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It is no secret that this has been a challenging year at St. Charles. A number of regional, national and even global factors have caused workforce shortages, patient capacity issues and financial struggles. Aftershocks of the COVID-19 pandemic continue to rattle hospitals across the country, including ours.

But I firmly believe St. Charles is on the right track, both operationally and financially, thanks to our caregivers’ team work, professionalism and dedication to patient care excellence. I want to give you a brief update and assure you that Central Oregon’s largest health care provider – and employer – is committed to being here and continuing to provide critical care to our communities.

Service lines

Based on input from physicians, frontline caregivers and leaders, we are making some significant structural changes to how we deliver care. The basic idea is care should be organized around the patient, rather than us operating in silos, and we must pull together to succeed.

One way we are doing this is the development of what we call service lines. In the health care industry, a service line is an organizational structure that aligns, coordinates and advances services for a certain patient population with similar clinical needs. Within the service line, we will group and manage services that support the patient’s journey from beginning to end. A service line structure is less about buildings, departments and geography and more about why patients seek care and how we can re-think the way we work to support their needs.

As an example, cardiac patients are often treated in both hospitals and clinics. Building a system that reinforces and promotes communication and support across different areas of the health system will improve patient care, patient outcomes and patient satisfaction. The goal, as always, is to do what’s best for you.

Financial improvement

On the financial side, we are starting to see green shoots of progress after months of efforts by everyone in the organization – from the Board of Directors to the frontline caregivers to the folks who balance the books – to seek out new sources of revenue and to spend only what’s necessary. In this way, our budget is probably a lot like yours at home.

One thing that has helped significantly is we have finished paying back $95 million in advance payments we received from the federal government as part of a pandemic relief program. Without this drag on operating cash flow, we will see more immediate impact from our financial stabilization and improvement efforts.

Here’s the good news: October was the fourth consecutive month in which we achieved a positive operating income, albeit modest. That result was driven by a decrease in contract labor and lower than expected use of medical supplies, among other factors.

The not-as-good news is that our year-to-date operating loss stands at nearly $28 million, so we are not yet out of the financial woods. But as I said above, I believe we are on the right track, and I’m grateful for all of our people who I see working hard every day to deliver great care and to keep us moving in the right direction.

Sincerely,
Steve

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With the addition of three OB-GYN physicians to its staff, the St. Charles Center for Women’s Health is improving access to reproductive health care for all women.

The three physicians – Michal Montana, MD, Nicole Berrigan, MD and Amy Yuan, DO – join the center’s robust group of providers, including nurse midwives, behavioral health experts, nurse practitioners and doctors. With many providers accepting new patients, it’s easier than ever to get in to see someone.

“Our patients love our providers, and they tell their friends who tell their friends. The word is out, and that has kept our schedules very full in recent months,” said Tricia Clay, administrative director of Women’s and Pediatric Services for St. Charles. “With these arrivals, we’re expecting wait times for appointments to see our providers to significantly decrease.”

The center offers an array of services, including routine and preventive women’s care; obstetrics from preconception through postpartum; gynecology and gynecologic surgery; and pelvic floor therapy and procedures for overactive bladder/urinary retention. Providers see patients in Bend, Prineville, Redmond and Sisters and they perform surgeries in Bend and Redmond.

The new physicians will also bring new options for care to the practice, Clay said.

“One in three women experience bladder leakage during their lifetime. This is known as urinary incontinence, and it often worsens with age,” Clay said. “We are excited to bring new, minimally invasive procedures to our practice that will offer women more treatment options for their bladder symptoms.”

Dr. Michal Montana
Dr. Michal Montana

Dr. Michal Montana completed residency training at Loma Linda University Medical Center and prior to that she attended medical school at Oakland University William Beaumont School of Medicine in Michigan. She lives in Bend with her husband, two daughters and dog. Together, they love exploring the region’s natural beauty.

“My interest in women’s health came from a desire to incorporate a passion for hands-on care with lifelong patient relationships,” she said. “I look forward to serving the women of Central Oregon throughout some of the most special, vulnerable and difficult times of their lives.”

Dr. Nicole Berrigan
Dr. Nicole Berrigan

Prior to joining St. Charles, Dr. Nicole Berrigan worked in private practice for three years in the Willamette Valley. She completed her OB-GYN residency through the University of North Carolina and medical school at the University of Nebraska Medical Center in her hometown of Omaha, Neb. She and her husband love trail running, mountain biking, skiing and paddle boarding, and they’re excited to do those things in Central Oregon.

Berrigan practices the full spectrum of obstetrics and gynecology with special interest in surgery including robotic hysterectomies and pelvic floor repair. She also received a degree in studio art and has a special interest in integrating art into her practice.

“Having a piece of art to focus on during an exam or playing music during a procedure has been shown to decrease patient anxiety and pain,” Berrigan said. “I am looking forward to integrating art into our practice.”

Dr. Amy Yuan
Dr. Amy Yuan

Board-certified obstetrician/gynecologist Dr. Amy Yuan completed her OB-GYN residency in Cincinnati, Ohio and then was in private practice in Colorado before moving to Oregon to join St. Charles. She loves spending time with her family, traveling, camping, mountain biking, snowboarding and skiing, and she is thrilled to move to the area.

Yuan enjoys all aspects of women’s health, including helping people through high-risk pregnancies, infertility, urinary incontinence, pelvic pain, sexual dysfunction, menopause, and minimally invasive surgery, especially robotic assisted procedures.

“As an OB-GYN,” she said, “it is my goal to provide a comfortable and safe space to address sensitive and important issues for people in Central Oregon.”

Learn more about the St. Charles Center for Women’s Health, or call 541-526-6635 to schedule an appointment with a provider.

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Six years ago, David and Tess Tappert moved to Post, a remote town about 25 miles east of Prineville.

At the time, Tess worked at Norco, a medical equipment supplier in Bend. Her commute? About an hour and a half one way – on a good day.

“And she was there every single day, even in the winter,” said David, her husband of 30 years.

After three years of that, Tess decided it was time to retire. With newfound free time to spend, she picked up a new hobby: quilting. And she quickly gravitated to a method known as collage quilting, where the maker uses layered fabric to create collage art, then quilts over the fabric to keep the pieces together.

“You can take a picture and recreate it using the fabric as your paint palette,” Tess said. “I just loved that, and I really got into it.”

Tess started making collage quilts of coastal scenes and donating them to the town of Seaside, where her sister is on the city council. Then, a couple years ago, she had the idea to make one that represents Prineville. So she and David drove around town taking photos of different places, including many angles of the iconic Crook County Courthouse.

Eventually, she decided to make a triptych, or three panels to be placed side by side, featuring the courthouse and other recognizable features of Prineville. (The panels are each 20 inches across and 40 inches tall.) Using photos as a guide, David drew a smaller “map” of the quilt to help with construction, while Tess began auditioning different fabrics for use in the piece’s sunset and water elements.

Two years and about 1,300 hours of work later, the piece is complete. The three panels are each 20 inches across and 40 inches tall, quilted by Yvette Thomas of Crooked River Quilting in Prineville and mounted on frames by David Tappert.

The couple has named it “Then and Now,” celebrating the people and the rich history of Prineville and Crook County. Among many others, featured elements include the courthouse, Bowman Museum, Club Pioneer, Barney Prine’s steakhouse, Les Schwab Tire Center, the Pine Theater, Meadow Lakes Golf Course, Parr Lumber, the “War Paint” horse statue, Steins Pillar and several individuals.

When it came time to decide what to do with the piece, the Tapperts didn’t have to think for long before settling on a donation to the annual St. Charles Hospice Christmas Auction, to be held Dec. 3. Presented by St. Charles Foundation, the annual event has a 30-year tradition of raising money for crucial support services for patients of St. Charles Hospice and their families.

It’s a cause that is near and dear to the Tappert’s hearts. In past years, they’ve donated other quilts to the auction, as well as elaborately decorated trees, handmade ornaments and furniture – including a fully outfitted sewing room.

“Hospice was there for my mother before she passed away,” Tess said. “They came out to Post three times weekly from Prineville and they were so good with her. They drove all the way out there and they were incredibly kind every time.”

Ezperanza “Tita” Montero moved to Post to live with Tess and David and lived there for a little over a year before she passed away in 2016 at the age of 97. In the final three months of her life, David was her primary caretaker, and he gets emotional when he talks about the care she received.

“I want to shout out Dr. Michael Knower, specifically, because he is an amazing man, as well as her nurse, Ginger Hearty, who treated her with such kindness and dignity,” David said. “The whole team she had was amazing. They went above and beyond. They really did.”

David had experience with hospice care, having experienced it through his own mother years before. He understands the impact hospice caregivers can have on patients and their families during one of life’s most precious and vulnerable seasons.

“Hospice means a lot to both of us,” he said. “We know there’s a great need for it, so as long as we’re able, we’ll be there to support it.”

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Grand Rounds - Nov. 18, 2022
"Quality Pain Care in Older Adults"

Speaker: Michael Bottros, MD. Clinical Operations & Medical Director of Pain Services, Associate Professor, Division of Pain Management, Department of Anesthesiology, Keck School of Medicine of USC.

 

 

Objectives

  1. Describe the impact of pain in older adults.
  2. Identify the barriers to pain assessment and management in older adults.
  3. Briefly describe the multifaceted nature of suffering when performing a comprehensive pain assessment.
  4. List both non-pharmacologic & pharmacologic treatment options.
  5. Develop a multimodal pain treatment plan for patients with complex pain.

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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Native American Market 2022

Our first Native Market at St. Charles Madras was a success! The community was able to come together, visit, build relationships and learn more about Native American culture. We are so grateful for the opportunity and we look forward to hosting this special event again next year.

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Pumpkin Pie Smoothie

Fall is the season for all things pumpkin. Eating pumpkin can be a healthy treat. Indulging in pumpkin has many health benefits - it's high in fiber, antioxidants, and vitamins A and B. Feel free to enjoy!

Ingredients

1/3 cup pumpkin puree

1/4 banana or apple

1/4 cup milk (dairy, nut, soy, hemp or rice)

1/4 cup Greek yogurt

1-2 tsp. honey or maple syrup

1/4 tsp. pumpkin pie spice

1/4 tsp. vanilla

1/4 tsp. ground cinnamon

Directions

Blend all ingredients with ice. Garnish with whipped cream and sprinkle with cinnamon (optional). Makes one serving.

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Grand Rounds - Nov. 11, 2022
"H-Pylori: Helicobacter Highlights"

Speaker: Peter S. Buch, MD, AGAF, FACP. Associate Professor, University of Connecticut School of Medicine; University of New England College of Osteopathic Medicine; Frank H Netter MD School of Medicine.

 

 

Objectives

  1. Identify techniques to improve H. pylori treatment.
  2. Utilize H. pylori eradication confirmation in your practice.
  3. Recognize the long term consequences of H. pylori infection.

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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Chicken Enchilada Soup

This zesty soup is a fun spin on a Mexican food favorite - enchiladas - but is kinder to the waistline. Each one-cup serving (this recipe makes 12) is only 170 calories and three grams of fat. And with the chicken, it's a good source of protein, too - about 13 grams per serving. 

Ingredients

  • 2 teaspoons vegetable oil
  • 1 cup chopped onion
  • 2 cloves garlic, minced
  • 1 teaspoon ground cumin
  • 1 can (16 ounces) navy beans
  • 1 can (28 ounces) diced tomatoes
  • 2 cans (14 1/2 ounces each) fat-free chicken broth
  • 1 can (8 ounces) tomato sauce
  • 2 cans (4 ounces each) chopped green chilies
  • 2 teaspoons dried oregano
  • 2 cups chopped cooked chicken
  • 1⁄2 cup chopped fresh cilantro
  • 1 cup shredded cheese
  • 10 thin corn tortillas

Directions

  1. Heat oil in a large pot. Add onion, garlic, and cumin, and sauté until onion is softened but not browned.
  2. Drain and rinse beans. Add drained beans, tomatoes with liquid, and chicken broth. Heat to a boil. Reduce heat.
  3. Stir in tomato sauce, chilies, oregano, and chicken. Simmer 15 minutes.
  4. When ready to serve, stir in cilantro and 1 cup cheese until melted. Serve tortilla strips on the side as soup toppings.

Refrigerate leftovers within two hours.

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Cancer and Exercise Symposium

The Cancer and Exercise symposium is a free virtual offering designed for physical therapists, exercise professionals, personal trainers, wellness coaches, nurses and other health care providers interested in learning evidence-based recommendations in how to safely exercise with cancer survivors.

Learn more

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Grand Rounds - Nov. 4, 2022
"The Cannabinoid and Opioid Connection"

Speaker: Kenneth P. Finn, MD. Springs Rehabilitation PC.

 

 

Objectives

  1. Review the endocannabinoid system and how it is related to the cannabinoid system.
  2. Educate and communicate with patients who may have questions about marijuana.
  3. Identify the close relationship between opioids and cannabinoids systems.
  4. Identify what conditions cannabinoids may possibly work for and how expanded cannabis programs impacted the opioid epidemic.

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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