In thIs Issue

2Letter From the CEO

Provider Directory

3Survivor Praises Cancer Screenings

4New Equipment, Physicians for Emergency Care

5Be Prepared for Emergencies

6Home Medical Equipment

Eye Care Expands in Region

7Stroke Screenings, Know Your Health Risks

8Patient Prefers Avera Marshall Emergency Department

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m a r s h a l l , m I n n e s o t a

Emergency Care You Can Trust

Minneota Resident tuRns to aveRa MaRshall FoR eMeRgency caRe

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letter From the Ceo

2 Copyright 2010, Avera Health. All Rights Reserved

Health care reform: Three words with a huge impact on providers and consumers alike. This year’s legislative session created heightened awareness as debates about health care insurance, payments and delivery system changes came to the forefront. No doubt, most consumers were a little concerned over some of the proposals. Certainly, proposed health care reform changes were followed closely by rural hospitals such as Avera Marshall.

As Avera Marshall continues to expand services into the region and add specialists to the medical staff, we are seeing firsthand what health care reform means to people needing care. Access to experienced providers, topnotch technology and being able to avoid travel are important to our consumers. The stories of how we impact the lives of individuals and families who have experienced an illness or injury really confirm the important work being done every day by 400-plus staff at Avera Marshall.

As Marshall’s third largest employer, we affect the economy in countless ways, and we know people rely on us to be ready should they have a need. Our investments and updates are necessary to stay on the cutting edge of skill and technology, but maintaining dollars to keep that lead is becoming more challenging. Insurance reimbursements to hospitals are shrinking,

costs for hospitals and nursing homes continue to grow, and industry integration is becoming the norm. We have also seen greater numbers of uninsured people and shifting of health care costs to patients in the form of higher deductibles and co-pays. Along with that, some simply cannot afford health care services, so they delay care for themselves and their family members. Finally, charity care and bad debt write-offs have steadily increased, a trend seen by many nonprofit hospitals.

With a new fiscal year beginning in July, our attention has moved to details of financial planning for the year ahead, including how to do more with less and keep our services strong. I am particularly proud of many of our staff who have kept their spirits high and their commitment to our patients strong as we weather challenging shortfalls and changes in the health care arena.

As we continue to grow, no doubt there will be challenges, but the future for Avera Marshall remains strong. Your health is important to us, and we want to be your first choice for care. Thank you for your continued support and trust in our providers and services.

In service,

Mary Maertens, President and CEO

Provider Directory

Av e r A m A r s h A l l r eg i o n A l m e d i c A l c e nt e r www.AveraMarshall.org

Paul Puetz, chair Jim Fuhrmann, vice chairBob Byrnes Randy GaffneyMary MaertensArt OlsonSr. Joan ReicheltMike RichSr. JoAnn SturzlJill VromanSr. Jodelle Zimmerman

Specialty care available in MarShall avera MarShall board of directorS

* Member of Avera Medical Group

Avera Marshall Grows During Challenging Times

emergency MedicineTim Hindbjorgen, MD * coming summer 2011 Terence Parr, MD *Omer Qureishy, MD *Ed Wolske, MD *Additional physicians provided by Wapiti, Inc. and ACI Inc.

family MedicineKristina England, MDLaurie Hill, MDBill Kremer, MDSteven Meister, MDTom Odland, MDGary Skrien, MDJill Vroman, DOJane Willett, DOJim Zwach, MD

General SurgeryGordon Bos, MD Michael Schneider, MD *

hospitalistPaul McHenry, MD *Additional physicians provided by Wapiti, Inc.

internal MedicineJoe Willett, DO

obstetrics/GynecologyKevin Gildner, MD * Donna R. Hartfiel, MD *Raymond Michael, MD

ophthalmologyChris Buntrock, MD *Ted Fritsche, MD *Curtis Louwagie, MD *

optometryNancy L. Hemmingson, OD * Roger D. Pabst, OD *

orthopedicsJohn Kemp, MD * Anthony Nwakama, MD

pediatricsAtul Mishra, MD

psychiatryTimothy Beyer, DO *Christi Leach, MD *

radiologyServices provided by Suburban Radiologic Consultants

allergy Amy Ellingson, MD

audiologyLinda Grong, Au.D. Melissa L. Tvete, Au.D.

bariatricsLaurie Hill, MDStephanie McKee, PA-C

cardiologyRaymond Allen, MDC. Thomas Gaeckle, MD Sean Halligan, MDChristopher Paa, MD

dermatologyBrian Knutson, MD

ear, nose, throat (ent)/otolaryngologyJonathan Mellema, MDKenneth Rogotzke, DO

GastroenterologyCharles Ulrich, MD

hematology/oncologyMark Huber, MD

nephrologyOleg Georgiev, MDRichard Jensen, MD

orthopedicsEvan Hermanson, MDEric Watson, MD

pathologyServices provided by Physicians Laboratory

perinatologyNaomi Wahl, MD

physiatryJonathan Stone, MD

podiatryMichael DeBrule, DPMMark Johnston, DPM

pulmonologyBrian Hurley, MD

UrologySheila Gemar, MDKevin Unger, MD

Wound, ostomy, incontinence care Valerie Buysse, RNRuth Lanoue, RNRhonda Lee, RNCourtney Pohlen, RN

Medical Staff at avera MarShall

3

avera MarShall board of directorS

i n g r e At Health Summer2010tm

Avera Marshall Grows During Challenging Times

ue Ann Moyars is passionate about early cancer detection. She’s so passionate, in fact, that she talks openly about her own breast-cancer diagnosis and experience at Avera Marshall in the hope that it will encourage others to have cancer screenings.

“My family and I decided to share my story because people may not know they can have screenings done in Marshall, and not everybody does what I did,” comments Sue Ann, a 35-year-old mother of two from Tracy. “If one person goes in and gets checked after hearing my story, that’s more than I could hope for.”

Sue Ann was diagnosed with a stage-3 invasive ductal carcinoma in June 2009 after she noticed a very slight change in her breast.

“If you notice any change in your body, please have it checked by your physician,” she urges.

Sue Ann was impressed with the care she received at Avera Marshall – first with her gynecologist, Dr. Donna Hartfiel at Avera Marshall Specialty Clinic, then with Pam Peyton at Avera Marshall Imaging Center and then with surgeon Dr. Michael Schneider at Avera Marshall Specialty Clinic.

“They read my mammogram right away, and they scheduled the ultrasound on the same visit at Avera Marshall. Pam stayed with me the whole time; she was wonderful that day,” Sue Ann says. “Later, Dr. Schneider spent more than two hours explaining everything to us. He made a very difficult time a little less stressful.”

Throughout treatment, Sue Ann had two mastectomies, a hysterectomy, chemotherapy and radiation. She appreciates that she was able to do many of her treatments, procedures and follow-up appointments locally. “It was awesomely convenient, especially when you’re not feeling well,” she adds.

Sue Ann and her family are staunch advocates of screenings for early detection available right at Avera Marshall. “Part of this whole cancer thing is easier because I have a local team that I trust and respect.”

SUEAnnMoyARSShARESExpERiEncEtohElpothERS

ancer SurvivorPraises Benefits of Early Detection

To schedule an appointment for a mammogram, call (877) 537-9189. Ask about programs at Avera Marshall (like the Sage program) that help cover the cost of mammograms.

S

Are you TOUGH enough to wear PINK?

Show your support for breast cancer awareness – purchase a Tough Enough to Wear Pink T-shirt!

shirts are on sale at the avera marshall Gift shop. the Gift shop is located at the main entrance of the hospital and is open monday-Friday from 9 a.m. to 4:30 p.m. You can also purchase shirts at lockwood motors on east College Drive in marshall or the marshall hy-Vee on east main street. shirts will also be sold at the PrCa rodeo at the lyon County Fair in august. shirts are $10 each for sizes youth small through adult extra-large. larger sizes are available for $12.

Proceeds will support efforts in the fight against breast cancer at avera marshall.

Also wAtch for the tough enough to weAr Pink truck in AreA PArAdes!

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“If one person goes in and gets checked after hearing my story, that’s more than I could hope for.”

– Sue Ann Moyars

Photo of Sue Ann Moyars and daughters used with permission of Jossie’s Photography in Walnut Grove, Minn.

r. Terence Parr appreciates that as an Emergency Department physician at Avera Marshall, he has the opportunity to get to know patients better than he would at a metro hospital. And for patients, that means they get better care.

“I saw a patient yesterday whom I’d seen four times before,” says Dr. Parr, a physician who works full-time in Avera

Marshall’s Emergency Department. “I knew the patient’s medical history, and I could sit and talk to him and really know his needs.”

New physicians, new high-tech medical equipment and a change in staffing methods have combined to make Avera Marshall a great choice for your emergency care needs.

e EmergencyconnectsphysicianstoSpecialistsThis year, Avera Marshall has implemented e Emergency, an innovative program that links emergency-trained physicians and rural physicians to provide 24-hour access to specialty care. e Emergency links two-way audio and video equipment between Avera Marshall and a hub located in Sioux Falls, S.D. The around-the-clock e Emergency team supports the Marshall physicians through access to a consult on request and ensures immediate emergency care.

“e Emergency helps us better stabilize and serve the patient,” says Dr. Parr. “We assess and care for the patient as we normally would. Then we use the cutting-edge technology of e Emergency so that we can have a consultation with another physician.”

Dr. Parr finds e Emergency to be more beneficial than having a phone conference only with a specialty physician. “The technology allows the specialist to have a visual and audible assessment of the patient,” Dr. Parr says. “Having specialists available for this allows us to put two heads together and provide even better care for patients.”

Avera Marshall also uses AveraeicU®cARE, which similarly links Avera Marshall physicians in the Intensive Care Unit with critical-care specialists at a hub location and uses sophisticated technology and alerts to monitor patients’ vital signs.

eICU® is a registered trademark of Visicu, Inc.

changesKeeppatientsnearhomeinanEmergencyPatients of the Avera Marshall Emergency Department have more access to resources and the ability to stay in Marshall for care, thanks to a recent trauma-level designation.

In March, Avera Marshall received a level-III trauma designation from the Minnesota Department of Health. These designations tell emergency medical providers what level of care and depth of resources are available at a hospital. A level-III designation tells emergency providers that a physician is on staff in the Emergency Department around the clock and a surgeon is rapidly available.

“Trauma patients now can come to our hospital instead of being sent immediately to another hospital,” Dr. Parr says. “We may not keep trauma patients here who are very complicated or unstable, but now we can evaluate, treat and stabilize many trauma patients at a level of care that they would expect in a bigger community.”

Emergency Care You Can Trust

Avera Marshall uses two-way audio and video equipment in the Emergency Department, which means specialty care is available 24 hours a day.

New Technology, More Avera Physicians Mean Around-the-Clock Specialty Care

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4 Av e r A m A r s h A l l r eg i o n A l m e d i c A l c e nt e r www.AveraMarshall.org

the latest teChnoloGY

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Dr. Edward Wolske confers with a member of the North Ambulance staff.

Emergency Care You Can TrustThe designation has improved care in other areas of the hospital, too. For the level-III designation, nurses who work in the Emergency Department are specially certified, which carries over into other departments.

“Nurses working in trauma or critical care need to have the same credentials for the designation,” says Angela Chesley, vice president of Patient Care Services. “So if you are a patient who has had great care in the Emergency Department and then you are admitted to the hospital, you will have the same level of care in Critical Care as you did in the Emergency Department.”

hospital-BasedEmergencyDepartmentphysiciansprovidecontinuityofcareAvera Marshall has hired physicians to provide consistent 24/7 staffing in the Emergency Department. Along with nurses and aides, they care for every type of emergency. Three emergency-trained physicians – Dr. Terence Parr, Dr. Omer

Qureishy and Dr. Edward Wolske – keep the department staffed 24 hours a day. A fourth physician, Dr. Timothy Hindbjorgen, begins in the department this year and will be full-time next summer.

In the past, Avera Marshall used doctors from medical agencies to keep the Emergency Department staffed. Having Avera Marshall physicians on staff makes a difference. “When you have the same doctors, you know what they need and how they function,” says Erin Muck, Emergency Department manager and Trauma coordinator. “You get repeat patients, and the physicians know these patients better, also.”

New Technology, More Avera Physicians Mean Around-the-Clock Specialty Care

5tm

Edward Wolske, MD

Terence Parr, MD

Omer Qureishy, MD

i n g r e At Health Summer2010

More than 300,000 Americans are treated in our nation’s emergency departments every day for a wide variety of medical conditions. Summer is an especially busy time in the emergency department. Avera Marshall’s Emergency Department is staffed by physicians, nurses and patient-care aides 24 hours a day to make sure care is here whenever you need it.

But how do you decide when a medical condition rises to the level of an emergency?

When an emergency StrikeS,

Be PrePared

n Difficulty breathing, shortness of breath

n Chest or upper abdominal pain or pressure

n Fainting, sudden dizziness, weakness

n Changes in vision n Loss of consciousnessn Seizures or convulsionsn Confusion or changes in

mental status n Any sudden or severe pain n Uncontrolled bleeding

n Severe or persistent vomiting or diarrhea

n Coughing or vomiting blood n Suicidal feelings n Difficulty speaking n Shortness of breath n Unusual abdominal pain n Severe injuries, such as

suspected broken bones, head or eye injuries

n Chokingn Suspected poisoning or

overdose, exposure to chemicalsn Domestic violence or rapen Sudden or severe headache

theAmericancollegeofEmergencyphysiciansoffersalistofwarningsignsthatindicateamedicalemergency:

emergency departments see patients based on the severity of their illnesses or injuries, not on a first-come, first-serve basis. remain calm and if time permits:

•Bringalistofmedications,includingthe nameofeachdrug,thedoseprescribed, andwhenyoutakethemedicine.

•Knowyourallergiesandtheallergic reactionsyouhaveexperienced.•Knowyourimmunizationstatus.•Bringinsuranceinformationwithyou.

Timothy Hindbjorgen, MD

6 Av e r A m A r s h A l l r eg i o n A l m e d i c A l c e nt e r www.AveraMarshall.org

For patients who need special supplies at home for their health care needs, Avera Home Medical Equipment of Marshall is the place to go.

While Avera Home Care in Marshall has closed, Avera Home Medical Equipment of Marshall continues to sell medical supplies and educate patients on equipment. The store, located at 1104 E. College Drive in Marshall, specializes in medical equipment and clinical respiratory products and services to help people live more comfortably at home.

Breast cancer survivor Sue Ann Moyars said it was very helpful to have a medical equipment provider nearby while she was going through treatments. “They brought equipment to the hospital for me after my mastectomy,” she says. “They also helped me pick out a prosthetic.”

Avera Home Medical Equipment of Marshall stocks respiratory equipment, mastectomy products, walkers, wheelchairs, therapeutic shoes, hospital beds and more. “These products help people stay at home and take care of their medical needs by themselves or with a little bit of help,” says Michelle Iott, manager of Avera Home Medical Equipment of Marshall.

The office is accredited by the Healthcare Quality Association on Accreditation and is staffed by a nurse, a respiratory therapist, a rehab clinician and three medical equipment technicians.

A member of the team is on-call for emergency needs 24 hours a day at (507) 537-7070.

your local Source for home Medical equipment

new anD noteworthY

People needing eye care now have more access to specialists. Drs. Curtis Louwagie and Chris Buntrock offer outreach care in several communities:

MARShAllAvera Marshall Southwest Ophthalmology is home to three ophthalmologists – Drs. Ted Fritsche, Curtis Louwagie and Chris Buntrock, experts in routine and specialty eye care.

Their combined experience and knowledge give patients the best in eye care. They treat many eye diseases such as macular degeneration and glaucoma, plus are available for eye emergencies such as sudden vision loss or eye trauma. In addition, they offer high-level procedures which many people may think they have to travel to have done, including injections, cataract surgery, eyelid repair, strabismus correction, retinal issues and OCT scanning to detect eye disease.

REDwooDFAllSAvera Marshall purchased PBR Optical in Redwood Falls this spring. Dr. Roger Pabst, the previous owner of PBR Optical, continues serving patients at the present location in Redwood Falls, which is now known as Avera Medical Group Optometry Redwood Falls. In addition, outreach services are provided by Dr. Louwagie on the first Tuesday of each month. 500 East Bridge Street, Redwood Falls • (507) 637-5715

oUtREAchlocAtionSMontevideo – Dr. Louwagie sees patients at the Chippewa County – Montevideo Hospital on the second and fourth Fridays each month. 824 North 11th Street, Montevideo • (800) 537-1427

Springfield – Dr. Buntrock sees patients in Springfield three days each month. 602 N. Jackson, Springfield • (507) 723-5115

Tracy – Dr. Louwagie sees patients at the PBR Optical office in Tracy one day every other month and may increase the number of days based on need. 505 State Street, Tracy • (507) 629-3230

avera Marshall expands eye care to the region

Forjust$50,learnyourriskforheartdisease.Theclinicchecks

•CalciumCT—crucialtoearly •Body-massindex(BMI) detectionofheartdisease •Cholesterolandbloodsugar•Bloodpressure

Thisisfollowedbyeducationandriskassessmentbycardiovascularexperts,diet-qualityindexandtobacco-cessationcounseling,ifneeded.

Make your appointment today! Call 1(877) AT-AVERA.

A Cardiovascular Risk-Reduction Clinic from Avera Marshall

Technician Heather Pringle tells a patient how

to use home medical equipment.

Dr. Curtis Louwagie examines a patient’s eye. Avera Marshall’s ophthalmologists provide both routine exams and specialty eye care.

7i n g r e At Health Summer2010tm

Do you have painful varicose veins? see if this procedure is right for you. to make an appointment for a free screening, call 1 (877) at-aVera.

wellness matters

vera Marshall offers two ultrasound screenings that can indicate a person’s potential for stroke or abdominal aortic aneurysm.The Avera Marshall Imaging Center offers two vascular screenings: the carotid-artery screening and the abdominal-aorta screening. Your vascular system is the entire blood-delivery system within your body including your heart, arteries and veins.

“In the past, independent, traveling companies have offered these types of services in Marshall, but not right here at the hospital,” says Libby Mertz, ultrasonographer. “We offer them at Avera Marshall so patients can have screenings when it is convenient for them, any day of the week. We believe that our combination of radiologist interpretation, state-of-the-art equipment and staff provide a higher standard of

care. If a screening shows further testing is necessary, patients can follow up with a physician.”

The carotid-artery screening measures the blood supply from the neck to the brain, and the abdominal-aorta screening measures the blood vessel that supplies blood to the whole body, including the abdomen and legs.

Both tests employ ultrasound, which uses sound waves to measure the arteries. The screenings are painless. A board-certified radiologist examines the screening images within 24 hours and sends the results to the patient by mail.

“It is important that patients share the results of their screenings with their primary-care provider,” Libby remarks.

SYMPTOMS OF STROKEStroke symptoms vary from person to person. Some people may have sudden symptoms, or symptoms might last for a few days. Some people don’t even know they have had a stroke. Here are some common symptoms:

n headachen Muscle weakness in the arm, leg or face,

usually on just one side of the bodyn numbness on one side of the bodyn difficulty speakingn vision or hearing problemsn loss of balance or coordinationn confusion or memory lossn personality changes

Risk Screenings

ScREEningSAtAvERAMARShAllcarotid-ArteryandAortic-AneurysmScreenings– these vascular screenings monitor the flow of blood in the body. cost: $40 each or both for $75. call (877) 537-9189 to make an appointment.

planetheart– An Avera cardiovascular risk-reduction clinic, checks calcium scores, blood pressure, body-mass index, cholesterol and blood sugar. cost: $50. call the Avera call center at (877) At-AverA to make an appointment.

Mammograms– these screenings check for lumps and other abnormalities in breast tissue. call (877) 537-9189 to make an appointment.

No referrals are needed. Confidential results are sent to you. You are responsible for follow up with your health care provider.

youR healthKnoWRisKs

Can Detect Probability of a Stroke

Carotid-artery ultrasound

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In thIs Issue

ary Bernardy of Minneota knew something wasn’t right when her arm felt numb in the middle the night. So she was glad to have the Emergency Department at Avera Marshall available nearby for her emergency care.

Mary, 80, had been sick all night, but the lack of feeling in her arm worried her. Her husband had a severe stroke nine years ago, so she knew the warning signs. She decided to go to Avera Marshall’s Emergency Department right away.

“When you come in with something like that, you’re a little bit scared, and they were totally helpful,” Mary says. “I can’t say enough good things. The nurses at night were wonderful. They were very comforting.”

The Avera Marshall Emergency Department staff ordered an MRI to see what was causing her illness. The results showed that she had experienced a stroke.

Once her condition was stabilized, Mary was admitted to the hospital for observation and went home the next day. Afterward, she received follow-up outpatient care and occupational therapy treatment at Avera Marshall. Mary has had only minor complications from the stroke. She has had some short-term memory loss, but it’s improving.

Mary says she’s thankful she didn’t have to travel farther than a few miles in an emergency. “I thought that part was real nice, that it didn’t involve traveling far,” she adds. “Avera Marshall is a good place to go when you don’t feel good.”

‘Good Place to Go’

Mary Bernardy Turn to page 4 to learn more about the services at Avera Marshall Emergency Department.

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isproducedbytheAveraMarshallCommunityRelationsDepartment,300SBruceStreet,Marshall,MN56258—DeannHollandandStacyNeubeck.

8 Av e r A m A r s h A l l r eg i o n A l m e d i c A l c e nt e r www.AveraMarshall.org 300 S BRucE STREET • MARSHAll, MN 56258

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