When Counting Sheep Fails

O, to sleep, to dream, and to wake up without feeling beat up , exhausted, and ready for a nap. Sleep apnea, restless legs, insomnias, parasomnias–there are categories and subcategories of all that steals sleep. Quite a few sleep disorders will actually affect good health: sleep terrors, REM disorders, obstructive sleep apnea can with frequency affect mental as well as physical health. Fortunately there are sleep study centers today, and in Valley City is lucky enough to have one.

CHI Mercy Health has opened a sleep center in the hospital. The center is run by Whitney Sleep Diagnostics & Consultants of Detroit Lakes, and coordinated by Karen Burchill for the hospital. The studies are conducted right in the hospital and patients receive follow up from a Board Certified Sleep Specialist.

“Traditionally in a smaller town,” said Jim Dunn, “the patient and his or her healthcare provider saw the results of the sleep study for the first time together and had to figure out what it all meant. Now the patient can talk directly to the Sleep Specialist who interprets their study via telemedicine right at CHI Mercy. We are able to diagnose, treat and provide continued follow up for most sleep disorders right in Valley City.” Dunn is Whitney Sleep’s Director of Business Development, and a Whitney Sleep success story himself.

There are eighty-four different sleep disorders, said Dunn, with insomnias the most prevalent, but Obstructive Sleep Apnea are the most commonly worked with.

“Obstructive Sleep Apnea,” said Dunn, “is a condition where the muscles in the back of the throat fail to keep the airway open despite efforts to breathe. People with sleep apnea have these pauses in breathing anywhere from 100 to 300 (or more) times each night. In most patients that are referred for a sleep study, we are able to do what we call a split night study. This is where we use the first half of the night to evaluate the patient’s sleep. If the patient displays enough breathing disturbances, we will use the remainder of the night to put the patient on CPAP therapy and manipulate the pressure to make sure the patient is breathing properly in all phases of sleep and in all body positions. Follow up with the Sleep Specialist takes place in a separate appointment.”

Dunn understands the full benefit of healthy sleep. In 2007, he had his sleep study done and learned he stopped breathing 25 times an hour. After starting CPAP therapy, he immediately noticed he had more energy, was more productive at work and at home, and was just in a better mood all day. “You don’t know how bad your sleep is until it is corrected,” he said. “I have never met anyone who said they wish they had waited longer to address their sleep.”

There is a simple diagnostic chart that may indicate a need for a sleep study. Snoring, excessive daily fatigue, hypertension, a large neck size are among the symptoms and an individual who exhibits two or more should consult a doctor, who may then refer the individual for a sleep study. Patients for the sleep studies are all referred by a healthcare provider.

For more information, contact CHI Mercy Health at 845-6400. Or ask your physician to refer you to Mercy for a sleep study with Whitney.

ASIST–Suicide Intervention at the HEC

Have you ever lost someone to suicide? Learn suicide prevention skills May 4 and 5, with Wellness in the Valley.

ASIST is Applied Suicide Intervention Skills Training, and is a two-day work-shop for all community members. ASIST develops and enhance the skills to intervene with a person at risk of suicide until either the immediate risk is reduced. The training, developed by LivingWorks Education Inc., is divided into four learning modules: attitudes, knowledge, intervention and resources. Skills and principles are illustrated with case studies, presented in videos, role-play simulations, discussions, and the Suicide Intervention Handbook. The workshop prepares suicide first aid caregivers to integrate intervention principles into everyday practice.

The ASIST training will be conducted by trainers certified by LivingWorks Inc., as accomplished practitioners in suicide prevention, intervention, and aftercare. Trainers are Debbie Anderson MS, LPC, NCC, Wellness in the Valley, and Cindy Miller, Executive Director, First Link.

Register by April 15, for ASIST Upgrade 11, May 4 and 5, 8:30 a.m. to 4:30 p.m., at CHI Mercy Hospital, in the Health Education Center. Class size is limited to 25 participants and will be first come first serve, so please register ASAP.

For more information on the program or how to register, contact Wellness in the Valley, 570 Chautauqua Blvd, Valley City, 701-845-6436

Setting the Body at Ease

clark-krutaClark Kruta knows what pain is. He’s had it, lived with it, and ultimately man-aged it. The patients he sees know that, and the new ones learn that. Kruta has true empathy for their suffering, and just as significantly has experienced the techniques he uses to relieve their pain. Kruta also has more than twenty-three years as a certi-fied nurse anesthetist and has more than fifteen years in pain management using in-terventional therapies.

Relieving pain isn’t just about prescribing some pills. It isn’t just a pharmaceu-tical solution. The therapies, the interventional therapies that Kruta employs for pain management are rather diverse and can incorporate radiological imaging for therapeu-tic pain injections. There are epidural steroid injections, sacroiliac injections, and trigger point injections, all with a specific purpose and desired result.

“Pain management therapy begins with a referral from a provider, and then is about administering an analgesic,” said Kruta. “It isn’t about masking the pain. Pain management uses anesthetics or an anti-inflammatory drug targeting a specific spot to help relax the muscles or reduce inflammation. The purpose is at that point to en-courage the body to heal itself.”

Kruta picked up model of vertebrae. “Here,” he said, pointing, “is where the spinal cord runs. Nerves run through here,” pointing again, “and out to the body. When there’s, say, neck pain due to a degenerating disc, I slip a needle in right here and into the epidural layer of the cord, which isn’t very big. The anti-inflammatory re-lieves the pain.”

Kruta just doesn’t sit down with a patient and start the therapy. He first visits with the patient, looking at history, and pinpoints the source and location of the cause of the pain. Pain in the leg may actually originate in the back. Kruta must know ex-actly where the source is for the therapy to be effective.

“Trigger point injections are used when a muscle is virtually cramped up and won’t relax,” Kruta said. “It can cause a person to list to one side when walking and affect other muscles and joints. I inject an anesthetic into the trigger point of the af-fected muscle which allows the muscle to relax, and the healing to begin.”

Sacroiliac injections help with the low back and cushions the spine from the hip and the impact of walking. When the SI joint (as it’s called) is inflamed pain can run from to the groin, abdomen, leg, and can be the cause of sciatic pain. This injection uses radiological imaging to administer the medication. The medication contains both an analgesic and a pain killer to relieve tissue swelling, as with a trigger point, and to reduce pain.

“How we offer pain management therapy at CHI Mercy Health,” said Kruta, “is a little different than how it’s offered anywhere around here. We do things a little differently. At other facilities the patient has to come back for a second shot for most therapies. I administer both at the same time. It’s cheaper for the patient, and it offers better relief. Instead of administering an analgesic and then have the patient come back for the trigger point injection, for instance, I administer both the same day. The healing can begin right then. It’s a much more effective therapy.”
For more information on therapeutic pain management, contact CHI Mercy Health at 845-6522. Follow us on Twitter and Facebook.

A Festival of Giving

November 29, was a night of laughter, furious bidding, beautifully decorated Christmas trees, and remarkable generosity. This year’s Festival of Trees was a full house at the Eagle’s Club in Valley City. The Festival is an annual fundraiser hosted by CHI Mercy Health Foundation, raising money for the hospital.

This year, the Foundation was raising money for the Physical Therapy Department and new equipment. The Foundation raised $17,000 this year for our Physical Therapy Department. which is well on the way to the $24,000 needed to purchase the four pieces of equipment.

There was the live auction of the Christmas trees and sprays and mantle pieces. There was a silent auction. And new this year was the auction of an elegant leather purse, donated by Sanford Health, by the designer Dooney and Bourke. What made the leather purse even more appealing was the cash stuffed inside as the purse was passed among the crowd. Donna and Lloyd Nelson won the purse, and the $310 inside.

A New England Shrimp Boil Experience was purchased by the Dwight and Robbin Kiefert family, which they enjoyed over the past weekend. Rum cake for dessert! There was the Deluxe Trip raffle this year with a selection of vacation destinations: Boston, New Orleans, and the Cancun vacation won by Misty Anderson.

The beautiful quilt made by Pat Langemo, quilted by Cindy Fitzner, and sponsored by Dacotah Plains Co-op and Inter Community Telephone was won by Amber Olson.

The CHI Mercy Health Foundation thanks everyone who came, with a special thank you to the CHI Mercy Health Auxilary, who contributed $1000 to the FOT, and to National Medical Resources Inc., who contributed $4000 as event sponsors!

For more information on the Foundation or the Physical Therapy Department, call 845-6400.

Rating Hospitals Is Customer Service

So you get home from the hospital. You were there for an MRI, or a short stay, an operation, the reason doesn’t matter, but you were there and now you’re home. A week later you receive a phone call from a very polite operator asking if you’ll take a quick survey about your “experience.” You’re courteous, have a few minutes to spare, and say, Yes, I’ll take the survey. Not knowing that you’re rating, nationally, the hospital.

The unwieldy name for this survey is “Hospital Consumer Assessment of Healthcare Providers and Systems,” thankfully “HCAHPS” (pronounced “H-Caps”) for short. This is the measure of all hospitals in the country. You may think this is just another customer satisfaction survey, one that will go to someone somewhere in management and get lost in an inboxes shortly thereafter.

But this survey is, according to Keith Heuser, Market President at CHI Mercy Health in Valley City, a standardized survey for data collection for measuring patients’ perspectives on hospital care. The survey, says the Centers for Medicare & Medicaid Services, in Baltimore, MD, “is designed to produce comparable data on the patient’s perspective on care that allows objective and meaningful comparisons between hospitals on domains that are important to consumers.”

The HCAHPS survey contains 21 patient perspectives on care and patient rating items ranging from communication with doctors and nurses; responsiveness of hospital staff; pain management; communication about medicines; discharge information; cleanliness and quietness of the hospital environment; and the transition of care. The survey is used for accountability and transparency when appraising the quality of hospital care, and is used by Medicare for reimbursement to hospitals.

Unlike typical customer satisfaction surveys where there is a grade of measurements (“Please rate from 1 to 10, with 1 the lowest and 10 the highest…”) with the HCAHPS survey of hospitals, Medicare uses the “always” response for their comparisons, so any other response is not taken into account for the statistical comparisons.

Negative scores are reported back to the hospital individually for management to act on but are not considered in the comparisons. And narrative responses are always shared with the facility but are, again, not counted in comparing hospitals to each other.

“This is where we really see ourselves improving the the patient experience here at Mercy,” said Heuser. “It is our job, our profession, to make certain that each and every patient we see has every reason to rate us in the top box. And residents of this com-munity need to know that we are offering, truly, transparently, and objectively, the very best care they can receive anywhere.”

CHI Mercy Health, said Heuser, asks that patients please take the few minutes to answer the survey questions. Watch over the next year, he said, as results become implemented.

For more information, contact 701-845-6400. Follow us on Facebook and on Twitter.

A Theater Performing Daily

chi-catarcts-orCHI Cataracts O.R.–Cataract surgery is performed right here at CHI Mercy Health.

CHI Endoscope–This endoscope is brand new, bought for the O.R. by the CHI Mercy Foundation. Anesthesia is provided for all ‘scopes, something not done elsewhere.
Well almost daily. There are some months when one or two days pass without a performance of some type. When the actors gather and perform for only one, who, after observing the staging, sleeps through the rest of the production.

The actors are surgical personnel, doctors and nurses; the audience of one is a surgical patient; and the performance is a surgical procedure. The theater is the operating theater, the surgical unit, at CHI Mercy Health in Valley City, where every month between 30 and 60 procedures are conducted.

“We can perform quite a variety of surgical procedures right here,” said Stephanie Kruta, Nursing Director for OR at CHI Mercy Health. “We have three general surgeons, a general dentist, a family practice physician and an ophthalmologist. We have a CRNA, certified registered nurse anesthetist, right here at Mercy, who can also help with pain management.”

The surgical procedures at CHI Mercy Health range from endoscopies of upper G.I. and colonoscopies, to cataracts, and general surgeries (gall bladder removal, hernias, feeding tube placement). The dental surgery, said Kruta, is often for special-needs patients. The CRNA provides anesthesia for endoscopies, something not done elsewhere.

“So many people don’t realize they can get exceptional care right here in town,” said Kruta. “We are local, closer to home, and all anyone has to do is ask their provider to schedule their surgery right here at CHI Mercy. We know the patients and they know us. We have a very high patient satisfaction–we won an award last year. We also have a zero percent infection rate here at Mercy, which is far lower than Sanford or Essentia. Nationally, the rate is five- to eight percent–and we have zero surgical site infections for the last two years. Local care, patient satisfaction, and a wonderful facility. This is the place to have a surgery.”
For more information on surgery at CHI Mercy Health, call 701-845-6400. Follow us on Twitter and Facebook.

CHI Mercy Health Is a Winner

stephaniekrutawinner

Congratulations to Our Winner! Stephanie Kruta was presented her Unit Specific Award for Outpatient-Same Day Surgery by CHI Mercy Health President Keith Heuser.

CHI Mercy Health is a winner because of Stephanie Kruta, who won a HealthStream Award of Excellence for Outpatient-Same Day Surgery. Kruta is the Nurse Manager for Surgery. Award winners are recognized based on data collected from the 2013 calendar year.

The awards acknowledges exceptional performance achieved by healthcare organizations with the use of our solutions–spotlighting innovative programs and superior leadership that support organizational excellence, workforce development, patient satisfaction, employee engagement, positive community perception, and more. It is an honor to recognize our customers’ dedication to methods and processes that lead to quality improvements and, in turn, improved patient outcomes.

Excellence Through Insight Award Winners

These awards recognize hospitals that excel in their ability to gain insight about their patients, employees, physicians, and community through research and use that information to build excellence within their organization.

Swing Beds Aren’t for the Front Porch

A rural hospital must be many things to many people. It is a trauma center for emergencies. A facility that accommodates equipment and technology offering MRI’s to endoscopy to pain management. And are medical centers with surgical facilities and with the means of caring for the ill. Swing bed units are what rural hospitals can offer the people in their communities and have available for patients’ recovery, with skilled nursing care.

CHI Mercy Health is one of those rural hospitals, because it’s a Critical Access Hospital (CAH) and a Medicare provider. CHI Mercy can use its rooms, “beds” as they’re called, to provide patients with either acute or skilled nursing facility (SNF) care–the beds therefore “swing” between the two. The swing bed (also called transitional care unit) concept allows a hospital to use its beds interchangeably for either acute-care or recovery care.

This is a great asset to a area like Barnes County. Patients don’t need to go to a nursing home to recover; they can recover at the hospital. Swing bed units can be used to rehabilitate patients recovering from surgeries, illnesses, or accidents. Debbie Anderson MS LPC NCC, our director of social and behavior services states, “During a swing bed stay,” said Debbie Anderson MS LPC NCC, “the staff here at CHI Mercy Health work as a team to rehabilitate the body, mind, and spirit of the patients. We feel it is a valuable part of their rehabilitation; the psychosocial aspect is as equally important as the medical side of things, if not more important.” Anderson is the Director of Social and Behavior Services at CHI Mercy Health.

Any patient receiving Medicare benefits is eligible for a swing bed stay after three-day qualifying stay in the hospital or nursing home. The three-day requirement does not apply to non-Medicare patients. There is no Medicare requirement to place a swing bed patient in a nursing home, and there are no requirements for transfer agreements between hospitals and nursing homes.

Swing bed unit at CHI Mercy Health is a wonderful alternative from either going home too early, or into a nursing home. A patient can recover in a private hospital room setting, receiving care, therapies, and discharge planning services to make certain that the patient is taken well care of in their home community while in recovery.

“Swing bed patients aren’t ill,” said Anderson. “They’re in recovery and rehabilitation, and stay here for therapy or for safe keeping until their families can take them home, or find the nursing home placement that meets the family needs, and these stays can be for extended periods of time because there is no length of stay restriction for any hospital swing bed patient.”

It’s that extra time healing, recovering, that’s so important. The longer the patient can stay, the better the outcome. “If they’re participating in activities, they’re eating, said Anderson. “And if they’re eating, they’re healing. It all works together, as do we, often forming close bonds with patients and their families. It’s one of the advantages of working in a small community hospital.”

For more information on taking advantage of a swing bed stay and skilled nursing care during recovery, call CHI Mercy Hospital, 701-845-6400.

Cleanliness Is the Best Preparedness

Truly, there is no need for panic. Yes, Ebola is a deadly disease, but there are many others out there. But with any disease, being prepared is the best offense. And in fact, Ebola is quite easily contained and eliminated with simple, everyday cleaning products.

CHI Mercy Health is preparing for Ebola, but there’s no reason for panic. CHI Mercy Health prepares for the flu season every year, too. And bad colds, respiratory illnesses, and anything else that goes around especially in the winter. We always prepare because our patients need protecting–their health is often already weakened.

“We are working on plans right now to prepare and protect our staff,” said Susan Kringlie, Infection Preventionist at CHI Mercy Health. “There’s no need to worry–there’s been lots in the news lately–but we have plans locally and at the state and federal government levels.”

The Ebola virus isn’t airborne, said Kringlie. The transmission of the virus occurs with direct contact of blood or body fluids. A person needs to actually touch the infected individual blood or body fluids, if the person is infectious.

“The virus just doesn’t fly in the air,” said Kringlie. “It can only be transmitted and contracted through contact with the blood or body fluid of the infected patient. Washing hands and equipment cleaning is very, very important.”

The Ebola is easily killed with simple cleaning products. “The Ebola virus is an easily killed virus,” said Kringlie, “much like the cold virus. So if you use bleach, or EPA-approved disinfectants, that should stop the transmission. So don’t be afraid, and wash your hands.” Which is why cleanliness is the best preparedness, not only for Ebola, but for every disease, including influenza or the Flu.
For more information, contact Susan Kringlie, at 845-6447.

Mammograms at Mercy: National Breast Cancer Awareness Month

“Not too many people know we do mammograms right here,” said Barbara Waite-Clark. “We have the latest in digital technology right here in this hospital, and it’s a lot more comfortable and personable right here.” Waite-Clark is a Mammographer and Radiologic Technologist at CHI Mercy Health in Valley City, ND.

One in eight women in the U.S., will develop invasive breast cancer over the course of their lifetimes, Waite-Clark said, and is emphatic that women have a mammogram once a year. “The fact is that women should begin having mammograms when they turn forty,” she said, “because by the time they turn fifty, it could be too late. Breast cancer needs to be caught early. It’s not the number of women who develop breast cancer, but it’s how young they are when they do. We need to catch it early.”

CHI Mercy Health has offered mammograms for a number of years, but in Valley City this is a hidden gem of a health service offered right at the hospital. The equipment used for mammography at Mercy is all digital. The room large and private. And it all is easily accessible, especially for the handicapped.

Women should get their yearly screening from their primary caregiver, and then call as no referral is needed, to CHI Mercy Health to make an appointment.

For more information on mammography and mammograms and CHI Mercy Health, call the Radiology department at 701-845-6441. And Like us on Facebook, and follow us on Twitter for events and timely and topical health tips.

Mercy Is Prepared for the Flu

Flu season is fast approaching and health care facilities around the country are preparing. CHI Mercy Health, in Valley City, has stocked flu vaccines to give all its pa-tients and its frontline staff–nurses, doctors, aides–who come into contact daily with the most vulnerable.

“We are prepared again this year,” said Susan Kringlie, Infection Control Practitioner at Mercy. “We have plenty of doses for our employees and in-patients. We feel that it’s very important to assure the safety of our patients, visitors and staff. That is why we promote the use of flu vaccinations every year. And there is enough vaccine available in the country so the shut down of the one facility won’t affect anyone.”

CHI Mercy Health uses a trivalent vaccine, which inoculates for three different viruses. Mercy plans to vaccinate employees within the coming weeks.

For more information, contact CHI Mercy Health, or for topical and timely posts and videos, go to our Facebook page.

Keep Up with Us

CHI Mercy Health has a Facebook page and Twitter account. You can keep up with what’s going on at the hospital and foundation during the month, and log on to find out about any weather-related notices or health concerns for our patients.

Go to Facebook, CHI Mercy Health, “Like” us, and follow us on Twitter, @CHIMercyVCND, and keep up with what’s happening with the Mercy community–your community.

Patients and families provide an important voice

Acting on national research that suggests patients and families can help hospitals improve safety and the patient experience, CHI Mercy Health has a Patient and Family Advisory Council (PFAC).

“Our goal is to partner with patients and families, along with staff from our hospital, to identify practices, policies and safety initiatives that will benefit from patient and family input,” said Stephanie Kruta, BSN, MSN, OR manager and PFAC lead. “While patient satisfaction, safety and quality have always been a focus, the Patient & Family Advisory council helps us better understand what’s important to patients and their families to contribute to improved care.”

The CHI Mercy Health Patient & Family Advisory Council meets quarterly, the advisory council works hand-in-hand with staff and administrators to bring about changes that make the care experience better for patients and their families.

Nationally, patient and family advisory councils have brought about helpful changes. Since its conception in 2011, CHI Mercy Health’s Patient & Family Advisory Council has helped form a new patient directory, develops menu choices and provided guidance around communication on medications.

If you are interested in learning more about CHI Mercy Health’s Patient & Family Advisory Council or would like to consider volunteering on the council, please contact Alana Wendel, ER Manager at 701-845-6400.

We’re listening. Learn how you may be able to help us make care better.

Safety First Inspires New Safety Culture at CHI Mercy Health

Mistakes happen. But at CHI Mercy Health, work is under way to eliminate mistakes that harm patients.

SafetyFirst is a multi-faceted program that will strengthen the organization’s commitment to always put patient, employee and medical staff safety first. This initiative helps CHI Mercy Health instill a new safety culture and reach its goal of zero safety errors that harm patients.

Employees and members of CHI Mercy Health’s medical staff participated in safety and error-prevention training learning behaviors proven to significantly reduce the number of safety errors in other health care organizations. Doctors and nurses at CHI Mercy Health have already adopted techniques used by “highly reliable” industries, such as naval and commercial aviation, and nuclear power. Some of these SafetyFirst techniques include: daily check in, safety coaches and mandatory education on SafetyFirst techniques for all new employees to CHI Mercy Health. Daily check in occurs Monday thru Friday and involve one member from each department of the hospital. At this morning huddle, each person reports on any safety concerns for staff or patients. This allows all departments to know if the concern is of value to their department and allows for managers to take away issues to make changes to help prevent safety related concerns. Safety coaches received additional training in SafetyFirst coaching and are involved with not only direct observations of care and SafetyFirst techniques but also in coaching and encouraging staff to use the tools that they have learned. The coaches meet monthly to talk about concerns and receive feedback and guidance in handling various opportunities to coach staff in safety techniques.

SafetyFirst is a national strategy coordinated by Catholic health Initiatives (CHI), CHI Mercy Health’s parent organization. CHI will continue to implement and optimize SafetyFirst over the next few years.

CHI Mercy Health Laboratory Updates Equipment

The CHI Mercy Health Laboratory has recently upgraded several analyzers used to perform medical testing. The “workhorse” of the department is the new Siemens Dimension EXL 200, which performs many chemistry tests twice as fast as the previous model. Everything from blood sugar (Glucose) to thyroid (TSH) to diagnostic testing for heart attacks (Troponin-I), the EXL 200 does it all!

Another upgrade to improve turn-around-time for faster test results is the Abbott I-stat. This analyzer performs lab tests on a small amount of blood in a very small timeframe. For example, patients who arrive in the Emergency Room for heart attacks, strokes or major accidents can report lab results quickly to help the provider determine the diagnosis or treatment in real time.

We are proud to serve our patients and community for your fast, accurate and reliable lab testing, 24 hours a day, 7 days a week! All you need is an order for Lab testing from your provider to have your blood drawn at Mercy Hospital. Please contact the Laboratory at 701-845-6447 with any questions.