Shannon Edgar, MBA, BSN, RN
Vice President, Chief Nursing Executive

Shannon Edgar serves as the Chief Nursing Executive for St. Charles Health System. In this role, she oversees nursing practices across St. Charles hospitals and ambulatory care, guiding clinical practice, professional development, and quality and safety programs. Shannon began her journey with St. Charles as a Certified Nursing Assistant (CNA) in 2001. She has led various nursing teams, fostering a collaborative and patient-centered care environment across diverse areas within the health system. Shannon holds a Bachelor of Science degree in Nursing from Linfield College and a Master of Business Administration with a focus on Healthcare Management from Western Governors University.

Grand Rounds - July 12, 2024  
"Update on Testosterone Replacement Therapy"

Speaker: T. Mike Hsieh, MD. Professor of Urology, Director, UCSD Men’s Health Center UCSD School of Medicine.

Objectives

1. Appropriately diagnose and evaluate male hypogonadism.
2. Identify management strategies for men who desire future fertility.
3. Counsel patients on the risk and benefit of testosterone replacement therapy.
4. Monitor for complications of testosterone replacement therapy.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)^TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

St. Charles Health System recently recognized several nurses for their extraordinary service and abilities. Four nurses received the DAISY Awards for Extraordinary Nurses, a national award that recognizes the outstanding, compassionate nursing care they provide patients and families every day; and, new this year, three nurse leaders received DAISY Award for Extraordinary Nurse Leaders.

The nurses earning DAISY awards are:

• Krista Munns, a Medical Services nurse in Redmond, was recognized by a family for her care and compassion, sharing that “she was hugely supportive during a very difficult time.”
• Katie Pink, an Emergency Department nurse in Bend, was recognized for her “fervent application of clinical knowledge honed with her compassion and patience.”
• Janna Raber-Stevens, a Medical Services nurse in Prineville, was honored by a patient specifically for her ability to find a creative way to help them get some sleep, saying her efforts “made a huge difference in my outlook and attitude.”
• Riley Schafer, a Wound Ostomy nurse in Madras, was recognized by a patient for her tremendous care helping with a slow-healing wound, saying “Nurse Riley stood above the rest with her care, attitude and compassion.”

The nurses, who represent all four St. Charles hospitals in Bend, Redmond, Madras and Prineville, were recognized with a ceremony on their respective units and presented with a certificate, a pin and a "healer's touch" sculpture by their hospital’s chief nursing officer.

St. Charles' inaugural winners of The DAISY Award for Extraordinary Nurse Leaders are:

• Ryan Huebscher, assistant nurse manager, Emergency Department, Bend, was honored for his “empathy, gentleness and strength.”
• Kelli Jo Hammack, nurse manager, Inpatient Services, Madras, was recognized for caring, approachable style and her tremendous clinical knowledge.
• Bethany Klier, nurse manager, Wound Ostomy, Madras, was recognized for being intelligent, strong, loving and fearless.

The DAISY Award for Extraordinary Nurse Leaders gives staff members a way to express gratitude for the compassionate environment fostered by nurse leaders. They are recognized for creating an environment where attributes of trust, compassion, mutual respect, continued professional development and ethical behavior are modeled and supported. They promote and enhance the image of nursing within the organization, community and the profession. DAISY nurse leaders are accessible, available and advocate for their teams, encouraging compassionate, skillful, patient-centered care.

About the DAISY Awards:

The DAISY Foundation is a not-for-profit organization that was established in memory of J. Patrick Barnes by members of his family. Patrick died at the age of 33 in late 1999 from complications of Idiopathic Thrombocytopenic Purpura (ITP), a little known but not uncommon auto-immune disease. (DAISY is an acronym for Diseases Attacking the Immune System.) The care Patrick and his family received from nurses while he was ill inspired this unique means of thanking nurses for making a profound difference in the lives of their patients and patient families.

This is one initiative of The DAISY Foundation to express gratitude to the nursing profession. Additionally, DAISY offers J. Patrick Barnes Grants for Nursing Research and Evidence-Based Practice Projects, The DAISY Faculty Award to honor inspiring faculty members in schools and colleges of nursing and The DAISY in Training Award for nursing students. More information is available at http://DAISYfoundation.org.

If you’re worried that a questionable mole might be skin cancer, there’s an app for that — thanks to Emma Nordstrom, a St. Charles volunteer and graduate of Bend’s Trinity Lutheran School.

Earlier this year, Nordstrom, 18, was one of 200 high school students in the country to be recognized as a National STEM (Science, Technology, Engineering and Math) Champion for her invention: A program that allows a person to scan a concerning lesion and will flag it if it shares characteristics with different types of skin cancer.

Nordstrom — who spends Monday afternoons visiting and brightening the days of St. Charles patients — initially created the program as a project for the International Science and Engineering Fair.

“I decided to go down the path of skin cancer, particularly because underrepresented communities are often more affected by skin cancer,” she said.

As a sophomore, Nordstrom developed the program to run on a computer using a type of artificial intelligence called machine learning, specifically a convolutional neural network. That means the AI is trained in a way that mimics the human brain. Just as children learn over time that a square shape with legs is a table, the neural network learned from thousands of images to decipher what is and what isn’t skin cancer.

Nordstrom used around 10,000 images of skin cancer to train the program. Those images covered three forms of the disease: Basal cell carcinoma, squamous cell carcinoma and melanoma. (A fourth set of images, benign lesions, was used as a control.)

The program will flag a lesion as suspicious if it matches skin cancer images used in training. It’s not meant to be a diagnostic tool, but rather a screening tool to give people guidance as to whether they should see a dermatologist. Primarily, Nordstrom envisions physicians using the program to help them decide whether to refer patients to a specialist. While wait times to see a dermatologist can stretch beyond six months, a physician who suspects a lesion might be skin cancer can fast-track the referral.

Through the development process, Nordstrom decided to move the program from a computer to a smartphone.

“Not everyone has access to a computer,” she said. “We might be able to use this here in Bend because we are a higher income area, but I want to make sure it’s accessible in lower income areas, too.”

As a junior, Nordstrom competed at ISEF with the app version of the program, called DermaSkan. Then, as a senior, she submitted it to the National STEM Challenge, a nationwide competition in which students submit a science-related project that attempts to overcome a real-world problem.

Roughly 4,000 people submitted projects to the STEM challenge. Nordstrom was one of fewer than 200 National STEM Champions.

“I was shocked,” she said.

Kara Magee was not shocked. She’s the coordinator of volunteer services for St. Charles, and a huge fan of Nordstrom, whom she met just over a year ago.

“When she first arrived here, she was telling me about this app,” Magee said. “I was like, ‘You are going to save people’s lives!’ We’re all one of a kind, but she is just an exceptional human being.”

Although Nordstrom hopes to obtain a patent for her app in the future, she isn’t planning to pursue medical AI as a career, she said. Instead, she will attend Oregon State University next fall, where she’ll start down the path of becoming a pediatric nurse.

That’s no surprise to Magee.

“She goes in and chats with patients every week, which is one of the most important jobs we have here because some of them have no one to talk to,” she said. “She’s already making a difference in their lives, and she’s going to make a huge difference in our world.”

OHSU-St. Charles Three Sisters Rural Track Program trains family medicine physicians, aims to improve health care access in rural Oregon

PORTLAND, Oregon -- Three newly minted physicians are the first trainees of the Three Sisters Rural Track Program, or RTP, a three-year family medicine residency program that is Central Oregon’s first graduate medical education program.

Oregon Health & Science University and St. Charles Health System jointly established Three Sisters RTP to help grow Central Oregon’s health care workforce and meet the unique health needs of rural Oregonians. Organizers hope many of the new program’s participants will continue to live and work in Central Oregon after they complete their residency.

The trio of residents began their advanced medical training at OHSU this month. Next summer, the residents will head to St. Charles Madras — a 25-bed critical access hospital located about 50 miles north of Bend — for two more years of training.

“We are excited to welcome the first residents of the Three Sisters Rural Track Program, and eager to help them provide thoughtful, comprehensive health care for the people of Central Oregon,” said Three Sisters Rural Track Program Director Jinnell Lewis, M.D., who is also a family medicine physician with St. Charles. “Once at St. Charles, the residents will immediately help fill a need in the region, providing care for an estimated 900 patients a year.”

The program creates a pathway for specially trained physicians to dramatically improve health care access in Central Oregon, where many towns have a shortage of providers. Research has shown that about 55% of physicians stay within a 100-mile radius of their residency site. This means, within 10 years, Three Sisters RTP is estimated to produce 23 physicians who would reside in Central Oregon and provide care for 20,000 to 40,000 patients in the region.

“It’s hard to overstate the powerful positive impact this program can have,” Lewis said.

Lewis moved to Central Oregon about a decade ago, after she completed another OHSU residency program that is focused on rural health: the Cascades East Family Medicine Residency in Klamath Falls. Three Sisters RTP is partly modeled after Cascades East’s more than three decades of success.

Residency programs provide additional training for physicians who recently completed medical school. Three Sisters RTP focuses on family medicine, a primary care medical specialty that involves caring for the whole family, ranging from children to pregnant people to seniors. Family medicine physicians offer broad care, and help patients both manage existing health conditions and prevent others. In rural areas where there are fewer physicians, primary care providers play a particularly important role in keeping their communities healthy. In addition to primary care, Three Sisters RTP residents will also train in family birthing, emergency medicine, behavioral health and hospital medicine.

One of the new Three Sisters RTP residents, Callie Krewson, D.O., was born at St. Charles Bend and graduated from Bend’s Mountain View High School in 2008. Krewson said she is excited to be part of the program’s inaugural class and would like to stay in Central Oregon after her residency.

“I look forward to returning to the places that I know and love,” Krewson said. “I want to give back to the community that raised me.”

During the residents’ first year in Portland, they will work and learn at OHSU hospitals and various outpatient clinics, as well as at the VA Portland Health Care System. And when the residents move to Madras for the final two years of their training, they will care for patients at the St. Charles Family Care Clinic in Madras and Mosaic Community Health’s Madras Health Center. They will also have learning opportunities at the Indian Health Services’ Warm Springs Health and Wellness Center.

OHSU is the host institution for Three Sisters RTP, and St. Charles is its primary training site. The program’s launch was made possible by a $750,000 grant from the U.S Department of Health and Human Services’ Health Resources & Service Administration, and a $1 million Healthy Oregon Workforce Training Opportunity grant. Donations to St. Charles Foundation will support ongoing training and recruitment efforts, technology upgrades and additional needs as the residency program grows.

The program’s launch is part of larger efforts to expand residency programs statewide. OHSU recently achieved the milestone of having more than 100 accredited residency and fellowship programs.

Meet the residents

Name: Callie Krewson, D.O.

• Age: 33

• Hometown: Bend, Oregon

• Family: Husband, two dogs

• Medical school: Pacific Northwest University of Health Sciences, Yakima, Washington

• Looking forward to: Returning to and working in Central Oregon, including working at the Indian Health Services clinic on the Confederated Tribes of the Warm Springs Reservation.

• Miscellaneous: She has helped lead rafting trips on the Deschutes River with her husband, who is a river guide.

Name: Ben Khalil, M.D.

• Age: 34

• Hometown: Richland, Washington

• Family: Wife, two cats

• Medical school: Oregon Health & Science University, Portland, Oregon

• Looking forward to: Combining love of outdoors with passion for providing comprehensive health care.

• Miscellaneous: While he enjoys trying new things, his favorite dessert will always be ice cream.

Name: Christopher Sutton, D.O.

• Age: 32

• Hometown: Warren, Pennsylvania

• Family: Girlfriend, one dog, one cat

• Medical school: University of the Incarnate Word School of Osteopathic Medicine, San Antonio, Texas

• Looking forward to: Working closely with patients in a rural setting like home, and enjoying Central Oregon’s outdoor recreation opportunities.

• Miscellaneous: Previously worked in the oil, gas and natural resources industries.

When October Grimes was born in September of 2018, she arrived 14 weeks early and weighed just over 14 ounces.

Immediately, nurses in St. Charles Bend’s Family Birthing Center wheeled her away to the nearby Neonatal Intensive Care Unit, where they could give October the highly specialized and around-the-clock care she needed.

She would spend the next 126 days in the NICU, with her mother, Lindsey Beaver of Bend, by her side for four to 12 hours per day, said Grimes’ father, Olen Grimes.

“The staff and the doctors were super amazing, super transparent and super caring. They truly cared for all of us,” Beaver said. “They kept us updated at all times. They helped me feed her and helped me change her diaper. They’d get her out of bed and bring her to me — anything to help make me comfortable in what was a really trying time.”

So when a friend told Beaver and Grimes about St. Charles’ NICU Reunion — held on a sunny recent Sunday afternoon at the Bend hospital — the couple RSVP’d immediately.

“We’re forever grateful for this staff,” Olen Grimes said. “Anytime they’re going to do anything for the community, we’re going to support that.”

The NICU Reunion was an annual event for years before the COVID-19 pandemic shut down gatherings in 2020. This year’s version was the first since 2019, and organizers created a fun and family friendly atmosphere by bringing in interactive games, crafts, face painting, a photobooth, refreshments, a bouncy house and more. Dozens of former patients — known affectionately as “NICU grads” — attended along with their families, as well as doctors, nurses and other staff from the unit.

The goal: To bring together families and the people who cared for their babies for a time of reconnection and celebration, said Stephanie West, a CNA and unit secretary in the NICU.

“It’s really rewarding to see the kids and see how much they’ve grown since they left us,” she said. “It’s just a lot of fun and it brings us all a bit of joy.”

Rochelle Simonds has worked as a registered nurse in the Bend NICU for 18 years. She spent most of the reunion giving kids fake tattoos — and smiling.

“When I discharge patients and they’re going leave the NICU … I say, ‘I’ll see you at Costco’ or ‘I’ll see you at Target’ and that’s really why we’re doing this,” she said. “The whole point of our job is to partner with parents to give their babies a jumpstart, and then to see them grow up and thrive and meet their potential. So it’s really nice that the parents are willing to bring their kids to this so we can connect with them again.”

Two of the children Simonds tattooed were Colby Wilson, 5, and his younger brother Owen Wilson, 1. Colby spent 30 days in the NICU in 2018; Owen spent 49 days there last year, said their mother, Kristi Wilson.

“We got to know everyone here really well and we had such a good experience, so it’s fun to be able to come back and see the doctors and nurses and staff,” she said. “We’re excited to see some familiar faces and to show them these healthy, happy kids.”

The feeling is mutual, said Eric Stuemke, a transport RN in the NICU who was born at 34 weeks on the fifth floor of St. Charles Bend in 1979 — before there was a NICU.

“The unknown is hard sometimes when a kid leaves and you don’t get an update on them,” he said. “It’s nice to see the families you took care of.”

Standing in a room full of glittery stickers, stuffed animals, ice cream and extremely active kids, Lindsey Beaver and Olen Grimes said the reunion event was a good reminder that their tribe expanded by more than just one member when October, soon to turn 6 years old, spent four months in the NICU back in 2018.

“Even though I don’t see the staff all the time anymore, they’re still dear in my heart and I think about them all the time,” Beaver said. “They became family in a way, you know?”

I recently received a heartwarming letter from a patient of St. Charles’ Bend hospital who had spent time in our Emergency Department, Imaging department, Medical Diagnostic Unit and Progressive Care Unit, encountering dozens of our caregivers along the way. He was grateful for the excellent care he received and highly complimentary of our staff – from the intake team to the doctors and nurses to the folks who cooked the food and cleaned the room.

We always appreciate hearing from patients here at St. Charles, but this letter particularly resonated with me because it came from a former colleague who spent decades working in health care at all levels, from the front line to executive leadership. He knows the industry inside and out, and he knows what it takes to provide high-quality care and a high-quality experience for patients.

This was, in other words, an especially informed patient. And he highlighted one experience at St. Charles that I want to share with you:

The nurse who had been caring for me for 12 hours was going home. She and the new nurse came into the room and the new nurse was introduced to me. Then the nurse who had been caring for me reached out to shake my hand and wish me all the best as I recovered. This small gesture has stuck with me, of all things. That simple gesture of respect during a vulnerable time for me was so kind and greatly needed. Shift change is a confusing time and this introduction helped greatly.

At St. Charles, we have the privilege of changing lives – even saving lives – every day. And when we tell our story, we have a tendency to focus on heroics in health care. But these moments of greatness wouldn’t be possible without all the small moments that make up each day – the warm smiles, the comforting words, the handshakes at shift change. These small acts of kindness create a culture of caring and compassion, and they accumulate to make St. Charles a force for good in Central Oregon.

As Michael Dowling, president and CEO of Northwell Health, wrote in an essay in early 2023, we must, “help ensure the value of health care is not defined by its highest highs or lowest lows, but by the millions of moments between the two in which lives are improved, health is restored and suffering is spared.”

There is extraordinary power in the ordinary, everyday work that often goes unsung. Please know that we value that work highly at St. Charles.

Sincerely,
Steve

Grand Rounds - June 21, 2024  
"Clinical Competence in a Globally Mobile World"

Speaker: David Hunt, JD. BCT Partners.

Objectives

1. Identify the National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care.
2. Understand the need for training in global medicine.
3. Describe new skills for delivering culturally and linguistically appropriate care.
4. Outline the importance of patient-centered care in improving the quality, safety, and culturally and linguistically appropriate care.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)^TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

Community members are invited to join cancer survivors, local leaders, patients and caregivers from St. Charles to celebrate the groundbreaking for the new Cancer Center in Redmond on Wednesday, June 26 at 10 a.m.

“We are thrilled to celebrate this milestone for our new Cancer Center, which shows our commitment to providing world class care to cancer patients throughout the region,” said Dr. Steve Gordon, President and CEO for St. Charles. “This new facility will have a tremendous positive impact on our community, as it will expand access and services to Redmond and surrounding communities, serving 300 or more cancer patients every day.”

In addition to the groundbreaking ceremony, attendees will be able to walk the footprint of the new 53,000-square-foot building and learn about the services provided, including radiation oncology, chemotherapy infusion, surgical oncology, expanded support services and much more. Those in attendance will also have the opportunity to contribute to an art display that will be part of the new center.

St. Charles board member and longtime Redmond resident Jon Bullock says that this cancer center is a positive development not just for cancer patients and their families, but for Redmond overall.

“We have the chance to be a special place in the world, where families can get the compassionate care they need at the most difficult time of their life. Our community can be there to take care of them,” said Bullock. “This could be a catalyst to positively impact the culture of Redmond forever. I’m so excited about it and look forward to kicking off the celebration together.”

Light refreshments will be provided.

Attendees should be aware that this is an active construction area and should wear closed toed shoes and dress accordingly.

More about the new Cancer Center in Redmond

The new two-story facility will be approximately nine times the size of the current Cancer Center in Redmond. It will include 36 exam rooms. The facility will include a 5,000 square-foot chemotherapy infusion room with 24 infusion chairs. It will also include world class technology including a high-dose brachytherapy suite (brachytherapy delivers localized cancer treatment through internal radiation) and a True Beam Linear Accelerator (which uses photon or electron beams to target and treat cancerous tumors). Visit our Cancer Care pages to see updates and view renderings.

Grand Rounds - June 14, 2024  
"Impacts of Postnatal Care: Giving Babies the Best Start through the Family Connects Model"

Speaker: Benjamin Hoffman MD CPST-IFAAP. Professor of Pediatrics, Division of General Pediatrics, OHSU School of Medicine.

Objectives

1. Discuss inequity and challenges faced by Oregon families with newborns.
2. Describe the Family Connects model and its impact on families with newborns.
3. Identify the steps that pediatric providers and their staff can take to collaborate with the Family Connects program.
4. Evaluate the benefits of Family Connects for both families and providers.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)^TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].