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Grand Rounds - Mar. 24, 2023
"Heart Disease in Women: A Global Threat Presents a Golden Opportunity"

Speaker: Malissa J. Wood, MD. Cathy E. Minehan Chair, Cardiovascular Disease in Women, Co-Director- MGH Corrigan Women’s Heart Health Program, Associate Chair for Diversity and Health Equity MGH, Chair ACC Board of Governors.

 

 

Objectives

  1. Recognize the risk factors and perform an appropriate risk assessment for cardiovascular disease in women.
  2. Order appropriate diagnostic testing.
  3. Manage acute and chronic coronary artery disease in women.
  4. Cite contributing factors of heart disease in women, such as age, ethnic background, and culture.

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].

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St. Charles Health System is proud to support and partner with organizations across Central Oregon through its Community Benefit program

One such organization is Rimrock Trails Treatment Services, which provides professional mental health counseling and substance abuse treatment programs. Established in Prineville in 1990, Rimrock Trails initially opened as the first residential substance abuse treatment center for youth in Central Oregon. In the years since, it has expanded to provide comprehensive behavioral health services to individuals, families and couples of all ages. 

With outpatient treatment centers in Prineville, Redmond and Bend, Rimrock Trails is dedicated to improving the lives of its clients and creating lasting change through evidenced-based treatment in a safe, judgment-free atmosphere. The organization’s mental health therapists are dual-certified as addiction counselors, allowing them to provide integrated treatment for co-occurring mental health and substance use disorders.

Having provided specialized treatment to more than 17,000 people since its inception, Rimrock Trails is an invaluable community resource whose services are needed now more than ever.

“We are seeing a tremendous increase in the utilization of our outpatient counseling services, anywhere between an 8% and 37% increase month to month,” said Executive Director Erica Fuller, citing the COVID-19 pandemic and increasing use of social media, particularly among young people, as primary factors. “Clients are definitely coming in with a lot of trauma, social disconnection and loneliness.”

St. Charles has partnered with Rimrock Trails frequently over the years, supporting projects that provide basic-need items and enrichment activities for teens in the residential center. The health system will also sponsor upcoming events such as Kiefer’s Magical Birthday Bash, a family-friendly fundraiser happening March 31 in Prineville and April 1 in Redmond that is open to the public. Created in memory of Kiefer Leutschaft, the annual event raises money for mental health awareness programs and scholarship funds to help supplement treatment costs for clients who may be struggling to pay for services.

If you’d like to support or volunteer with Rimrock Trails or learn more about their services and events, visit their website at www.rimrocktrails.org.

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The St. Charles Rheumatology clinic in Bend first opened its doors in 2015, offering comprehensive care for people with conditions such as rheumatoid arthritis, gout, osteoporosis, psoriatic arthritis and lupus.

Now, there’s good news for patients in the northern reaches of Central Oregon: The health system has expanded rheumatology services into Redmond, where people there and in Prineville, Madras, Sisters and points beyond can receive the care they need closer to home.

The new Redmond clinic will be serviced by Dr. Andrew Shaffer, who joined the rheumatology team last August. He’s currently taking appointments on Tuesdays and plans to add more clinic days in the near future.

Central Oregon has hundreds of rheumatology patients, partly due to its popularity as a retirement area; around 16% of Bend’s population is over the age of 65, according to U.S. Census Bureau data. The Bend rheumatology clinic will remain open, and the expansion to Redmond comes at a good time, as Deschutes Rheumatology closed its doors at the end of January.

“We've seen a pretty big spike in volume because of that. I'm confident that we have the capacity to accommodate all those patients, though,” said St. Charles’ chief of Rheumatology, Dr. Heather Hansen, who ran the department on her own for about seven years. She was joined by physician’s assistant Tianna Welch in September 2021 and Shaffer in 2022.

Dovetailing with the Redmond expansion, a new outpatient infusion clinic also recently opened on the Bend hospital campus. Previously, rheumatology patients needing an infusion had to go to the St. Charles Cancer Center. That option will remain, but the new outpatient clinic offers a more affordable and convenient place for infusions. It’s also in the same building as the Bend rheumatology clinic at 2600 NE Neff Road.

There is a “higher degree of physician supervision than you would have in a lot of freestanding infusion rooms,” said Hansen, who is also the director of outpatient infusion. Patients needing neurology, G.I. and other non-oncology treatments will also be able to receive infusions in the outpatient clinic. 

“The proximity to their rheumatology physician is wonderful and allows us to collaborate on visits,” said Jonnie Becker, administrative director of Surgical Services and Medical Specialties. “Having our own space allows us to develop our team [and] work together with the immediate team in service of our patients.”

Nationwide, Hansen said there’s a growing demand for rheumatology services. Millions of people in the United States suffer from some form of rheumatic disease, and rheumatology is one of the top specialties experiencing a provider shortage, she said.

“It is an ever-increasing need,” Becker said. “Our medicine continues to evolve and change and grow, and we're helping people to improve the quality of their life as they age.”

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Grand Rounds - Mar. 17, 2023
"Adult ADHD – The Hidden and Preventable Cause of Death, Disaster, and Disability"

Speaker: Lisa Jacobs, MD, MBA.

 

 

Objectives

  1. Consider the scope of preventable medical, financial, emotional, and vocational problems caused by ADHD.
  2. Recognize the signs and symptoms of ADHD and how they appear in adulthood.
  3. Choose evidence-based treatments.
  4. Identify ways to improve quality of care delivered to adults with ADHD by targeting commonly comorbid medical and psychiatric issues.
  5. Access the various pathways for treatment.
  6. Consider societal and cultural factors that contribute to the accurate diagnosis and improved recognition of adult ADHD.
  7. Reflect on the patient populations most affected by ADHD and consider how implicit bias may impact appropriate care of these patients.

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].

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Sharlet Rasmussen, a rehab therapy technician in Bend, is the kind of person who focuses on the present – the patient in front of her, the caregivers around her, the care they’re providing as a team.

Generally speaking, she’s not the type to spend a lot of time reflecting on the past. With her 50th anniversary at St. Charles arriving this week, however, the enormity of her tenure recently hit her out of the blue.

“I think back on 50 years and I just think, ‘Wow,’” she said. “It really didn’t feel like 50 years, because the time just flew by.”

Rasumussen’s hire date was March 14, 1973, when she started delivering food to patients at St. Charles’ former location “on the hill” in downtown Bend, near the intersection of Franklin Avenue and Lava Road. The hospital opened its current location in 1975, and soon after, Rasmussen took a job as a cashier in the cafeteria.

“Everyone said, ‘What are you moving out in the farmers’ fields for?’” she said. “There was really nothing out here but cow pasture.”

After 10 years with St. Charles, Rasmussen – whose family moved to Bend when she was 5 – started her career in patient care after she was hired as a therapy tech. Even 40 years later, it’s seeing her patients make progress in their rehab that is the most rewarding thing about her work.

She prides herself on being a strong advocate for her patients.

“I feel very protective of them because they’re why we’re here,” she said. “Patient care is the number one thing.”

Patients aren’t the only people she works with, of course. For Rasmussen, her time at St. Charles has been filled with wonderful fellow caregivers, both past and present. While many things have changed over the years, one thing that remains the same, she said, is “the tightness of the employees.”

On the Ortho/Neuro floor where she works, for example, she feels like everyone – Environmental Services, nurses and so on – is on the same team.

“That’s a good feeling,” she said. “I have absolutely fantastic co-workers.”

Rasmussen is also one of the few remaining St. Charles caregivers who worked with the organization’s famous founder, Sister Catherine, who she describes as “a phenomenal person” who was “dearly loved” by the employees.

“We would have parties at Sunriver and she would ride the bus and she was just a hoot. She was so darn funny,” she said. “She was so loving and kind, and she knew everyone by name. It meant a lot to work here.”

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Welcome to St. Charles Inpatient Rehab

Your admission to our Inpatient Rehabilitation Facility is an important first step in your recovery. Here you will receive three hours of therapy per day, six days per week. Your doctor and rehabilitation team will work with you to set goals and determine when you are ready to go home and get back to the life you love.

For questions related to an inpatient rehabilitation stay or information about whether you might qualify, please reach out to our admissions coordinator at 541-706-2663.

How Inpatient Rehabilitation compares to a skilled nursing facility

Inpatient Rehabilitation provides intensive therapy (at least three hours per day) involving at least two therapy disciplines; in a skilled nursing facility the intensity of therapy is much lower. Your care is overseen by a physician who specializes in rehabilitation medicine and conducts rounds at least three times a week. In addition, we have access to a full range of hospital resources such as: emergency diagnostics, imaging, surgical and medical services.

Our Rehabilitation facility is staffed with highly knowledgeable Nurses, Physical, Occupational and Speech language therapists that have experience and specialty training in treating complex medical, orthopedic and neurologic conditions.

Inpatient rehabilitation provides an interdisciplinary approach to your care. Your interdisciplinary team includes:

  • Physiatrist

  • Rehabilitation nurse

  • Physical therapist

  • Occupational therapist

  • Speech language pathologist

  • Neuropsychologist

  • RN case manager

  • Discharge planner/social services specialist

Consulting services

Based on your medical needs, your rehabilitation physician will consult with the appropriate medical team members who will follow your care and make recommendations as needed. We also have access to the specialists and specialty services (dialysis, infusion, respiratory therapy, nutritionist, radiology, etc.) that you may require while in rehabilitation.

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Before becoming the St. Charles Center for Orthopedics & Neurosurgery, The Center had a long history in Central Oregon. 

The Center got their start in 1958 when the Bend Orthopedic & Fracture was founded. Then, in 1979, the Bend Neurosurgical Group was founded. In 1999, the two groups merged to form The Orthopedic & Neurosurgical Center of the Cascades.

The Redmond location was opened in 2001.

In 2003, a new name and new vision was created and the organization became The Center Orthopedic & Neurosurgical Care & Research.

The next year, The Center moved into the current Neff Road location.

In 2005, the Cascade Surgicenter was opened, then expanded to add two more operating rooms in 2022.

In 2016, the Shevlin Health & Wellness Center opened.

In 2025, The Center joined St. Charles Health System to form the St. Charles Center for Orthopedics & Neurosurgery.

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Kale, Caesar!

This salad is packed with fiber, antioxidants, calcium, iron and vitamins C and K.

Ingredients

  • 2 teaspoons minced garlic
  • 2/3 cup mayonnaise
  • 1/4 cup avocado oil
  • 1 teaspoon Dijon mustard
  • 1 teaspoon anchovy paste
  • 1/4 c lemon juice
  • Salt and pepper
  • 1/4 cup grated parmesan
  • 1 1/2 cups croutons (optional)
  • 8 cups shredded kale (any type)

Directions

Place shredded kale in large bowl. In small bowl, whisk together first eight ingredients and use to toss with kale until coated. Add croutons, if desired.

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Grand Rounds - Mar. 10, 2023
"Non Accidental Trauma: an evidence-based clinical pathway"

Speaker: Kim Ruscher, MD, MPH. Pediatric Surgery, PeaceHealth.

 

 

Objectives

  1. Diagnose patients who may have experienced NAT using evidence-based history and examination criteria.
  2. Employ evidence-based decisions for medical workup and clinical management.
  3. Perform medical documentation that is accurate and thorough to provide optimal legal support.

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].

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Grand Rounds - Mar. 3, 2023
"Gender Discrimination and Bias in the Workplace"

Speaker: Natalie Good, MD and Mark Hallet, MD. St. Charles Health System.

 

 

Objectives

  1. Distinguish the difference between bias and discrimination.
  2. Describe the impact of gender discrimination in the workplace.
  3. Demonstrate how to be an ally/how to address when you see an issue.

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].

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