Kaylyn Applegate, radiologic technician, shows a CT scan machine to a group of third graders during a tour of McKenzie County Healthcare Systems March 22.

Small-town hospitals fill a need in rural areas, and area facilities are continually finding new ways to take care of their communities. These centers have made a number of changes in the past year to enhance their services. The facilities provided some of their past year highlights, which follow.

St. Aloisius Medical Center

Last August, St. Aloisius Medical Center in Harvey re-opened a full-service clinic next to the hospital that had been closed for more than 30 years.

Drs. Rick Geier and Imran Dean, who arrived in January, and family nurse practitioner Kim Thorson practice at the clinic.

Harvey native Dr. Kelly Krohn, commutes between his Harvey and Arizona homes once a month to provide bone health services. The hospital acquired a DEXA scan machine for assessing bone density. Dr. Ronald Skipper comes from Rugby to do general surgeries, colonscopies and clinic procedures.

The clinic also offers joint injections and Department of Transportation physicals.

Beth Huseth, community liaison for St. Aloisius, said clinic numbers have exploded from about 350 visits a month last fall to about 600 a month this spring. Harvey has two other independent clinics, giving the community three doctors and four mid-level providers. Huseth said the service area could support seven physicians so the community is trying to meet the demand.

Improvements at the hospital include a 32-slice CT scanner, added last August as an upgrade from the previous scanner. The hospital is finalizing the purchase of an upgraded mammogram machine, Huseth said. The hospital added nuclear medicine and other testing options for physicians. A mobile MRI unit comes weekly rather than every other week. Physical therapy added Graston therapy, a technique for soft tissue injuries, and dry needling, involving placement of needles for pain or movement impairment.

CHI St. Alexius Health Garrison

The CHI St. Alexius Health Garrison Nursing Facility has been recognized as a Best Nursing Home for 2018-2019 by U.S News & World Report. This is the first time CHI St. Alexius Health Garrison has received this national recognition.

“It is an honor to be recognized as a Best Nursing Home by U.S. News & World Report. These rankings acknowledge the outstanding care that our staff delivers to our residents each day,” said Tod Graeber, administrator of CHI St. Alexius Health Garrison, in a news release.

For the 2018-19 rankings, U.S. News evaluated more than 15,000 nursing homes and short-stay rehabilitation facilities. U.S. News recognized nursing homes as high performing across multiple areas of care.

Also, this past fall CHI St. Alexius Health Garrison became a host location for the Dakota Nursing Program through Bismarck State College. The first class has six students working toward their licensed practical nurse degrees. Another LPN class will begin this fall, along with a registered nursing course.

The Dakota Nursing Program is a nursing education consortium made possible through the collaborative efforts of four state colleges: BSC, Lake Region State College, Dakota College at Bottineau and Williston State College.

The four community colleges provide education for a practical nursing certificate and an associate degree in nursing. Students are educationally prepared to continue on to a four-year BSN degree and beyond. Courses are delivered in a combination of face-to-face lab and clinical courses with theory courses over Interactive Video Network.

Mountrail County Medical Center

Mountrail County Medical Center recently began offering orthopedic care once a week. Dr. Ravindra Joshi with McKenzie County Healthcare Systems and family nurse practitioner Leah Brewster are providing the service.

The physical therapy department is enhancing its services. Among programs being offered are LSVT Big, a researched and proven treatment for the physical impairments of Parkinson’s disease. The department also offers dry needling and Rock Blades.

With dry needling, the goal is to deactivate a trigger point, using needles to reset the nervous system input to the specific muscle. In Rock Blades therapy, metal tools are used with different rates and depth to affect different sensory receptors to decrease pain, improve range of motion and flexibility or improve muscle activation.

McKenzie County Healthcare Systems

McKenzie County Healthcare Systems opened a new facility last July.

The new facility is over 125,000 square feet and came with a $76 million price tag. The new facility has 24 inpatient hospital rooms. The old facility had one emergency room; the new one has nine.

The Emergency Department has seen more than 3,200 patients since it opened. Located nearby, urgent care has been seeing no less than 50 patients a day.

Lynn Welker, marketing consultant for the healthcare system, said the previous one-room emergency department had been inundated before urgent care was established.

“That allows for those cases to be triaged as far as who needs to be seen in the ER, who needs to be seen in urgent care. I think that’s just very innovative to have in a community that’s grown so much,” she said.

“It’s hard for me to say that it was the new building or designing it that way, or just the population growing or changing, but our urgent numbers have about doubled since we’ve moved in,” added Michael Curtis, chief administrative officer. “The popularity of that particular service is enormous.”

“In rural communities, it’s so important to have a facility like this,” Welker aid. “Really, McKenzie County Healthcare Systems is able to address anything within an hour-plus in the perimeter. It’s very much a blessing that the new facility is here.”

Days after the new hospital opened, a tornado struck the community, turning the Emergency Department into ground zero in addressing the needs of the individuals injured, she said.

The new hospital has the space and equipment for labor and delivery services, which will be available in the future as program implementation occurs. A partnership with Great Plains Women’s Health Center has been established so those seeking obstetric and gynecological care can obtain it locally in Watford City through the specialty clinic.

3D mammography is now available as a new service, and the radiology department now has an MRI machine. The CT Scan machine was upgraded to 64-slice capability.

There is a helipad on the new location, which is critical for transporting patients if next-level trauma care is necessary.

The Good Shepherd Home has 44 private resident rooms and three couples rooms. There are three community rooms in each of the three wings.

Heart of America Medical Center

After a year-log fundraising campaign, this spring 3D mammography equipment will be installed in the radiology department at Heart of America Medical Center, Rugby.

Three-dimensional mammography is the new standard in the detection and diagnosis of breast cancer, and in recent years, HAMC providers had begun to refer some of their patients to other facilities for 3D mammograms. Soon, Rugby-area women will be able to access this life-saving diagnostic tool close to home.

Tioga Medical Center

Tioga Medical Center began offering patients the option of a portable heart-monitoring device in October.

Nancy Larson, a registered nurse and cardiac rehabilitation director at the medical center, said it had been about 20 years since the hospital has been able to provide the service. The hospital sought for about two years to get the service, which became possible last fall when cardiologist Dr. Peerawut Deeprasertkul began coming once a month from CHI-St. Alexius Williston. The service requires a cardiologist to interpret results.

The single-use monitors are fairly small devices that adhere to the skin near the heart. Patients wear them for 14 days before mailing them to the company, which then sends results electronically back to the Tioga hospital.

“We actually have been using them a lot more than I thought we would,” Larson said. In the first six months, six patients had used the monitors.

She explained the Zio XT monitors from iRhythm Technologies are useful for patients who present with heart issues that aren’t consistent, which means they may not show up when patients are tested. Monitoring the heart over a longer term can reveal any abnormalities.

Having the capability to provide longer term monitoring is important in serving the cardiac needs in the Tioga area, Larson said.

“People are having a lot more heart issues. That’s becoming more prevalent in society in general,” she said. Getting care has meant traveling to Bismarck or Minot, so any service, such as the monitoring, that can be made available locally saves residents considerable travel time and expense.

In addition, Tioga Medical Center has begun offering Stop the Bleed training in the community. Clinic manager Shelby Dean said the program was developed in response to mass shootings around the country, but it is applicable to a variety of trauma situations, including vehicle and farm accidents.

The 90-minute course includes a formal presentation and hands-on practice of direct pressure application, wound packing and use of a tourniquet. The course was developed for a nonmedical audience to provide immediate response to control life-threatening bleeding until help arrives.

The medical center worked with Tioga Ambulance to obtain donated kits to equip each participant who took the first class. Dean said efforts are being made to offer more classes, including in the schools.

Last August, the medical center began a palliative care program to educate staff and the community on advanced directives. With that training, the medical center seeks to incorporate Dementia Live training.

Dementia Live is a simulation experience that results in a deeper understanding of what it’s like to live with cognitive impairment and sensory change. Participants are outfitted in gear designed to simulate common age- and dementia-related vision, auditory and tactile sensory changes.

In another initiative, medical staff are utilizing a medical necessity test with laboratory and radiology orders, which provides information to patients regarding possible out-of-pocket costs associated with procedures. The information can assist a patient in discussing with their providers the most suitable and affordable diagnostic options.

Other tools now available for providers and their patients are the Medtronic iPro2 for glucose monitoring and Buzzy to block needle pain.

The glucose tool involves an implant that captures a glucose reading every five minutes and creates a personalized report. Small and discrete, it can be worn up to six days. Used with a smart phone app, the device enables patients to see how their daily routine affects blood sugar and allows them to set reminders to test for blood glucose.

Buzzy is ideal for children but can be used by anyone of any age when there’s a concern over pain from needle injections. Chilled, Buzzy is placed on a site for up to a minute prior to the injection, then moved up and secured before the vibration is switched on. The device activates the brain’s natural ability to block pain.

The medical center also recently obtained a portable ultrasound machine for the clinic and emergency room. With regular ultrasound services available only three days a week for an hour, the screenings provided by the portable machine fills a void in quickly getting information to aid in decision making. Among uses are prenatal care, bladder scans and other abdominal screenings.

Internally, the medical center has equipped its staff with the Quick Access phone app giving employees access to emergency policies and procedures and allowing for emergency alerts. Created for schools, Tioga is among the first healthcare facilities to adopt it.

This is the first year that Tioga Medical Center has engaged with Williston State College to provide an offsite nursing program campus.

“It’s a good opportunity for those students and it’s a great opportunity for us,” said Dean, who noted the program can be a recruiting tool for the medical center. Students are able to take their clinical training and much of their coursework locally through the program.

In addition, Tioga’s long-term care center updated its transportation offering with a new 10-passenger, handicapped-accessible bus to take residents to appointments and activities.