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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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Enduring Materials - Mar 2, 2023
"Prevention and Treatment of Alcohol Use Disorder in Primary Care"

Speaker: Jess LeBlanc, MD, MPH. Mosaic Medical.

Objectives

  1. Understand the epidemiology of AUD.
  2. Explain the neuropsychological as well as the physical effects of alcohol on the body.
  3. Review Adolescent Predictors of Alcohol Use Disorder.
  4. DSM-V criteria for AUD – mild/moderate/severe.
  5. AUD prevention strategies for adolescents and adults in Primary Care.
  6. AUD treatment strategies for adolescents and adults in Primary Care.
  7. Local resources for referral to treatment programs in Central Oregon.

Accreditation: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of St. Charles Health System and Mosaic Medical. St. Charles Health System is accredited by the ACCME to provide continuing medical education for physicians. St. Charles Health System designates this live virtual activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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]

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As a child, Steve discovered a love for music and began playing the guitar. After a career in several different trades, his passion for the instrument led him to Breedlove Guitars, where he was able to combine his love for music with the art of building some of the most exceptional stringed instruments available. However, Steve's passion was threatened when he began experiencing pain in both hands. He sought treatment at The Center, where he was diagnosed with carpal tunnel and arthritis in his thumb carpometacarpal (CMC) joint. He was reluctant to undergo surgery, so he opted for injections to alleviate his pain. Unfortunately, after a year, Steve's condition worsened, and he was unable to perform even the simplest daily tasks, let alone play music or do his job without experiencing excruciating pain.

Although Steve was apprehensive about surgery, Dr. Soma Lilly alleviated his fears and earned his trust. As a result, Steve underwent surgery on his left hand, which yielded remarkable results. Following the removal of his stitches, he made rapid progress in his recovery. Although he experienced some discomfort, it paled in comparison to the agony he had endured for years. Steve diligently followed the physical therapist's instructions and even incorporated guitar playing into his therapy. He said, “The feeling I got when I hit that first D chord, I got goosebumps.”

Steve is now back to work and playing music. He knows that he will eventually need surgery on his right hand. However, he is determined not to delay seeking treatment next time so he can continue to live the life he loves, pain free.

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The opening of St. Charles’ new Wound Ostomy care clinic in Prineville means people in Crook County who need wound and ostomy services can get the care they need closer to home.

Located in the Prineville hospital, the clinic is open Monday through Friday, 8 a.m.-5 p.m. by appointment only. It is the health system’s third hospital-based, outpatient Wound Ostomy clinic in Central Oregon, joining locations in Bend and Madras, where planned expansions are designed to better serve Jefferson County, too.

For patients traveling to and from appointments multiple times per week, less travel can mean better health outcomes, said Bethany Klier, manager of Wound Ostomy for St. Charles.

"People shouldn’t have to commute 30 miles, 60 miles and even 100 miles to receive care. It is our priority to bring care closer to where our patients reside,” Klier said.

The experienced and board-certified clinicians in Wound Ostomy treat patients with problematic, chronic, or hard-to-treat conditions such as pressure ulcers, diabetic ulcers, surgical wounds, and arterial wounds. They also provide comprehensive ostomy care and management for patients with stomas, ostomies, from pre-op counseling and education to dietary help and support groups.

But more than just providing a medical service, the staff in Wound Ostomy hopes to be a source of support and community for their patients.

“We’ll partner with you to get optimal healing outcomes, but we don’t see it as just providing a service,” Klier said. “We create connections by listening, empathizing, educating, and supporting one another. We truly care about our patients and want to provide a safe healing environment for all.”

The planned Wound Ostomy expansion in Madras includes an additional exam room and more staffing to meet the demand that is higher than anticipated, Klier said.

“We’ve grown pretty consistently as the years have progressed, despite a lot of people not knowing who we are or what we do,” she said. “We weren’t expecting the amount of patient volume when we opened our Madras location, and we’ve found that we really hit a population that we didn’t even know existed or needed our care. It humbled all of us who’ve worked there. It’s obvious that the community needs us more than ever.”

If you think you could benefit from wound and ostomy care or would like more information about ostomy support groups, please contact your primary care provider for a referral. Visit our website to learn more about St. Charles’ wound and ostomy services.

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