JRMC Holds Volunteer Recognition Banquet

On Tuesday, April 24th we held our Volunteer Recognition Banquet in coordination with National Healthcare Volunteer Week.  JRMC thanks the many men and women who donate over 6,500 hours to JRMC a year. Each one of them that makes the difference in the lives of those we serve.
Shirley Flieth who was recognized as the 2012 Volunteer of the Year. Shirley donated over 500 hours to JRMC this past year. Congratulations!

JRMC Seeks Affiliation Agreement to Work with Sanford Health

Jamestown Regional Medical Center will pursue an affiliation agreement with Sanford Health, the JRMC Operating Board decided unanimously last week at a planning retreat.

An affiliation agreement — the lowest level of relationship Sanford offers — would allow JRMC’s local board to retain all its decision-making powers, while also allowing JRMC to offer patients more cancer care options.

“It’s all about bringing services here,” said Connie Krapp, chairman of the JRMC Operating Board.

Should the affiliation agreement be finalized, JRMC will also be able to install and use Epic, an electronic health record system already in use by the Sanford and Essentia clinics in Jamestown.

“I think Sanford wants the relationship because they have a lot of investment in the community with the two clinics,” said Todd Hudspeth, CEO of the medical center. “They want to deliver care as close to the patients’ home as possible.”

Through cooperation with the Sanford Roger Maris Cancer Center, JRMC will be able to expand its chemotherapy offerings, and eventually, radiation therapy may be offered as well.

“Three to five years out, we’ll address that,” Hudspeth said, explaining that adding radiation cancer therapy would require the hospital to invest approximately $5 million in equipment. “The long-term goal is to get that out here, but we’re going to start with medical oncology.”

Currently, very little chemotherapy occurs at JRMC. It is offered in a small space in the emergency department, Hudspeth said.

Chemotherapy is rated at four different levels, based on potential complications and strength, and JRMC offers level 1, and a little bit of level 2. The idea, Hudspeth said, is that JRMC will continue that work but offer additional levels of chemotherapy as time goes on.

In addition, cancer treatment will be moved from the emergency room to a dedicated cancer center in the JRMC’s clinic building.

The medical center has long recognized a need for more local cancer treatment, Krapp said, even before the new hospital was built.

“That’s been on the wish list for several years,” Hudspeth said.

Partnering with Sanford could potentially allow JRMC patients to participate in Sanford clinical trials at JRMC, too.

For the most part, patients who aren’t being treated for cancer likely won’t notice any changes, Hudspeth said.

Utilizing the Epic record-keeping system will mean that the JRMC’s electronic records are totally compatible with those of Sanford and Essentia clinics, both of which use the same system.

While the hospital does already have an electronic records system, it doesn’t really “talk” to the clinics’ system.

Physicians feel that the new system will help improve patient care, Hudspeth said, and it also has the potential to reduce duplicate testing, as patients’ previous lab results will all be easily accessible.

“For quality and safety, it really makes a difference,” Hudspeth said.

Recent information from the hospital’s current system will be migrated into the Epic system.

“It’ll be a lot safer, more efficient for the patient,” Krapp said.

The licensing cost for the new system is extremely high, and installation is estimated to cost approximately $1 million. Much of that — probably 70 to 80 percent — will be reimbursed by the federal government, Hudspeth said.

Under the Affordable Care Act, the hospital would eventually be penalized financially if Epic or a similar system were not installed and utilized, Hudspeth explained.

However, a hospital as small as Jamestown Regional Medical Center would not be able to license itself under Epic, because it’s not big enough, he added.

Currently, Sanford is in the process of installing Epic in all its medical facilities, Hudspeth said. JRMC would likely install it sometime next winter, using its own IT staff and the back-office support of Sanford’s computer centers in Fargo.

Talks about partnering with Sanford or other larger health systems have been going on for a long time, but they intensified after the Affordable Care Act became public, Krapp said.

“We’re seeing tremendous change in healthcare with increasing focus on the cost and efficiency of care,” said Rick Giesel, president of the Sanford Health Network, Fargo. “Closer collaboration and integration lends itself to better align incentives and potentially avoid duplication of services.

“Evaluating a closer affiliation between JRMC and Sanford seeks to address our changing environment so that we can continue to offer the best patient care possible.”

Students look at medical careers at JRMC

a1kidstourcolorOriginally published in The Jamestown Sun, 4/11/13
By: Keith Norman

Photos by John M. Steiner

Students from Edgeley and Kulm elementary schools were given patients to care for Wednesday at Jamestown Regional Medical Center. The students, dressed in scrubs, disinfected the patients and vaccinated them and before performing lab tests.

The patients are not expected to recover.

The goal was not to improve health of the “patients” — oranges, actually — but to build interest for careers in health care.

“The goal is to introduce kids at a young age to the medical professions,” said Kylie Nissen, senior project coordinator for the University of North Dakota Center for Rural Health. “We want them to come back to the rural areas and work down the road.”

The program is called the Rural Collaborative Opportunities for Occupational Learning in Health, abbreviated as “R-COOL-Health.” The program provides grants to hospitals and schools to bring classes to the hospital for a day of hands-on learning.

“A lot of these kids only know about doctors and nurses,” Nissen said. “This expands their knowledge about medicine and all the jobs it entails. PT (physical therapy) is a big attraction especially to those into sports. There is not a single health profession that doesn’t have shortages in North Dakota.”

Nissen said this is the fifth year of the program with 10 grants provided to schools around the state.

The grant provides scrub-like shirts for the students and staff attending and helps cover the costs of syringes and oranges for the hospital demonstrations.

Tony Hanson, administrator of LaMoure County Public Health, said the program was about the future.

“It is about developing careers for the young kids,” he said. “It is a grass roots effort but really the only way we’ll fill our staffing needs in rural health.”

Hanson said the setting and instructions increases the benefit of the program.

“Doing things hands on — like giving a shot to an orange — gives them a chance to experience and learn,” he said.

The program comes at an ideal time in the child’s education, according to Jason Carroll, sixth grade teacher from Edgeley.

“Some of these kids only see a hospital when someone is sick or injured,” he said. “This lets them look at health care from a different perspective. The sixth-grade age is where kids start asking about occupations. Most start out wanting to be a pro athlete but it is a good idea to get them thinking about other professions.”

Some of the students were already sold on the medical field.

Sixth-grader Lucas Nitschke, Jud, N.D., said he was already considering becoming a doctor.

“I enjoy learning about health care,” he said. “Learning about it helps me to see if it’s something I want to do.”


Maren Berntson, a fifth-grader from Kulm, said she enjoyed learning about all the different jobs in healthcare.

“I think I would like physical therapy because it is helping people to recover,” she said.

Abby Wald, a registered nurse with Lamoure County Public Health, said the students were good learners.

“It gives them a glimpse of what we do,” she said. “Maybe it will inspire some people to go into the health field. Besides the orange is a good patient for them to work with.”

Sun reporter Keith Norman can be reached at 701-952-8452 or by email at knorman@jamestownsun.com

JRMC Auxiliary Meets for April Meeting

The JRMC auxiliary held their monthly meeting on April 1 with Alice Williams presiding in president Carolyn Exner’s absence.

JRMC CEO Todd Hudspeth addressed the group announcing that a new foundation director had been hired. The VA will move into their new clinic space located in the Jamestown Clinic Building in late April.

The 25 members in attendance voted to pay $8,000 toward their $70,000 pledge to JRMC Foundation leaving a balance of $12,000.

The volunteer recognition dinner will be held on April 23.

A number of members will join delegates Sandy Hill and Linda Greer at the Hospital Auxiliary of North Dakota convention on May 16 in Mandan.

The gift shoppe is planning an open house for the public and hospital employees on May 6 from 3:00 – 7:00 p.m. to introduce new products acquired at market recently.  The open house will include tasting of food products available in the shoppe.

When is Foot Surgery Necessary?

Foot Health Awareness Month is a time to encourage everyone to be mindful that foot health has an overall impact on total body health. A podiatrist is key to ensuring optimal foot health. How do you know when you need to have surgery on your feet? Dr. Harris, JRMC Podiatrist, would like to give you some tips on foot surgery and when it is necessary.

Ankle braceWhen is Foot Surgery Necessary?
Many foot problems do not respond to “conservative management”. Your podiatrist can determine when surgical intervention may be helpful. Often when pain or deformity persists, surgery may be appropriate to alleviate discomfort or to restore the function of your foot.

Types of Foot Surgery
Fusions: Fusions are usually performed to treat arthritic conditions of the foot and ankle. A fusion involves removing all cartilage from a joint and then joining two or more bones together so that they do not move. Fusions can be done with screws, plates or pins or a combination of these.

Tendon Surgery: Surgery on the tendons can be performed for acute injuries such as ruptures but is also commonly done to lengthen or shorten the tendon, depending on the problem. In some cases, tendons may be re-routed to improve foot and ankle function.

Metatarsal Surgery: Surgery on the lesser metatarsals is performed for a variety of reasons but is commonly done to redistribute the weight bearing on the ball of the foot. In some severe cases, such as rheumatoid arthritis, surgery may involve removing the metatarsal heads (the bones in the ball of the foot area).

Bunion Surgery: There are many different types of bunion surgery depending on the severity of the bunion and the joint involvement. Your podiatrist can explain the bunion procedure that is most appropriate for your bunion. Depending on the surgery necessary, the recovery time can be very different – particularly if you need to be on crutches after the surgery or in a cast.

Hammer Toe Surgery: Hammer toe surgery may involve removing a portion of the toe bone to realign the toe or could involve fusing the toe joint (see Fusions, above). In some cases, it may involve placing an implant in the toe to maintain realignment.

Neuroma Surgery: Neuroma surgery involves removing a benign enlargement of a nerve, usually between the metatarsal heads in the ball of the foot. This soft tissue surgery tends to have a shorter recovery time than bone procedures, but it leaves some residual numbness related to the removal of the piece of nerve tissue.

Heel Surgery: based on the condition and the chronic nature of the disease, heel surgery can provide relief of pain and restore mobility in many cases. The type of procedure is based on examination and usually consists of plantar fascia release, with or without heel spur excision. There have been various modifications and surgical enhancements regarding surgery of the heel. Your podiatrist will determine which method is best suited for you.

Reconstructive Surgery: Reconstructive surgery of the foot and ankle consists of complex surgical repair(s) that may be necessary to regain function or stability, reduce pain, and/or prevent further deformity or disease. Unfortunately, there are many conditions or diseases that range from trauma to congenital defects that necessitate surgery of the foot and/or ankle. Reconstructive surgery in many of these cases may require any of the following: tendon repair/transfer, fusion of bone, joint implantation, bone grafting, skin or soft tissue repair, tumor excision, amputation, and/or the osteotomy of bone (cutting of bones in a precise fashion). Bone screws, pins, wires, staples, and other fixation devices (both internal and external), and casts may be utilized to stabilize and repair bone in reconstructive procedures.

Preoperative Testing and Care
As with anyone preparing for any surgical procedure, those undergoing foot and ankle surgery require specific tests or examinations before surgery to improve a successful surgical outcome. Prior to surgery, the podiatrist will review your medical history and medical conditions. Specific diseases, illnesses, allergies, and current medications need to be evaluated. Other tests that help evaluate your health status may be ordered by your podiatrist, such as blood studies, urinalysis, EKG, X-rays, a blood flow study (to better evaluate the circulatory status of the foot and legs), and a biomechanical examination. A consultation with another medical specialist may be advised by a podiatrist, depending on your test results or a specific medical condition.

Postoperative Care
The type of foot surgery performed determines the length and kind of aftercare required to assure that your recovery from surgery is rapid and uneventful. The basics of all postoperative care involve to some degree each of the following: rest, ice, compression and elevation. Bandages, splints, surgical shoes, casts, crutches or canes may be necessary to improve and ensure a safe recovery after foot surgery. Your podiatric surgeon will also determine if and when you can bear weight on your foot after the operation. A satisfactory recovery can be hastened by carefully instructions from your podiatrist.

From the American Podiatric Medical Association (APMA)