Once a patient is diagnosed with cancer, a clock begins ticking. Every moment that passes between a doctor creating a treatment plan and when treatment begins can be agony for patients.

“In addition to the emotional toll — the fear and anxiety — we know that at some point, delays in treatment can also lead to worse health outcomes for patients. Every day matters when it comes to treating cancer,” said Dr. Linyee Chang, senior medical director for Cancer at St. Charles. “Reducing the time that patients spend in limbo — between diagnosis and treatment — is what makes us so excited and hopeful about the new instant approval process that started in January.”

The new pilot is an innovative arrangement between PacificSource and St. Charles that allows patients who are receiving treatment that follows national best practice guidelines to receive automatic insurance approval with no delays. (About 93% of all care plans at the St. Charles Cancer Center are guideline-adherent; the exceptions are those rare or complicated cases where definitive research doesn’t yet exist.)

This pilot developed out of concerns raised by providers and patients about delays related to pre-authorization with health insurance companies and especially Medicare Advantage plans. Typically, when a patient receives a cancer treatment plan from a physician, St. Charles financial advocates then reach out to insurance companies for approval. No treatment can begin until the plan is OK’d by the insurance company — and that can take days or sometimes even weeks to approve.

The instant approval process is working to reduce delays for patients. Since January, 93 patients have been part of the pilot program. Of those, 82% received authorization to begin treatment the very same day, compared with just 54% of patients on other insurance plans. And Chang expects to see these numbers improve as the program is more established.

“Sometimes with the instant approval, we get insurance confirmation on the same day,” said Hidie Baker, financial advocate for St. Charles. “I do a happy dance as soon as I get one approved because I know I’m making a difference in helping the patients out.”

For St. Charles President and CEO Steve Gordon, the results of the pilot program are gratifying.

“Last fall, we made a point to publicly call attention to the delays and administrative burdens we were experiencing with many Medicare Advantage plans. Now we are seeing a creative solution put into action that benefits patients that is a direct result of us raising those concerns,” Gordon said. “This is a story of the waste and barriers we experience and how some health systems and hospitals are working to do something about it.”

National standards
One of the reasons this program is possible, according to Chang, is because the St. Charles Cancer Center has worked diligently for 20 years to drive clinical excellence through protocols, processes and practices to build a world class cancer center. The cancer center follows National Comprehensive Cancer Network guidelines, which are standards created by 33 academic cancer research centers across the nation.

“These guidelines form the foundation for our quality program, and they became our standard of care in 2004,” said Chang.

NCCN guidelines designated as 1 or 2a mean that more than 85% of experts agree that the treatment is a best practice. This is critical for the instant approval process, as patients whose treatment plans include 1 or 2A guidelines are automatically approved and don’t require an independent review.

“This removes a lot of waste for our staff, but the biggest improvement is for patients,” said Mari Shay, service line administrator for Cancer Services. “A patient can come in on a Monday, receive a plan for radiation and leave with a schedule in hand to start the next day. It’s life-changing. And because St. Charles Cancer Center follows NCCN guidelines, patients are assured that it’s the best care.”

Both Chang and Shay are hopeful that this program will prove successful and grow.

“Our goal is to expand this program. We have built it with expansion in mind. We want all of our St. Charles cancer patients to have this fast-track option available,” said Chang.

Dr. Mike Hatch wishes an instant approval process had been available for his family last year, when his 30-year-old sister-in-law was diagnosed with stage 3 breast cancer.

“The oncologist with whom we met told her, ‘I would like you to have started chemotherapy yesterday,’” said Hatch.

But from the time she received her diagnosis to the time she started treatment, about three weeks elapsed.

Hatch, an anesthesiologist, noted that most of the patients he works with are undergoing elective surgery, in which timing is not always paramount. He was not prepared for the urgency that came with a cancer diagnosis. “We learned that a cancer diagnosis and the daunting treatment course to follow is thrust upon a patient with a timeline that can feel pretty terrifying. It wasn’t until that moment of diagnosis that we came to fully understand the urgency of it and the number of hurdles we would need to clear as a family to initiate treatment. Every day that passed on the calendar felt like another day that we could be a day late.”

Hatch says his sister-in-law is halfway through chemotherapy and the family is feeling hopeful about her progress.

“From my perspective, if a patient can get to appropriate care even one day sooner, it would offload an enormous amount of anxiety and worry. I am grateful to St. Charles for making this a priority and I’m equally excited for the patients whom this will benefit.” 

More than 20 years ago, Dr. Linyee Chang and her colleagues at the St. Charles Cancer Center made a bold decision that I’m guessing many Central Oregon residents haven’t heard about.

The cancer team was a fairly early adopter of National Comprehensive Cancer Network (NCCN) guidelines, which are standards of cancer care created by 33 academic cancer research centers across the nation. Dr. Chang and her colleagues throughout the region — who were not all employed by St. Charles — agreed in 2004 to collaboratively follow these guidelines when treating patients with the most common types of cancer diagnoses. They worked together to regularly review the research-driven protocols, make sure what they were doing was having the intended result and have maintained quality care standards for decades that mean cancer patients treated in Central Oregon have impressive outcomes.

I like to say that at St. Charles we hit above our weight class in terms of the types of care we are able to provide for a relatively small-sized health system. Our cancer team is a shining example of this truth. In fact, when visited by our accrediting agency in the fall of 2022, the reviewer said that he could find no useful suggestions for improvement at St. Charles Cancer Center. Our oncologists’ treatment plans concur with NCCN guidelines nearly 100% of the time; the exceptions are those rare or complicated cases where definitive research doesn’t yet exist.

It’s because of this commitment and decades-long track record of excellence that we have been able to launch a pilot project in collaboration with PacificSource Health Plans. The instant approval process means patients who are covered by PacificSource health insurance who receive a cancer treatment plan that falls within NCCN guidelines from the St. Charles Cancer Center are automatically approved for insurance coverage and can start treatment immediately if they choose. We were able to come to agreement because most health plans rely on the same NCCN guidelines when they authorize cancer care. By looking at the information together, the St. Charles and PacificSource teams realized we could save patients and health care workers time and frustration by removing the pre-authorization barrier to proven, appropriate care.

The full impact of this effort is hard to quantify after only a few months, but I can tell you that in conversations with patients, family members and our staff of caregivers and physicians the emotional burden of waiting for treatment has been greatly reduced. The toll on physicians and caregivers tasked with spending time and energy on insurance approvals has lessened. And, ultimately, we believe that by getting patients into treatment earlier we will see an improvement in their long-term health.

I’d like to thank our colleagues at PacificSource for being willing to try something bold that challenges the status quo and looks at patient care in a logical, evidence-based way. I’m hopeful this model will serve to inspire creative thinking for others and that we can move toward building more programs like this that remove administrative burden and improve the health care experience for all.

When we work together with the best interest of our patients in mind — like Dr. Chang and her colleagues have done for 20 years — everyone wins.

Sincerely,
Steve 

St. Charles Health System announced today recipients of a variety of Community Benefit grants, awarding more than $190,000 to 35 local organizations in Central Oregon. The grants were awarded to provide basic needs, to support local diversity, equity and inclusion initiatives, to sponsor local events and as part of St. Charles’ Priority Grant to increase a sense of belonging and reduce loneliness and isolation.

Organizations receiving funding to reduce isolation and increase belonging include:

• Destination Rehab, which received funding to create a new line of programs for adults with disabilities to engage in community events and activities throughout Central Oregon.

• Bend-La Pine Schools, which will use funding to support Sources of Strength curriculum in 20 middle and high schools.

• Bend Farmers Market, which will use funding to expand opportunities for underserved populations to engage with the market.

• Horses on the Ranch, which will use funding to engage diverse youth populations with therapeutic experiences on the ranch in Crook County.

“Our Community Benefit team is thrilled to provide funding for these organizations to create opportunities for welcoming and belonging in Central Oregon. Our hope is that, through these ongoing partnerships, we will see more Central Oregonians feel connected to their communities and reduce isolation and loneliness,” said Carlos Salcedo, Community Benefit manager for St. Charles.  

The trauma team at St. Charles Redmond recently received a visit from a former patient that they had never forgotten. Arlo was just 15 months old when his mother carried him into the Emergency Department more than a year ago. The little boy was in need of life-saving intervention after an auto accident. The team activated quickly and worked for more than three hours, doing all they could to stabilize Arlo so he could be brought to a hospital in Portland.

Many that helped care for him didn’t think they would ever see Arlo again. But more than a year later, the little boy – now 3 – visited the team with his parents Emma and Jarib. The couple wanted to say thank you to the team who they credit with saving their child’s life.

In a card, Emma wrote: “Words cannot describe how truly grateful we are. I know Arlo is still here today because of the team that was on the day of the accident. We are blessed to have Arlo here with us today. Thank you for everything.”

Arlo spent 599 days in and out of the hospital in Portland, but is now back home in Central Oregon surrounded by family and friends. Emma says that he loves dinosaurs, animals and playing with his cousins – just like any 3-year-old. 

The visit from the family was tremendously meaningful to caregivers from Redmond who had helped care for Arlo that day.

“This means so much to us. We often don’t get the full story and we’ve definitely thought about you guys a lot,” said Danielle Taylor, a nurse who cared for Arlo, told the family. “I’m just so glad he’s OK and to see you guys smiling.”

The pilot who flew Arlo to Portland, Wesley Wilburn, and the Deschutes County Sheriff’s Deputy who helped comfort the family also came to visit.

“The hospital staff here knocked it out of the park. It was impressive to watch everyone circle the wagons. I believe part of the reason he’s here is the fast-acting staff,” said Deputy Kevin Riding.

Emma said that this visit to the team in Redmond “felt like a really important step to take in our healing.”

And no doubt, getting to see Arlo doing well with his family, was healing for the caregivers as well.

BEND, Oregon – Central Oregon will have a new option for people wanting to become nurses starting this summer, thanks to close collaboration among Oregon Health & Science University, St. Charles Health System and Central Oregon Community College.

The OHSU School of Nursing’s Accelerated Bachelor of Science Program has opened a new location in Bend, and the program will begin teaching its first group of eight Central Oregon-based students in July. Previously only available to Portland- and Ashland-based students, the 15-month-long program is geared toward people who want to change careers and become a nurse. It helps individuals who have already earned a bachelor’s degree in another field to quickly earn a second bachelor’s degree in nursing.

“OHSU is honored to bring our well-established accelerated curriculum option to Bend in partnership with St. Charles, Central Oregon Community College and many other local leaders,” said OHSU School of Nursing Dean Susan Bakewell Sachs, Ph.D., RN, FAAN. “The OHSU School of Nursing is proud to both help students from Central Oregon become nurses without having to leave home, and also to help the Bend area grow more of its own nurse leaders.”

“This is a huge win for our community, as we provide local access to this high-quality, in-demand accelerated program,” said St. Charles Chief Nursing Executive Joan Ching, D.N.P., RN, CPHQ. “I am excited that, through collaboration with our partners, we are increasing the pool of highly trained nurses who will live and work in Central Oregon.”

“Central Oregon Community College is pleased to be able to lease our nursing lab and simulation space to OHSU’s accelerated BSN program,” said Julie Downing, Ph.D., an instructional dean at COCC. “We’ve been working collaboratively with St. Charles and OHSU to increase the number of bachelor’s degree-prepared nurses in Central Oregon. And with COCC soon starting an RN-to-BSN program, OHSU’s efforts perfectly complement our own, as each institution is reaching different students with different prior education credentials.”

The program’s arrival in Bend is the result of conversations among OHSU Provost Marie Chisholm-Burns, Pharm.D., Ph.D., M.P.H., M.B.A., FCCP, FASHP, FAST, FACHE, Oregon State University Provost Edward Feser, Ph.D., and Ching. Chisholm-Burns and Feser organized a series of meetings with leaders from the OHSU School of Nursing, St. Charles, COCC, OSU-Cascades and other community organizations. The group collectively determined that bringing an accelerated bachelor’s degree in nursing program to Bend would be an effective way to meet Central Oregon’s pressing nursing workforce needs, and would also complement COCC’s planned new RN-to-BSN program. Chisholm-Burns said she is appreciative of the support received from the community, including St. Charles, COCC and OSU.

While OHSU nursing students occasionally have community-based learning opportunities in the Bend area and the OHSU School of Nursing has five regional campuses throughout the state, the school hasn’t had an official presence in Central Oregon until now.

The Bend location for the OHSU School of Nursing’s Accelerated Bachelor of Science Program will be based out of COCC’s campus. Following classroom instruction and practicing techniques in a simulation lab, OHSU students will have hands-on learning opportunities at St. Charles and other community clinics. Bridgette Bochner, Ph.D., RN, who has worked locally as a nurse for 24 years, has been hired to serve as the OHSU program’s Bend-based leader.

Applications for the OHSU program’s first group of Bend-based students are being accepted through April 15. More information is available on the OHSU School of Nursing website.

In addition to tuition, the program’s Bend location is supported by funding from the OHSU Provost’s Office, which is leading efforts to grow and diversify OHSU’s health profession student body. Scholarship opportunities are available for eligible students based at all OHSU School of Nursing locations, including Bend.

COCC’s registered nurse program has long offered associate degrees in nursing. Now, COCC is also developing a bachelor’s degree in nursing program that could welcome its first students as soon as 2025. Their new program is being designed for students who haven’t previously earned a bachelor’s degree, which will make it distinct from and complementary to OHSU’s accelerated bachelor of science program.

Theresa Drulard, MBA
Vice President, Performance Optimization

Theresa Drulard holds a bachelor’s degree in sociology with an emphasis in research methods and a master’s in business administration with a supply chain focus from Westminster College in Salt Lake City. Prior to joining St. Charles, she supported the continuous improvement office for PeaceHealth Oregon Network. Before she worked in health care, Drulard held senior leadership positions in the medical device and equipment industries, managing global regulatory, quality and operations. Deeply committed to continuous improvement practice, Theresa co-founded Lean Pop-Up, a no-fee, cross-industry lean learning and sharing organization in Salt Lake City.

Hospice and Bereavement team guide new walking groups starting April 8 in Prineville, aimed at those who have lost a loved one

New walking groups in Prineville aim to provide innovative support to individuals who have experienced the loss of a loved one. Healing Hearts walking events, which begin April 8, invite individuals experiencing grief to participate in a series of guided walks led by caregivers from St. Charles’ Hospice and Bereavement team in partnership with Crook County on the Move.

Every other week, the group will gather at St. Charles Prineville for a guided walk that will focus on a different topic including understanding grief, six needs of mourning, support networks, leveraging self-care and more.

Aaron Contreras, the bereavement coordinator for St. Charles Hospice, said the idea for the walks came from someone who had experienced a loss. “She wanted to have a group that let her work through her loss, while also having a community to do something active with. Our hope that a walking group like this might be helpful to those who are managing a loss in their life while also engaging in a great self-care activity in the community.”

Contreras will lead the walking groups alongside Mindy Laidlaw, supervisor of home-based care support services for St. Charles.

The walking groups are in partnership with Crook County on the Move, a local group that aims to keep residents healthy and active. The group has numerous events planned this spring, including general walking groups, community garden party, a community-wide Cancer Awareness Walk June 1 (which will feature a walk-through colon from St. Charles), and Heart Health 101 classes taught by a St. Charles provider.

Learn more about all the of upcoming activities at Crook County on the Move’s website. The Healing Hearts walking groups do not require registration. Interested individuals can meet at 1p.m. in the healing gardens at the north end of St. Charles Prineville.

Dozens of traveling nurses opt to make St. Charles their permanent workplace, citing strong culture and competitive pay

In the past year, St. Charles Health System has seen a major turnaround in the strength of its workforce, according to a variety of metrics: Vacancy rates have decreased from near 20% to approximately 6-7% for acute nursing; in 11 of the past 12 months, the number of hires has been more than the number of caregivers leaving the system; and St. Charles has significantly decreased its reliance on high-cost temporary traveling nurses to fill needed positions. In the first two month of 2024, St. Charles hired just 5 temporary traveling nurses, compared with 196 in Jan/Feb of 2022.

Additionally, many traveling nurses are opting to make St. Charles their permanent home by securing positions with the health system.

“These are highly skilled nurses who could find a home anywhere. They are choosing St. Charles – that speaks to our strong culture and competitive rates of pay,” said Rebecca Berry, Chief Human Resources Officer for St. Charles. 

Chris Collins, a Client Relations Manager for FocusOne, which provides traveling nurse staffing for hospitals across the country, says that the percentage of travelers converting to be permanent nurses at St. Charles is notable. “With many of our clients typically experiencing conversion rates of less than 5%, St. Charles definitely stood out with their impressive 12% conversion rate in 2023. There are several likely factors that helped contribute to that success. Notably, St. Charles offers attractive pay packages and is situated in a location known for its picturesque scenery. However, it's the culture St. Charles has created that sets them apart and makes them attractive to those looking for a permanent position.” 

Michael Teeters spent more than six years as a traveling nurse before becoming a permanent staff member at St. Charles last month. He’s one of 14 traveling nurses to be hired as a permanent caregiver in 2024.

“St. Charles feels like home, like where I’m meant to be. The people that work here are incredible,” said Teeters.

Learn more about Teeters and additional stats.

If you followed conversations during the recently concluded Oregon legislative session like I did, you might have noticed a common thread: People have wildly varied ideas about hospitals and clinics as organizations, what we do, how we function, and even why we exist.

Like many of you, those of us who work in health care organizations are deeply concerned about the stability, affordability and quality of health care and the wellbeing of caregivers. These concerns are not new, and big solutions seem as out of reach as ever. But two fresh concerns seeped into the state-wide discourse lately. First, what role should private equity investors play when it comes to essential services? And second, are out-of-state interests taking over Oregon health care and what should be done about it? These are complex questions, and the legislative session closed without much in the way of answers. But that doesn’t mean these questions are going away.

The interests of private equity investors and out-of-state corporations vary widely. Time will tell whether their increasing activity in Oregon leaves us better or worse off. Meanwhile, I want you to know where we stand.

St. Charles is a nonprofit, locally operated, community-oriented organization. We aspire to behave in such a way that society is happy we exist, and not unhappy. We strive to prosper for and along with Central Oregon, not to its detriment. We are not beholden to out-of-state interests or private equity investors. Money spent at any of our facilities goes back into the community through wages, benefits and educational opportunities for our more than 4,800 employees; through investments in equipment and facilities; and through direct dollars that we donate to support other community nonprofit organizations.

St. Charles is many things. As the largest employer in Central Oregon, we are a crucial economic driver for the region. We are an essential provider of “safety net” health care services. We are a place where many people experience some of the most joyful and most harrowing days of their lives. We are a collection of people – your friends, your family members, your neighbors – who have taken on the responsibility of caring for the communities we serve. And you’d better believe we take that responsibility seriously.

The decisions we make today about the care we provide are tied directly to our ability to ensure that you have access to safe, quality health care services for the long term. Because we serve a vast, rural, geographically isolated region, we also find ourselves increasingly partnering with other local organizations to lift each other up and help each other maintain services. These partnerships are exciting as they show that our community is willing to come together for the greater good.

Health care is a complicated business, but at the end of the day my hope is that you know St. Charles is made up of local people who care about doing what’s right for the beautiful and unique communities we are all lucky enough to call home.

Sincerely,
Steve

After being closed for almost a year, the St. Charles Madras gift store has reopened thanks to wonderful volunteers from the community. Two of those volunteers, Julia and Sunny, come from Opportunity Foundation of Central Oregon, a local nonprofit that provides job training and placement for adults with disabilities.

Julia and Sunny love volunteering at the St. Charles Madras gift store. The pair, pictured here with their volunteer mentor Melissa, volunteer at the store every Wednesday morning as part of the job training program. In addition to stocking the shelves, conducting inventory and ringing up sales, the pair also like getting to interact with caregivers.

“I love working here. I’m happy to be with my friends. It makes me happy being here because the people are my friends. It brings me a good mood to see my friends,” said Julia, 53, who has lived in Madras for 40 years.

Vicki Woods, manager of support services for St. Charles Madras, says Julia has gotten to know so many of the caregivers, who love stopping by to say hi during her shifts. She says Sunny is a great worker who loves giving back to the community by volunteering.

“It’s so much fun to have Julia and Sunny here,” said Woods.

Caregivers in Madras are especially appreciative because for many months the gift shop had been closed. Having this support from the Opportunity Foundation helped to reopen the gift store.

Lew England, business relations director for Opportunity Foundation, also praised the partnership between the two organizations and hopes to use the same model in other communities. “It's been outstanding. Staff there are great and it’s a wonderful partnership for us."