealthcenter.

championcyclistandcancersurvivorlanceArmstrongwaskeynotespeakerattheblack-tieoptionalGala.Armstrongbattledandbeattesticularcancerwhichhadspreadtomajororgans,andlaterwentontowinsevenTourdefrancetitles.hundredsturnedouttoridewithArmstronginaTwitterride,whichbeganfromtheAveraMcKennancampusat4p.m.theafternoonoftheGala.Alsospeaking at the gala was dr. davidKapaska, newly appointed regional

presidentandceoofAveraMcKennanhospital&Universityhealthcenter.

TheprogramwasheldinahugetentjustwestofthePrairiecenter;therestofthegalatookplaceonthreefloorsoftheAveracancerinstituteaswellastheAverasurgerycenteronfourthfloor.eachfloorfeatureddifferentfoodbuffetsandlivemusic.

The Prairie center is the largestbuildingprojectinAverahistoryatatotalcostof$93million.Thefive-story,260,000-square-footbuildinghasspaceequivalenttofiveacres.fromconceptiontoopening,thecenterwasthreeyearsin themaking.Most cancer servicesincludingdiagnosticimaging,radiationtherapy, chemotherapy, and, in somecases,same-daysurgery–areavailableinthenewcenter.■

Avera

Celebrates

Grand

Opening

with

Building Hope Gala

Lance Armstrong, Michelle Lavallee, David Kapaska

18

American Cancer Society Awards

CeO Cancer “GOlD

STANDArD” AwArD

TheAMericAn cAncer socieTY AnnoUnces ThAT AveraMcKennan hospital & University health system has become a ceocancer Gold standard company, certified by the ceoroundtable oncancer. Joining such national companies as the dana farber cancer

institute, Johnson & Johnson and Md Anderson, Avera McKennan is the firstemployerinsouthdakotatoreceivethisdistinction.

TheceocancerGoldstandardaccreditationrecognizesthecommitmentoforganizationstoreducingtheriskofcancerforemployeesandtheirfamiliesbypromotinghealthylifestylechoices,encouragingearlydetectionthroughcancerscreeningsandensuringaccesstoqualitytreatment.AveraMcKennanpartneredwith theAmericancancersociety’scorporaterelationsWorkplacesolutionsprogramalongthewaytotheaccreditation.Workplacesolutionshelpscompaniesconnecttheiremployeeswithhealthandwellnessprogramsthatreducetheirriskofcancer.

“TheAmericancancersocietysalutesAveraMcKennan’scommitmenttohelpingtheiremployeestolivehealthierandlongerlives,”saidlaurieJensenWunder,Vice-PresidentofMissiondelivery,Americancancersocietyinsiouxfalls.

TheAmericancancersocietyestimatesthatthisyearinsouthdakota,morethan4,000peoplewillbediagnosedwithcancerand1600willdieofthedisease.AveraMcKennan is one of 69 hospitals nationwide to receive theceoGoldstandardaccreditation.■

By Charlotte Hofer, American Cancer Society


Before inpatient or outpatient surgery,ask your doctor about Sioux Falls Surgical Hospital.

Befoask your do

9 1 0 E . 2 0 t h S t r e e t , S i o u x F a l l s6 0 5 - 3 3 4 - 6 7 3 0 • w w w . s f s u r g i c a l . c o m

WE LEAD.For 25 years, we’ve set the standard

for quality and patient care.

dr.dAVidKAPAsKAhasavariedresume,frombasketballrecruiterandcoach,toU.s.Airforcepilot,tosalesand marketing rep, to family practi-tioner to chief medical officer. eachexperiencehasuniquelypreparedhimforhisnewest roleasregionalPresi-dent and ceo of Avera McKennanhospital & University health centerinsiouxfalls.

PreviouslyseniorvicepresidentforMedicalAffairsatAveraMcKennan,dr.Kapaskawasnamed the16th topadministrator in the100-yearhistoryofAveraMcKennan.hesucceedsfredslunecka,whohasbeennamedchiefoperatingofficerforAverahealth.

raised in sac city, iowa, dr.Kapaskawent to theU.s.AirforceAcademy incoloradospringsonabasketball scholarship. After pilottraining,UsAfcapt.Kapaska f lewthec-141cargojetasapilotandair-craftcommanderforatotalof2,500hoursworldwide,intheVietnamcon-f lict aswell aspeacetimemissions.

duringhisservice in theAirforce,heearnedhisMBAatsouthernilli-noisUniversity.

Afteraciviliancareerasasalesandmarketingmanager,dr.Kapaska theUniversityofosteopathicMedicineindesMoines.he completed a familypractice residency at iowa lutheranhospitalandpracticedfamilymedicinefor10yearsiniowa.Aftercompletingagraduateprograminmedicalmanage-ment with the American college ofPhysicianexecutives,dr.KapaskacametoAveraMcKennanaschiefmedicalofficerin1999.

hesays it isagrowing trend forphysicianstoserveinhospitaladmin-istrativeroles.

“There’sarealizationthatweneedphysicianswhoaremoreengaged inthe intricaciesofhospitaloperations.infact,90percentofthecostsofcaringforpatientsareorderedbyphysicians.forphysiciansnottobepartofmanage-mentandcostcontainmentmaybeabigoversight.”■

Kapaska named Ceo of Avera McKennan Hospital & University Health Center

Midwest Medical Edition 20 Midwest Medical Edition

Grape Expectations

Add Some ‘Sparkle’ to Your Holidays

iABsolUTelY loVe the holi-days.ilovethesnowandhelpingmy kids write their christmaswishliststosanta.ilovehearing

BingcrosbyanddavidBowie’s“littledrummer Boy” duet which, by theway,isthebestchristmassongever.ievenlovethecrazyandfranticpaceinourstorethatdoesn’tenduntilthefirstof January. And my husband and ireallylovesparklingwine.

Theterm“sparklingwine”encom-passesallwineswhichhaveacertainamountofeffervescenceor“fizz”.spar-klingcanonlybecalledchampagneifitcomesfromthechampagneregionoffrance.ProseccoandAstiarefromitaly,cavaisfromspain,sektfromGermanyandsparklingwinefromeverywhereelse.Whereverithailsfrom,thereisjustsomethingaboutthefestivenatureofasparklingwinethatcan,withonesip,reviveyoursenses,cleanseyourpalate,refreshyourmindandjusttastegreat.

Unfortunately,onlyasmallpercent-ageofwinebuyersconsumesparklingwine other than during the holidaysfromThanksgivingtonewYear’seve.Although closely associated with

celebrations such as weddings, babyshowersorshiplaunches,ihavecomeupwithmy own list of celebrations.howaboutgettingthroughatoughdayatwork?orhey,thekidsareinbedandmyhusbandandihaveaquiethouralonetogether.otherfavoritesincludegettingthelaundrydone,thesunisshiningandthewindchillisn’tbelowzero.

AsMadameBollingeroncesaid,“idrinkchampagnewheniamhappy,andwheniamsad.sometimesidrink itwheni’malone.Whenihavecompany,iconsideritobligatory.itriflewithitifi’mnothungryanddrinkitwheniam.otherwiseinever touch it–unlessiamthirsty.”from1941to1971MadameBollinger ran the prestigious frenchchampagnehouse,doublingitsalestomore than amillion bottles. in 1969MadameBollingeralsointroducedthefirstchampagnetobemadeexclusivelyfrompinotnoirgrapes.Untilthenandstill today,most champagneswere ablend of chardonnay, pinot noir andpinotmeunier.

sparklerscanvarygreatlyinprice,butthereisabottleforeverybudgetjustasthereisastyletosuiteveryone’staste.Theycanrangefromverysweetsuchas

anitalianMoscatod’Asti,toabonedryfrenchextraBrut.ifyoulikechardonnay,perhapsyoucanbeginwithaBlancdeBlanc,meaningthewinewasonlymadewithchardon-naygrapes.ifyouareaPinotnoirfantrytheBlancdenoirstylemade

withonlypinotnoirgrapes.And i am serious

whenitellyouthathotbutteredpopcornandanextradrystylesparklingisagreatpairing!ifyouarenotthepopcorntype, then try sushi especiallywhenlightly seasoned with the traditionalginger,wasabiandsoysauce.

Morethananythingsparklingwineisastateofmind.sayitwithme,“iamspecialanddeservesparklingwine!”Thereisanticipationintheopeningofthebottle,hearingthehissofthereleaseasyougentlyremovethecork,thepour-ingofthewineintothefluteandfeelingthelightspritzofliquidonyourfaceasyoubringtheglasstoyourlips.Withover56millionbubblesinabottleofchampagne, how could one not findcelebration and joy in every glass?remember,youarespecialanddeservesparklingwine!■

By Heather Taylor Boysen


Under The cUrrenTstandard of amputee care,success is too often mea-sured inhowfarapatient

canwalk,insteadofhowwellheorshewalks. Unfortunately, being able towalk300feetdownastraighthallway,or being able to navigate a few smallenvironmental barriers, doesn’t dem-onstratethatanamputee’sgaitisfullyoptimized. With the current standardof care, amputees are more likely toexhibitpoorgaitmechanicsthatproduce:a trunk forward posture, decreasedstancetimeontheirprosthesis,increasedloadingontotheirsoundside,andevenacompensatorylimp.

Amputeesconstitutelessthan5per-centofthetotalrehabilitationpopulation.Most therapists only see one or twoamputeecasesayear,makingitdifficultto develop the expertise required togenerate the outcomes that are trulypossible.

somehospitalsystemstrytobetterservethispopulationbyholdingmonthly“Amputeeclinics”.Whiletheconceptisgood,itstillleavesthepatienttravel-lingbackandforthbetweenthetherapistand the prosthetist for weekly care,whichcanbetimeconsuming,frustrat-ing,inefficientandineffective.

Whenapatientexperiencesproblemsunderthecurrentsystemofcare,athera-pistcanonlycalloremailtheprosthetistherunderstandingoftheproblem.iftheprosthetistcan’tseetheissuefirst-handinthetherapysetting,itismuchharder

toknowhowtorectifytheproblem.eachtimeaproblemgoesunsolved,thepatientreturns to therapyunable toperformexercisesandactivitiesmeanttoimprovetheirfunction.

A BeTTeR APPRoACHAnytherapistwhohasgaittrainedan

amputeewithhighleveltherapytech-niqueshaslearnedthatanill-fittingormisalignedprosthesis doesn’t upholdtherapyactivities.Thisisespeciallytrueintheearlystagesoflimblossrehabilita-tionwhentheresiduallimbundergoesthe greatest amount of change. it isimportantthatlimblossrehabilitationstartswithspecificisometricmatexer-cisethatbeginstobuildafoundationofstrength to support upright standingposture.

oncethepatientgraduatestostand-ingactivitieswiththeprosthesis,focusshiftstowardcontinuingstrengthbuild-ing under single leg weight bearingconditionswithsomewalking.

ifaprosthesisbecomeslooseduetolimbshrinkage,thesocketpressuresarenotmaintainedinweighttolerantareas.This loss-of-limb to socket interfacereducesthepatient’scontrolofthepros-thesis, and their ability to properlymanagetheirbodymechanics.ifthefitoftheprosthesisisnotproperlymain-tained, weight-bearing exercises/activitieswillnotbepossible.Thisisthetimewherethereneedstobeseamlesscoordinationbetweenprosthetist andtherapist;bothworkingtobalancepros-theticfitwiththerapyactivities.

Whenapropergaithasbeenestab-lishedandtherehabfocusswitchestoendurancetraining,thisisagreattimeforthetherapistandprosthetisttoana-lyze the patient’s gait and fine tuneprostheticalignment.Arehabilitationprograminwhichthetherapistandtheprosthetistworkinthesamefacilitycandirectapatienttowardbuildingaqualityandfunctionalgait thatyieldsamorefavorableoutcome.itisimpossibleforapatienttomakemeaningfulprogressintherapyifthefitofapatient’sprosthesisisn’tmonitoredandadjustedthroughoutallstagesofgaittraining.

BeYond PHYSICAl THeRAPYoncenewpatientsexcelinaquality

rehabprogram,theimportanceofpros-thetictechnologycannotbeoverstated.someofthenewestsocketinterfaceandsuspensiontechnologyembracestheuseofelevatedvacuumappliedwithinthesocket.fortherightcandidate,vacuumtechnologyprovidestheweareragreatmanybenefitsincludinglimbvolumemanagement, improved linkage andincreasedprostheticcontrol.

Whenawell-fittingsocketandsus-pendedsocketispairedwithoneoftwonewprostheticfeet,patientsatisfactionandfunctionaregreatlyenhanced.ThePropriofootandechelonbothprovidewearerswithimprovedgroundcompli-ance.Bothfeetprovideincreasedanklemovement, inbothplantarflexionanddorsiflexion, improving theability towalkonunevengroundaswellaslevelterrain.■

101 Part 2

Amputee Rehabilitation

By Jeff Boonstra, CP

Midwest Medical Edition 22 Midwest Medical Edition 22

TheBoArdofdirecTorsoftheMake-A-Wish foundation® of southdakota has named Paul Krueger ofsiouxfallsitsnewPresidentandceo.Kruegerstartedhispositiononoctober11, replacing Mary olinger who isretiringafter18years.“iamconfidentthis whole organization will continueto thrivewith Paul at the helm,” saysBradBuche,chairoftheMake-A-WishBoard of directors.“his genuine pas-sionforthekids,alongwithhisenergyand enthusiasmwill prolongMake-A-Wishfoundation®ofsouthdakotaasoneofthebestperformingchaptersinthenation,”

Mostrecently,KruegerservedasadirectorofdevelopmentatAugustanacollege.heworkedatAugustanaformorethan11yearsandalsoworkedtwoyearsattheUniversityofsouthdakotaAlumni Association in Vermillion.KruegerholdsaB.A.injournalismandcommunicationsfromAugustanacol-lege and an M.s. in AdministrativestudiesfromtheUniversityofsouthdakota.heandhiswifeJonihavethreechildren,emily,Matthewandsarah.■

new leadership at Make-A-wish

A note from Paul KruegerI am excited to work with the staff, board of directors, volunteers,

donors, and the children and families of Make-A-Wish. To be a part

of an organization that gives so much hope and joy to families is an

honor and I look forward to sharing our important mission with

others across the state. To physicians and healthcare professionals

across South Dakota, thank you for referring children to Make-A-

Wish. To date, we have granted 858 wishes. Sixty three wishes were

granted last year. One of our goals is to make sure that every child in

South Dakota who is eligible for a wish receives one. This is where

you can continue to help us. If you know of a child who has been

diagnosed with a progressive, degenerative or malignant medical

condition, please call us at 1800-640-9198. You can learn more

about Make-A-Wish and our chapter at www.southdakota.wish.org.

Thank you for your partnership with us.

Chances are your protection is coming up short.

05-2844 The Northwestern Mutual Life Insurance Company, Milwaukee, WI (Northwestern Mutual). Michael W Mohr is an Insurance Agent of Northwestern Mutual (life and disability insurance, annuities) and a Registered Representative and Investment Adviser Representative of Northwestern Mutual Investment Services, LLC (securities), a subsidiary of Northwestern Mutual, broker-dealer, registered investment adviser and member FINRA and SIPC.

Until you retire, your most important asset is your ability to earn income. Yet the average employee disability program covers only about 60% of your salary. At Northwestern Mutual, we offer disability insurance that can help close the gap, leaving you and your income protected if you’re sick or hurt and unable to work.

Michael Mohr Financial AdvisorThe Lowrey Financial Group(605) 995 - 0300 michaelmohr-nm.com

Let it be known that seven new physicians have joined Sanford Children’s and that we

have added three new specialties: pediatric urology, pediatric nephrology and pediatric

infectious disease.

No longer is it necessary to travel to lands far away for the best care. That care can be

found right here in the Castle of Care™. Sanford Children’s team of pediatricians and

pediatric specialists is ready to meet the unique medical needs of all of the children in

our region.

We at Sanford Children’s welcome our newest members and we look forward to the

opportunity to meet the needs of those we serve.

sanfordchildrens.org

Hear ye, hear ye...

Carl Galloway, MD

Pediatric Hospitalist

John Sanders, MD

Pediatric Nephrology

Mir H. Ali, MDPediatric Critical Care

Maria A. Carrillo Marquez, MD

Pediatric Infectious Disease

Romano DeMarco, MD

Pediatric Urology

Margaret Clarke, MD

Pediatric Critical Care

Kudzai Vengesa, MD

General Pediatrics

Aberdeen

500-54300-0283

24

national Research Corporation names Sanford Medical Centers

“ToP HoSPITAlS”for The fifTh YeAr in A roW,sanfordUsdMedicalcentersiouxfallsandsanfordMedicalcenter fargo havebeenselectedbynationalresearchcor-poration as consumer choice Awardwinners. The award identifies hospitalswhichhealthcareconsumershavechosenashaving thehighestqualityand imageinover300marketsthroughouttheU.s.

GinnyMartin, President of nrc’sTicker division, said winners aredetermined by consumer perceptionsonmultiple quality and image ratingscollected in the company’shealthcareMarketGuideTickerstudy.ofthe3,200hospitals named by consumers in thestudy,thewinningfacilitiesrankhighestin their core Based statistical Areas(cBsAs),asdefinedbytheUscensusBureau.TheTickerstudysurveyedover250,000 households representing over450,000 consumers in the contiguous

48statesandthedistrictofcolumbia.“healthcarehasbecomeanincreas-

inglyimportantissueacrossthecountryandempoweredconsumersaremakingdecisions for themselves and theirfamilieswhenselectingtheirhealthcarefacilities and services,” Martin said.“Theseconsumerchoiceawardwinnersexemplify the dedication it takes toprovidequalityhealthcaretotheircom-munities,andwearepleased tohonorthemthroughtheeyesoftheirpatients.”

nrc’sTickersurveyisthenation’slargestandmostcomprehensivestudyofitskind.nootherstudyusedtomeasurehospital performance andpreferencescontainsmoreconsumerresponsesthannrc’sstudy.Thestudyhasamarginoferrorof+or–0.2percentatanationallevel.co-winnersarenamedwhenscoresfallwithinthestatisticalmarginoferrorforagivenmarket.■

Have you read a book, seen a movie, heard a concert, etc. that moved you? Whether it made you mad or make you

laugh, MED wants to help you share it with your colleagues. Send your reviews to [email protected]

reviewed by Patty Peters, MD

House Calls and Hitching Posts Stories from Dr. Elton Lehman’s Career Among the Amish

As told to dorcas Sharp Hoover

house Calls and Hitching Posts astoldtodorcassharphoovertells the story of dr. elton

lehman,ageneralpractitionerwhohasworked with the Pennsylvania Amishpopulation since the 1960’s. i found itfascinatingtoreadhowheworkedinhisfirstofficeinhishomewithhisteacher-wifeashisassistant.TheAmishdidnotusetelephones,cars,orevenelectricity

so this doctor’s medical practice wasunderstandably challenging. in 1998,dr. lehman was named the countrydoctor of the Year as well as familyPhysicianoftheyearbytheohiostatesociety of the American college ofosteopathicfamilyPhysicians.

iwouldrecommendittoanyonewhoisinterestedinsomerecenthistoryofhowacountrydoctorworkedwithout

beepersandcellphones.Thisbookalsodoesagoodjobofportrayingthespiri-tualsidetomedicine.itisaquickread,butthestoriesreallycometolifewhentheauthortalksaboutdeliveringbabiesat farmhousesandduringblizzards.overall,ifoundittobeagoodrepresen-tationofthetruecalltobeaphysician,alongwith all of its heartaches andfulfillments.■

NudgeImproving Decisions About Health, Wealth, and Happiness

By Richard H Thaler and Cass R Sunstein.

reviewed by Kenneth M. Scott, MD

What You’re Reading, Watching, Hearing

In Review

25MidwestMedicalEdition.comDecember 2010 MidwestMedicalEdition.com

nudge: Improving Decisions about Health, Wealth and Happiness byrichardThaler

andcasssunsteindiscussesthathowachoiceispresentedeffectswhichchoicepeople will tend tomake. it also dis-cusseshowinstitutionsandindividualsareusing thisknowledge to intention-allynudgeus toward the choices theywouldpreferustomake.

Bothauthorsareprofessors,oneintheUniversity of chicago school ofBusinessandtheotherintheharvardUniversityschooloflaw.Theyreferto

anyoneresponsiblefororganizingthecontextofourchoicesasa“choicearchi-tect”.Thesechoicearchitectscannudgechoicestowardtheirfavoredresultsbymanipulatingthewaytheoptionsarepresentedtothechooser.

Asphysicians,wearenearthetopofthe authors’ list of choice architectsbecausewepresentourpatientswithtreatmentoptionseveryday.Wearealsoon theotherendaswemakeendlesschoiceseverydayinthegrocerystore,cellphonestoreandalsowheninteract-ingwith administrators, government

agencies, and insurance companies.Theseagenciesallhavetheirownrea-sons to nudge us into making thedecisionsthattheywouldprefer.

i highly recommend this book. itremindedmehowbiasescancreepintomanydecisionsimakeoroffertoothersandcouldhaveasignificanteffectonmylifeandprofession.Keepingtheselessonsinmindhelpsmetobeamoreinformedconsumerbutalso remindsmeofmyresponsibilitiesasachoicearchitectformypatientsandstaff.■


WorKPlAceslipsandfallsfrequentlyresultinsevereinjuriesrequiringextensiveandexpensive

recoveryandlosttime.A slip/trip/fall prevention team

canbeavaluableassetinthereductionoftheseincidentsthroughoutahealth-care facility. Teammembers shouldincluderepresentativesfromenviron-mentalservices,arepresentativefromadministration, safetyofficer(s),anddepartmentalsupervisorsoremployeerepresentatives from at risk areas.Proactive tasks for the preventionteamcaninclude:

completing a hazard assessmenttwiceeachyearinallareasofthefacilitytoidentifydangersincludinginadequatelighting,loosetiles,uneventhresholds,curledmats,cracks inpave-ment, slippery surfaces,poolingwater,poordrainage,damagedsteps,triphazardsorobstructionsinwalkways.

reviewing the facility’shistory of slip/trip/fallincidents to identify trends.incidents should be investi-gated immediately andthoroughly to determine therootcause.

Problem-solvingandimplementinganyneededchangesinprocedure,envi-ronmentalstructure,equipmentorstaffeducationbasedonthehazardortrendassessments.

distributing and enforcing afootwearpolicywhichencouragesthewearofclosed-toe,closed-heel,secure-fitting footwear, with an anti-slipsoft rubber sole indented with deeptreadsorchannels.

reviewinghousekeepingpracticesand cleaners used on floors. floorcleanerdatasheetsshouldbereviewedto assure that slippery surfaces are

notcreated.floorwaxesshouldhavenon-slipcharacter-istics which donot decrease thecoefficientoffric-tion for the floor.Appropriate de-greasing cleanersshouldbeused infoodserviceareas.

o v e r s e e i n gon-going preven-t ion e f fo r t sincluding layingout appropriate

lengthmattingatallentrances,provid-ing umbrella bags at employee andvisitorentrancesonrainydays,apply-ing icemelt inadvanceofandafterprecipitation,placingbucketsofsalt/sandmixtureatemployeeexitsduringwintermonths, providing a regularsupplyofabsorbentmaterialstostaffforquickcleanupofspills,andhang-ingawarenessposters indesignatedemployeeareas.

A little teameffortcangoa longway in reducing the frequency ofemployee,patientandvisitorslip/fallincidents.■

lori Berdahl is an Occupational Therapist

and holds the Certified Ergonomic Evaluation

Specialist designation. She is an Ergonomic

and Loss Control Specialist with Risk

Administration Services in Sioux Falls, SD.

Slips, Trips and Falls in the WorkplaceBy Lori Berdahl, OTr/L, CEES

Six Tips for Avoiding

Workplace Injuries

1. Conduct hazard assessment twice each year

2. Review the facility’s history of slip/trip /fall incidents

3. Problem-solve and implement any needed changes in procedure

4. Implement a work-place footwear policy

5. Review housekeeping practices and cleaners used on floors

6. Oversee on-going prevention efforts

Slips, trips and falls are the second leading cause of workplace injury in the healthcare industry.

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iThAsBeenABUsYyearforthenewbornandPediatriccriti-cal care Transport Team atchildren’s hospital & Medical

centerinomaha.onTuesday,nov.2the team marked its 500th patienttransporttripof2010.

“in all of 2009,wewent on 216transportcalls.Tomore thandoublethatnumberoverashortertimeframeshows significant need for this ser-vice,” says robert chaplin, Md,medical director of the children’scriticalcareTransportTeam.october2010wasa record-settingmonth forchildren’swith67transports.Thehos-pitalanticipatestheteamcouldreach600totalpatienttransportsbytheendoftheyear.

children’s hospital & Medical

centerbeganofferingspecializedtrans-portservicesin2006withthecreationofthehospital’sneonataltransportteamfor newborns and infants up to twomonthsofage.inseptember2009,chil-dren’sexpandeditsprogramtoincludepediatrictransportserviceforallotherages.Theteamservesnebraska,west-erniowa,northernMissouri,northernKansas,easterncoloradoandsouthdakota.

infall2009,children’spartneredwith American Medical response(AMr)toprovidegroundtransporta-tion in its own dedicated pediatricambulance.inJuly2010,thechildren’sTransportTeampartneredwithlifenet,inassociationwithAirMethodscorpo-ration,toprovidehelicopterserviceforthesickestchildren.

Theteamhasbeenpresentfor thedeliveryofnewbornswithanticipatedcomplications,andin2010has trans-portedthesebabies(justminutesold),aswellaschildrenthroughage18,fromhospitalsandmedicalcarecenters innebraska,iowa,KansasandMissouri.The shortest trip by ambulance thisyearhasbeenjustshyoftwomilestoTheAmbassadoromaha.Thelongestambulancejourneytooktheteam182miles north to o’neill, nebraska.They’vecoveredroughlythesamedis-tancebyairwiththelongesthelicopterflighttakingthemtoKearney.

Thechildren’snewbornandPediat-ric critical care Transport Team isavailable24/7byphysicianreferralandrequestviathePhysicians’Priorityline,1.888.592.7955.■

Children’s Newborn and Pediatric Transport Team

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new service aims to make on-Call less stressfulA company called first call, llc isofferingauniqueservicetohelplessenthe‘oncall’burdenforareaphysicians.staffedbyobstetric-trainedrns,PAsand nPs, and using protocols devel-opedbyobGynphysicians,firstcallwilldirectafter-hourscalls toanursefirstwhocan advisepatients on acuteproblems.firstcallnursesaretrainedtodeterminethelevelofurgencyofthecallandeitherofferappropriateadviceor decide whether physician involve-ment is needed. The goal is to allowphysicianstoenjoyalessstressfulcallschedule,while ensuring that patientsareservedquicklyandaccurately.Thenewbusinessisbasedinsiouxfalls.■


TheGoredforWoMenconfer-ence andluncheonwill take place atthe sioux falls convention centerfrom10am–1pmfebruary25,2011.The American health Association-sponsoredconferenceincludesmorningbreakout sessions, in which womenandmen can learn about their risk ofheartdiseaseandhowtodecreasethatrisk,andasilentauctionandluncheonincluding an inspirational keynotespeaker.

TheGoredforWomenconferenceattractedmorethan500peopleineast-ern south dakota who support thecause,includinghealthcareprofession-als,businessleaders,legislativeleaders,culturalleaders,communityleaders,andcitizens.Theluncheonaimstoeducateattendeesabouttheirriskofheartdiseaseandstroke–thenumberoneandnumberthreekillers–andwhattheycandoto

decrease that risk. italsoencouragesattendeestospreadthewordthroughoutthecommunity,includingamongat-riskpopulations like native Americans,hispanic Americans, and AfricanAmericans.

The auction raises money forresearch,awareness,andeducation.inthepast2yearsinsouthdakota,forevery dollar raised, the Americanheart Association has spent threedollars on research, education andawareness.Thisyear’s luncheonfea-tures a special group of men andwomencalledthecircleofred,featur-ing those who have made a $500personalcommitmenttotheAmericanheartAssociation.cardiologistTomstysofsanfordhealth isoneof thechief organizers of the event. findmore informationatwww.heart.org/southdakota.■

February 25, 2011.10 am – 1 pm

Conference and LuncheonSioux Falls

Convention Center

The cenTers for diseAsecontrol and Prevention has inviteddr. donald Warne to serve on theAdvisory committee on Breastcancer in Young Women, a federaladvisory committee established bythe Affordable care Act, subject toprescribed appointment procedures.dr. Warne was recently nameddirector of native American healthat sanford health. he is the formerMedical director of the AberdeenArea Tribal chairmen’s healthBoard,aswellastheformerPresidentoftheBoardofthenativeAmerican

communityhealthcenter, inc., andPresident andceo of theAmericanindianhealthManagement&Policy,inc.(AihMP).

inhisroleonthecdccommittee,dr.Warnewillhelptodevelopinitiativestoincreaseknowledgeofbreasthealthandbreastcanceramongwomen,par-ticularlyamongthoseundertheageof40 and those, such as the Americanindianpopulation,atheightenedriskfordevelopingthedisease.

dr.Warne isoneof15 clinicianschosenforthecommitteefromaroundthecountry.■

CdC names local Physician to Advisory Committee on Breast Cancer in Young women

national wear Red day

Friday February 04, 2011

AHA ‘Go red’ Conference Set for February


News & NotesHappenings around the region

regioNalJames Engelbrecht, M.D., and Shari Fechner,certifiednursePractitioner(cnP)havejoinedthestaffofregionalMedicalclinic.engelbrechtspecializesinrheumatologyandearnedhismedicaldegreefromtheUniversityofiowa.hecompletedhisinternalmedicineresidencyandrheumatologyfellowshipattheUniversityofUtahAffiliatedhospitalsinsaltlakecity.sharifechner,cnP,alsospecializesinrheumatology.

Borders Books Music & Cafe in rapid Citywillteamupwithchildren’sMiraclenetwork(cMn)tobringnewtoysandbookstochildreninthehospitalthisholidayseason.Borderswillsellnewchildren’sholidaygiftitemsandhaveadonationdropboxintheirrapidcitystorefromnov.2throughdec.24.ThegiftswillbedonatedtocMnandgiventochildreninthePediatricsdepartmentatrapidcityregionalhospitalfortheholidays.

Five regional Medical Clinicsrecently received awards formaintainingimmunizationratesof90percentorgreaterwhileservingchildrenbetween24and35monthsold.GoldensyringeAward(clinicswith50ormoreclientsinthe24-35monthagegroup):MassaBerryregionalMedicalclinic,sturgis,spearfishregionalMedicalclinic.consistentlyMaintainingAward(clinicswithatleastfiveclientsinthe24-25monthagegroup):BellefourcheregionalMedicalclinic,BuffaloregionalMedicalclinic,newellregionalMedicalclinic.spearfishregionalMedicalclinichasreceivedtheGoldensyringeAwardconsistentlyforthepastfouryears.

Aroundthistimenextyear, Queen City regional Medical Clinicpatientsinspearfishwillenteranewly-expandedandrenovatedfacility.Theclinicbrokegroundinnovemberona$5million,14,000-square-footconstructionprojectthatwillallowfortheadditionofnewclinicservices,enhancedpatientcare,

centralizedpatientcareareas,andmoreconvenientparking.TheprojectalsoincludesanextensiveremodelofspearfishregionalMedicalclinic,whichwillfollowthecompletionofQueencityinearly2012.

averaThe first STAr Ankle replacement surgeryintheregionwasperformedinearlynovemberatAveraMcKennanhospital.sTAristhelatesttechnologyforanklereplacementapprovedbythefdA.itofferscertainadvantagesoverothertypesofartificialjointsforreplacementofarthriticanklejoints.Avera McKennanhospital&Universityhealthcenterinsiouxfallshasbeennamedasoneof10 “Trailblazing Hospitals” nationwideforinnovationbyfiercehealthcare.fiercehealthcarerecognizeshospitals

thatarenotonlyconsideredamongthebestaccordingtonationalrankingorganizations,butalsoareconsideredtobetechnologicallyinnovative.Twoconsiderationswereusedtodeterminewhichhospitalsweremost“innovative”:Thehospitalhadtoappearonatleastoneofthreemajorlistswhichrankhighqualityhospitals(healthGrades,Thomsonreuters,orU.s.news&Worldreport’slistofbestU.s.hospitals)andtheorganizationhadtoappearoneitherthe“MostWired”and/or“MostWireless”hospitalslistscompiledbyhospitals&healthnetworksMagazine.

Avera Medical Group and Orthopedic Consultants/Alvine Foot & Ankle Center announcedanewpartnershipeffectiveinnovember.ThenewentitywillbecalledcoreorthopedicsAveraMedicalGroup.

saNfordNorth Dakota seniors cannowchoosesanfordselectfortheirMedicaresupplementinsuranceneeds.Thenorthdakotainsurancedepartmenthascompleteditsapprovalprocess,allowingindependentlocalagentstooffersanfordhealthPlan’sMedicareselectsupplementalhealthinsuranceplaninsoutheastnorthdakotaandastandardMedicaresupplementproducttoresidentsacrossnorthdakota.

otherCheri Kraemer, Pharm.D,ownerofPharmacyspecialties,inc.insiouxfallsrecentlyreceivedtheOutstanding Service alumniawardfromsdsU.ofthe75,000alumni,fewerthan300havebeenchosenforsuchanaward.shewasnominatedbythecollegeofpharmacyandchosenbythealumnicommittee.Pharmacyspecialties,inc.isanindependentlyownedcompounding-onlypharmacythatopenedin2001.

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Happenings around the region

Learning Opportunities

December 2010 and February 2011

December 1, 2010 Internal Medicine Grand rounds: Survivors of Pediatric Cancer: 12:00 pm From Specialty to Primary Care location:sanfordschoolofMedicine–hsc–room106 creditsoffered:AMAPrAcategory1–1.00;Attendance–1.00

December 10, 2010 Obstetrics and Gynecology Grand rounds: TBA

12:00 pm location:sanfordschoolofMedicine–hsc–room106 creditsoffered:AMAPrAcategory1–1.00;Attendance–1.00

December 10, 2010 Internal Medicine Grand rounds: Obstetrics and Gynecology 12:00 pm location:sanfordschoolofMedicine–hsc–room106 creditsoffered:AMAPrAcategory1–1.00;Attendance–1.00

Just for fun….

December 19, 2010 Children’s Care Holiday Jam! Featuring the Hegg Brothers 4:00 pm location:orpheumTheatreinformation:www.cchs.org

December 30, 2010 Test event: Psychiatry winter Update8:00 am location:sanfordschoolofMedicine,Testfacility,confroom1creditsoffered:AMAPrA category1–1.00;Attendance–1.00

February 3–5, 2011 SDAFP winter Seminar location:Thelodgeatdeadwood information:www.sdafp.org cMeoffered:Upto70,withfollow-upmaterials

February 16, 17, 2011 Fundamental Critical Care Support Program8 am – 5 pm location:AveraMcKennaneducationcenter,classroom1information:605-322-8950

February 25, 2011 American Heart Association, GO reD FOr wOMeN Conference

location:siouxfallsconventioncenter information:heart.org/southdakota

MED reaches more than 3000 doctors and other healthcare professionals across our region 8 times a year. If you know of an

upcoming class, seminar, webinar, or other educational event in the region in which these clinicians may want to participate, help us

share it in MED. Send your submissions for the Learning Opportunities calendar to the editor at [email protected].

Lakeport Commons4830 Sergeant RoadSioux City, IA 51106

712-255-7229

The Bridges at 57th2109 West 57th StreetSioux Falls, SD 57108

605-338-9060

In whose hands will you place her?

Physicians’ Priority Line 1.888.592.7955

www.ChildrensOmaha.org

Intensive Care for Newborns

When a newborn is critically ill, a single call gives you instant access to our neonatal intensive care specialists and a full range of pediatric and surgical subspecialists, all supported by state-of-the-art technology and equipment. It can also link you to our neonatal transport service team, who will arrange for transport to Children’s Hospital & Medical Center based on the child’s needs. Twenty-four hours a day, seven days a week, one call links you to physician-to-physician consults, referrals and admissions. There’s no problem too large, no child too small.

MEd Midwest Med Ed, Nov, 2010.indd 1 11/8/10 10:48 AM

med-midwest medical edition-december 2010

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