February is American Heart Month, and a great time for everyone to review basic tips to keep their heart healthy.
St. Charles' team of Heart Failure Nurse Navigators are leading several free classes throughout Central Oregon to share tips during the month of February. The events are all free and open to the community. Attendees at the Heart Health 101 classes will learn how to improve heart health while developing skills to prevent or manage cardiovascular conditions. The class will include information about how the heart works, how to recognize signs of a heart attack, nutrition tips and more.
Classes take place at the following times and locations:
Feb. 15, Bend Larkspur Community Center noon to 1:30 p.m.
Feb. 15, Sisters Parks and Recreation, noon to 1 p.m.
After several difficult years of COVID-19 pandemic response, staffing shortages and financial challenges, St. Charles Health System’s operating performance turnaround has been recognized positively by two large, influential credit-rating agencies.
S&P Global Ratings revised the organization’s outlook to stable from negative and affirmed its ‘A’ long-term rating assigned to bonds the health system issued in 2016 and 2020 under the Deschutes County Hospital Facilities Authority.
“The outlook revision from negative reflects our view of St. Charles’ meaningful rebound in operating performance and solid days’ cash on hand that have allowed it to withstand operating pressure and recent industry headwinds,” according to S&P Global Ratings.
Moody’s Investors Service revised St. Charles’ outlook to stable from negative and affirmed its ‘A2’ revenue bond rating to reflect the health system’s successful execution of financial turnaround plans.
“(St. Charles’) favorable credit profile is supported by (its) strong market position as the dominant system in central Oregon, its comprehensive array of strong clinical offerings, and its favorable location in a quickly growing, desirable region, which will continue to fuel strong revenue growth,” according to Moody’s.
As a nonprofit health care organization, St. Charles issues bonds to reinvest in its facilities and infrastructure to continue providing high quality, critical care to Central Oregon communities. The affirmed rating and improved outlook strengthen the health system’s capacity to borrow additional capital dollars in the future.
"We have been working incredibly hard for the past 18 months to stabilize the health system and it is nice that others recognize our improvement,” said St. Charles President and CEO Dr. Steve Gordon. “We have stabilized our workforce, stabilized our finances and are now able to lay the groundwork to better meet our region’s growing needs for essential services now and in the future.”
About St. Charles Health System St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, Madras, Prineville, Redmond, La Pine and Sisters. St. Charles is a private, nonprofit Oregon corporation and is the largest employer in Central Oregon with more than 4,500 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.
Grand Rounds presentations are held every Friday from 7:00 to 8:00 AM. These sessions cover a range of topics, including emerging medical research, advancements in diagnostic and therapeutic modalities, and cultural considerations, all delivered by leading subject matter experts. Since 2020, Grand Rounds have been available in a hybrid format, accessible via Microsoft Teams and in person at St. Charles Bend. For the most current schedule, please refer to the portal link Portal - CE Calendar
Target audience: Although our educational content is primarily designed for MDs, DOs, and Advanced Practice Providers (APPs), Grand Rounds is open to all individuals with an interest in attending.
Teams link for 2025: (we recommend creating a free teams account for ease of use)
Grand Rounds is on a Summer Break for August. Join us again September 5th!
You can watch past Grand Round recordings for credit! After watching be sure to follow the "claim credit" link to sign in and fill out your eval for credit.
Interested in presenting at Grand Rounds or have a topic suggestion? Email us at [email protected]
Body
Maintenance of Certification (MoC)
MOC, or Maintenance of Certification/ Continuous Certification, credits are part of a continuing education process for physicians who are board-certified. The purpose of MOC is to ensure that physicians stay current with the latest medical knowledge and practices throughout their careers.
Here's a brief overview of how MOC credits work for boarded physicians:
Requirements: Physicians who are board-certified by organizations like the American Board of Medical Specialties (ABMS) or its member boards must participate in MOC programs to maintain their certification. These requirements typically include continuing medical education (CME), self-assessment, and sometimes participation in quality improvement activities.
Credit Categories: MOC credits often fall into several categories, including:
Professional Standing: Proof of a valid medical license and a clean record of professional behavior.
Medical Knowledge: Participation in CME activities or passing examinations that demonstrate up-to-date knowledge in their specialty.
Practice Performance: Engaging in activities that improve the quality of care, such as performance improvement projects or practice audits.
Patient Care: Involvement in activities that enhance patient care, such as patient safety or communication skills workshops.
Renewal Cycle: MOC requirements are usually part of a multi-year cycle, often spanning 10 years. Physicians must earn a certain number of MOC credits within this cycle to maintain their certification status.
Assessment and Documentation: Physicians must keep track of their MOC activities and submit documentation as required by their certifying board. They may also need to pass periodic exams or assessments to demonstrate their continued competency.
Currently, St. Charles CME has collaborations in place with:
American Board of Anesthesiology (ABA) American Board of Internal Medicine (ABIM) American Board of Orthopaedic Surgery (ABOS) American Board of Otolaryngology–Head and Neck Surgery (ABOHNS) American Board of Pathology (ABPath) American Board of Pediatrics (ABP) American Board of Surgery (ABS) American Board of Thoracic Surgery (ABTS)
A board badge and statement will be present at event that is offering MOC.
To claim MOC at CME activities:
Attend the CME event
Sign into your EEDS account with the event code and fill out the evaluation.
Mark the box for "claim ____ MOC"
Take the post test for MOC credits
Make sure your EEDS account has the correct year for your DOB and full name listed on your NPI (this is how the system will find you and send credit info to your board on your behalf)
Reach out to [email protected] if you need help claiming MOC or need to find options for specific MOC.
St. Charles’ Board of Directors has a new chairperson: Ann Rhoads, a 10-year resident of Bend.
Rhoads joined the Board in 2021 and spent the past year as Vice Chair, shadowing outgoing chairperson Jamie Orlikoff to better understand the role and its responsibilities. (Orlikoff will remain on the Board.)
Previously, Rhoads served on two St. Charles committees, one focused on investment and another on audit and compliance. She was a natural fit for those after her 33-year career as an audit professional with PricewaterhouseCoopers, she said.
“My background is in finance and accounting,” Rhoads said. “Serving on this Board appealed to me because of my interest in health care in and of itself, and how it’s being delivered.”
A former member of the local Volunteers in Medicine Board and a current member of the Tower Theatre Foundation Board, Rhoads also joined the St. Charles Board because of her commitment to giving back to the community she has called home for a decade.
“I have a very strong affinity for the fact that we have an excellent health system in Central Oregon that serves the community and is interested in making the community healthier,” she said. “When you live here and you see that every day, you want to be a part of it and help make sure it’s going to be around for a long time.”
After focusing on workforce and financial rebuilding in 2023, St. Charles is well-positioned, Rhoads said, to pursue initiatives within the Board’s three priority areas for 2024:
Sustainability: “We got our financial house in order last year,” she said. “Going forward, we can now really reinvest in the organization. We can make sure we’re providing the right services and the right number of beds for the communities we serve. And we’re prepared to do some fairly big things, like the Redmond Cancer Center. That’s an exciting place to be.”
People and culture: “At one point, we had more people leaving the organization than staying with us. But we’ve stabilized that. We’re on a positive upswing and we’re building the nursing staff back to where it needs to be,” Rhoads said. “We want people to be proud to work at St. Charles and to be happy in their jobs. We want to be a place with an irresistible culture, where people feel respected and valued for not just their skills but simply who they are.”
Safety and quality: “Obviously, safety is Job One for a hospital. We closely monitor the safety and quality of the care we provide and we’re working hard to develop new ways to improve,” she said. “We’re well on our way to where we need to be, but of course this is the kind of thing that needs constant attention, and it’s intertwined with having the right people in place and giving them the tools they need to do their jobs.”
Overall, Rhoads is looking forward to serving as Board Chair because she believes St. Charles’ future is as bright as ever.
“There have been bumps in the road, obviously,” she said, “but I feel like we’re on the right track.”
Tom Foster, MBA Vice President, Strategic Initiatives and Transformation
Tom Foster works with the leadership team of St. Charles and our community partners to define and deploy strategic initiatives needed to grow, improve and transform the way health care services are provided to our patients and within our communities. He grew up in Bend, Oregon where his dad previously worked at St. Charles as a radiologist.
Tom has a Bachelor of Arts from Whitman College and a master’s in business administration from the Melbourne Business School in Australia. Prior to joining St. Charles, Tom worked as a consultant for Point B and Ernst & Young.
A major investment in training Madras and Prineville nurses over the past three months means more patients in Jefferson and Crook counties can get the care they need closer to home rather than transferring to Bend, Redmond or beyond.
St. Charles spent nearly $500,000 to train nurses at the two hospitals, giving them the additional breadth of knowledge they need to provide the same level of care patients receive at Intermediate Care Units (IMCU) in Bend and Redmond. IMCUs serve as an essential link in the health system, taking care of people who don’t need the long-term critical care of an Intensive Care Unit, but who need a higher level of care than is typically available in a Medical Services unit.
To provide IMCU care, nurses need to have a robust understanding of things like administering heart medications and advanced life support techniques.
“The skill set has always been there,” says Dr. Maggie King, chief medical officer at St. Charles Prineville. “We just expanded it.”
As an example, a patient with Type 1 diabetes who is experiencing diabetic ketoacidosis – a serious condition caused by lack of insulin – requires an insulin drip and, often, an overnight stay. That’s a treatment typically provided in IMCUs.
Before the new training, patients with diabetic ketoacidosis in the Madras and Prineville areas had to be taken to Bend or Redmond. Now, those patients can stay at their local hospital to get the treatment they need, saving them a trip across Central Oregon and keeping them closer to friends, families and other resources.
And to be clear, it’s not just diabetics who benefit. Any patient who needs hospital care, but not ICU-level care, can stay closer to home.
“It’s been a wonderful thing for our community,” says Kassidy Apperson, a registered nurse at St. Charles Prineville who was in the first cohort of IMCU trainees last summer.
The training took place in Bend over the course of three months, beginning with classroom instruction and then hands-on learning in patient-care units, said Todd Shields, vice president and hospital administrator for Madras and Prineville. Another cohort is scheduled to start in February.
IMCU-level care started in Madras and Prineville in August. Since then, more than 40 patients who would’ve previously transferred have been treated in the two hospitals, Shields said. This not only saves the patients and their families the hassle of moving hospitals, he said, it also frees up ambulances and emergency workers, as each transfer removes them from service for about three hours. Finally, keeping these patients close to home reduces patient load for caregivers in Bend and Redmond, opening space for people local to those towns.
Nurses in Madras and Prineville have greatly benefited from the training, too. “(We’ve) really seen from the staff this level of pride,” King said. “There is a stronger sense of capability in keeping patients here and a push to care for them locally.”
For caregivers who are wholly dedicated to doing what’s best for their patients, that’s a great feeling, said Apperson.
“Being able to keep (them) in the community … has been so good for our patients,” she said. “It’s just awesome.”
To kick off a new year, I want to tell you about a project that we’re really excited about at St. Charles – a project that aims to make Central Oregon healthier, now and for generations to come.
It’s called the Three Sisters Rural Track Program, and it’s a collaborative effort between St. Charles and our partners at Mosaic Community Health, Indian Health Services in Warm Springs and Oregon Health & Science University in Portland. Together, we are building a rural medicine residency program that will create a pipeline of uniquely trained doctors to Central Oregon.
This program – the first graduate medical education program in the region – will significantly transform access to health care in Jefferson, Crook and Deschutes counties and beyond, especially in outlying rural areas.
Why does this matter? Because rural communities across the United States are facing a critical shortage of primary care doctors. This shortage can force patients to drive long distances for care or visit Emergency Departments with routine health concerns. Even worse, they may forego medical care altogether.
Central Oregon is not immune to this shortage. In the tri-county area, we are expecting a shortage of at least 100 primary care doctors by 2030.
Which is precisely why we’ve prioritized the Three Sisters program, and a team of St. Charles caregivers has been working hard to bring it to life. Starting in July, residents will spend one year training at OHSU, and then two subsequent years in residency in Madras. These residents will complete core training and elective training at St. Charles, Mosaic Community Health and Indian Health Services in Warm Springs, giving them culturally inclusive, full-spectrum training in family medicine.
And here’s the long-term effect: Studies show that roughly 55% of physicians stay and practice within a 100-mile radius of their residency program site. Bringing them to Central Oregon to train significantly increases the chance they’ll choose to remain here, put down roots here, serve patients here and increase access to health care here.
That’s why I’m excited about this program, and I hope I’ve stirred some excitement in you, too. This is important, and the future of health care in the region is an issue that should matter not just to St. Charles, but to every person who lives here.
The St. Charles Foundation is raising funds for the Three Sisters program right now. If you’d like to invest in the future of health care in Central Oregon, you can donate through the Foundation’s website. To learn more about how you can help, please contact Angela Saraceno at [email protected].
A cancer treatment now available at St. Charles has the potential to transform cancer care for women in our community who have gynecologic cancer, according to Dr. Whitney Sumner, a radiation oncologist.
Dan Nicewonger and Dr. Whitney Sumner
For some types of gynecologic cancers, like cervical cancer, treatment using external beam radiation can limit the delivery of an effective dose due to damage to surrounding tissues as it passes through the skin and surrounding organs to get to the tumor or area that requires treatment.
This newly available treatment, called brachytherapy, reduces that risk by providing radiation from INSIDE the body. This reduces possible damage to skin, and nearby organs – and provides even more effective targeted treatment. It’s able to treat right at the site of the tumor with minimal spread of dose, according to Sumner.
Sumner has been working with physicist Dan Nicewonger and a team at St. Charles to bring this new treatment to St. Charles for more than a year. In December the team was able to treat their first patient and already have several more on the schedule. Before brachytherapy was available at St. Charles, patients would often travel for treatment or choose to forego radiation treatment all together.
For some patients with endometrial cancer, brachytherapy alone is the recommended therapy to reduce the risk of local recurrence. “External beam radiation therapy is too aggressive of a therapy for some of these early-stage patients – a lot of patients would forego any therapy or have to travel to Portland,” said Sumner.
Currently, St. Charles Bend is able to provide brachytherapy treatment to patients experiencing endometrial cancer, cervical cancer and other gynecologic cancers.
Nicewonger explains because the radiation is delivered through a closed system hollow tube inserted into the patient’s body, the patient never touches anything radioactive.
The patient does not feel or hear anything from the radiation source during treatment.
The radiation dose is delivered from a tiny radioactive source material, smaller than a rice grain, that travels along the hollow tube. The physicians are able to shift the direction and location of the dose allowing targeted treatment within a millimeter in accuracy.
“It’s actually kind of simple – it goes along a path and is very predictable,” said Nicewonger.
In the future, Sumner and Nicewonger would like to see brachytherapy also offered to treat skin cancer, prostate cancer and potentially gastrointestinal cancers. But for now, they are just excited to begin making a meaningful difference in the lives of many patients.
Sumner expects that they will treat about 25-30 patients a year, with each of those patients requiring about three to five treatments.
“Our hope and long term goal is to optimize our process and build on our expertise to become a destination for brachytherapy,” said Sumner.
For Sumner, this profession was a natural calling. As someone who always loved math and science, but also wanted to help people directly – radiation oncology, and particularly brachytherapy, is a perfect fit.
“How often do you get to use math and physics that are so profoundly interesting, in a way that has a real impact on this person sitting in front of you?” said Sumner. “I love this work. It means we get to keep our Central Oregon patients closer to where they feel comfortable to get the care they need.”
