Brookings Health System Steps Into Its Future with Bold Expansion

By: Alex Strauss

In many ways, the growth of Brookings Health System is a reflection of the growth of Brookings itself. Since the first Brookings Hospital opened its doors in 1964, the community, located just an hour north of Sioux Falls, has grown by 60 percent. With that growth have come changes in the community’s healthcare needs.

According to CEO Jason Merkley, more than 70 percent of Brooking’s patients—many of whom hail from communities such as Flandreau, DeSmet, Arlington, Estelline, and Lake Benton, Minnesota—now come to the hospital on an outpatient basis, reflecting a nationwide trend.

In contrast, back in 1964, 80 percent of the patients who came through the doors ended up as inpatients and were usually less sick than patients staying on the medical-surgical unit in 2017. That called for a change in the way care was managed and delivered.

Another reason for the hospital’s recent 62,000+ square foot expansion and renovation project: Expectation.

“Today’s patients expect a 5-star experience when they go to the hospital,” says Merkley. “In the old facility, we could not provide some of the everyday comforts that we tend to take for granted, such as privacy, quiet, individual bathrooms, and large windows. We needed to make these things happen even from an infection control standpoint.”

Today’s patients and doctors also expect efficiency, easy access, and top-level technology, 

 such as high-tech operating rooms, robotic capabilities, in-house MRI to accommodate all body types, and a dedicated area for outpatient surgery. On all counts, Brookings is now meeting—and even exceeding—expectations.

Redesigning Inpatient Care

The newly expanded Brookings Hospital, which is licensed for 49 beds, opened for business in February. The project took a little over a year and a half but put Brookings decades ahead of where it had been in its ability to efficiently care for patients.

“The layout was designed by nurses with physician input, so it is very, very efficient,” explains Karen Weber, RN, a 31-year veteran of the Brookings hospital staff and Director of both the Emergency Department and Inpatient Care. Weber says the old layout, with patient rooms fanned out from a central circular nurses station, was often noisy, distraction-filled, and crowded, especially when physicians were doing rounds.

“We now have four decentralized nurses stations that comfortably fit two staff,” says Weber, explaining that patients are strategically assigned to the hospital’s 24 inpatient rooms to put them closer to nurses. In addition, 80 percent of supplies and medications needed for each patient are now located in locked cabinets in each room that can be restocked from the hallway. Even the storeroom is now on the unit, minimizing steps and maximizing time for provider-patient interaction.

“I think we are taking better care of patients because we are able to spend more time in the room with them,” says Weber.

The new layout also includes a workroom on the unit for brief, daily team planning meetings that have taken the place of lengthy twice-weekly care conferences.

“Every day the flow gets a little better,” says general surgeon Theresa Oey, MD, who will mark five years at the hospital this summer. “With private rooms and nice light coming in through all the windows, it’s easier for patients and their families to be comfortable, even though they are not at home. It’s a whole other level of care.”

A newly-initiated hospitalist program provides an extra level of care for hospitalized patients overnight on weekdays and 24-hours a day on the weekends. “The bottom line is that the overall patient experience, in terms of privacy, comfort, healing environment, access to what they need—it’s all going to be better,” says Merkley.

Modernizing Surgical Care

In 1964, surgery usually meant a mandatory hospital stay. Today, 40 percent of procedures at Brookings, as at so many other hospitals, are now performed endoscopically. With two new suites dedicated to endoscopy, and three spacious new ORs, both same-day surgery patients and those who need larger operations will experience fewer delays getting scheduled.

“Surgery is one of our high growth areas,” says Merkley. “Before the expansion, we were having trouble getting blocks for our surgeons because the same rooms were being used for things like colonoscopies and hernia repairs.”

 The new ORs are nearly double the size of the old ones and are fully-integrated with high-tech lighting, high definition in-line video capabilities, more space for the robotic surgery system, and booms that keep equipment and cords off the floor.

“All of the equipment has been upgraded to allow us to do some amazing things here,” says Dr. Oey, who helped choose the new equipment. “Our lights are better and our rooms are bigger, which allows us to have everything that we need close at hand and circulators to move about with ease.”

Dr. Oey says the rooms are well equipped to handle all different kinds of surgeries as the hospital expands its options.

Here, too, the “flow” has changed significantly as a result of the expansion. Whereas same-day surgery patients were previously transported to the inpatient unit to be prepped for surgery, a new dedicated prep and recovery space with 12 rooms now allows patients and families to stay put.

“After their procedure and recovery, patients go straight back to the same room they were in,”

says Dr. Oey. “They no longer have to be by the sick patients who are upstairs, which is better for both patients and families.”

Upgrading for the Future

Some of the upgrades, such as the five LDRP suites (up from 3), the larger private rooms, and the redesigned entrance and public spaces are highly visible, designed to be physical reflections of the hospital’s forward momentum.

“We have always had high quality care, but from the street, we looked like we were still practicing medicine the way we did 30 years ago,” says Karen Weber. “Now, people are just amazed by the clean lines, the great art, and the space as soon as they walk in the door.”

“Now, the outside really reflects the great care that the staff provides, which also helps with recruitment,” agrees Dr. Oey.

Other upgrades, including the updated heating and cooling system, strategically located private transport corridors, and new pharmacy are less visible but just as vital to the hospital’s ability to care for patients, both now and in the future.

“I’m a big proponent of providing the highest quality of care we can possible provide. Volume follows quality,” says Merkley. While some rural hospitals flounder, Merkley says this growing community’s long-standing support of its hospital has allowed Brookings Health to maintain a positive balance sheet, opening the door to partnerships that, in turn, help keep it vital. It is a delicate balancing act.

“As an independent rural hospital, we are poised to say ‘let’s keep one foot on the dock, and one on the boat’,” says Merkley. “You don’t want to get lost in the shuffle. We are providing a vision of future healthcare in our community. I hope ours lasts until 2067.”

The Brookings Health System Expansion at a Glance

-       Hospital Expansion: adds 62,400 sq. feet

-       Medical Plaza: adds 30,000 sq. feet

-       Renovation: remodels 17,750 sq. feet;[AC2] 

-       Cost: approximately $46 million

-       Financing: 70% funded by capital financing; 20% funded by hospital reserves; 10% funded by donations

-       Project Groundbreaking: July 2015