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Grand Rounds - Sep 23, 2022
"Lessons from the Cockpit"

Speaker: Robert Stephenson. Military Pilot.

 

 

Objectives

  1. Build upon medical professionals' teamwork and crisis management skills by applying 'best practices' utilized in aviation.
  2. Equip medical professionals to analyze medical mishaps with techniques applied during aviation accident investigations.
  3. Enable medical professionals to identify hazards, mitigate risk, and prevent mishaps based on lessons learned and existing programs in aviation.
  4. Draw a direct correlation between medical and aviation professionals concerning human error and teamwork performance.
  5. Identify areas for improvement in the medical profession for teamwork, risk management, and mishap prevention.

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 - Sep 16, 2022
"Aspirin for Primary Prevention"

Speaker: Matt Budoff, MD, FACC. Professor of Medicine, Director, Cardiac CT, Program Director, Division of Cardiology, Harbor-UCLA Medical Center, Torrance CA.

 

 

Objectives

  1. Review primary prevention trials for aspirin.
  2. Evaluate benefit-risk balance for aspirin in primary and secondary prevention.
  3. Discuss guideline recommendations.

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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As the pandemic evolves, St. Charles updates COVID-19 vaccination policy for health care workers  

Unvaccinated health care workers who apply for and receive a medical or religious exception from the state’s vaccine mandate can provide patient care if they wear a N95 respirator 

St. Charles Health System is now allowing unvaccinated people who apply for and receive a medical or religious exception to the state’s vaccine mandate to work in a health care setting if they wear a N95 or higher filtering respirator—or other reasonable accommodation to the extent applicable—while providing direct care. 

“With the use of this type of personal protective equipment, we believe we are taking reasonable steps to ensure unvaccinated providers and staff are protected from contracting and spreading COVID-19 to coworkers, patients and visitors in a manner consistent with state and federal mandates,” said Joan Ching, St. Charles’ chief nursing executive.  

When unvaccinated employees are in a St. Charles health care setting but are not rendering direct patient care, they will be expected to wear a medical grade procedure mask. Masks can be removed to eat in a break room, but physical distance of 6 feet or more is expected to be maintained. 

St. Charles’ infectious disease subject matter experts—who convene regularly to review the latest scientific literature and the organization’s internal policies—recently concluded that because of  

revised CDC guidance, the prevalence of COVID-19 in the community, the severity of the current strains of COVID-19, availability of personal protective equipment, COVID-19 treatment options and immunity levels in the community, the health system could make reasonable accommodations that allow unvaccinated people who apply for and receive a medical or religious exception to work in a St. Charles health care setting. 

“As the pandemic evolves, it is important that St. Charles evolve with it,” Ching said. “We believe we’re now in a place where we can reasonably allow unvaccinated people to work in a health care setting—without putting others at significant risk—if they wear a N95 respirator.” 

Unvaccinated people who were previously granted an exception but could not be reasonably accommodated in a St. Charles health care setting are invited to apply for available positions for which they are qualified. St. Charles will use its regular hiring practices to assess re-employment as well as wages and benefits for successful candidates. New candidates interested in working for St. Charles who are not fully vaccinated against COVID-19 will be given the opportunity to apply for a medical or religious exception as allowed by the Oregon state mandate, which remains in effect.  

“To be clear, we believe staying current on your vaccination series remains the very best way to protect yourself from the virus,” said Dr. Cynthia Maree, medical director of infection prevention. “The data tell us that staying current on recommended boosters prevents infection, severe disease and death. The bivalent COVID-19 vaccine is now available and is designed to provide broad protection against the Omicron variant. We strongly encourage people to talk to their health care provider about receiving it.” 

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, La Pine, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit 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. 

 

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Grand Rounds - Sep 9, 2022
"Utility of Psychedelics for Palliative Care and the Treatment of End‐of‐Life Existential Distress"

Speaker: Anthony P. Bossis, MD, PhD. NYU Grossman School of Medicine.

 

 

Objectives

  1. Identify factors and symptoms in existential and psycho-spiritual distress in palliative and end-of-life care.
  2. Recognize the importance of meaning and transcendence in end-of-life distress and psychedelic research.
  3. Describe the characteristics of mystical experience; summarize the scientific findings from current psilocybin cancer anxiety research.
  4. Identify clinical implications from psychedelic research for palliative / hospice care.

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 - Sep 2, 2022
"HIV/AIDS Diagnosis, Management, and Care Updates"

Speaker: David J. Cennimo, MD, FACP, FAAP, FIDSA, AAHIVM. Associate Professor of Medicine and Pediatrics, Associate Dean of Education, Rutgers New Jersey Medical School.

 

 

Objectives

  1. Describe the HIV disease burden in the US and the recommendations for testing.
  2. Discuss and plan treatment with a patient newly diagnosed with HIV.
  3. Counsel on HIV transmission and risk mitigation including PrEP, PEP, U=U.
  4. Recognize new HIV treatment modalities.

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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Over 34 million people in the U.S. have diabetes and another 88 million are prediabetic. That means 1 in 3 people in America struggle with some form of the disease.

Two years ago, the Central Oregon Health Council awarded St. Charles a grant to purchase several continuous glucose monitors, which give diabetics an easy way to keep an eye on their blood sugar levels. (No more pricking fingertips!)

We launched a pilot program with 55 patients, and the results have been truly life-changing. Today, there are more than 200 St. Charles patients using the devices.

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“There were definitely a lot of people involved in this, and it just feels good knowing that I have such great colleagues to work with who were all willing to go above and beyond to learn what we were doing and understand the goal and help us improve. It’s nice to see that we can come together to make a more efficient process that will benefit the health system and, ultimately, our patients.”

Paulina, a coordinator on the Bend Ortho/Neuro floor who recently collaborated with several groups across the health system – including the Lean Improvement Office, Epic analysts, Wound Care nurses, the OR team, Environmental Services, Clinical Informatics, unit secretaries and more – to improve how the health system manages and tracks the use of rental wound vacuum-assisted closure (VAC) machines. Previously, Paulina was the only caregiver managing and tracking the machines, an extremely manual and time-consuming process. By incorporating Epic technology and working together to improve processes, the team was able to cut Paulina’s management time by half and increase the availability of VACs for patients.

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Workforce shortages, capacity concerns are rampant at Oregon hospitals

Over the past few weeks, you’ve likely seen a lot of headlines about hospitals’ capacity problems—including those at St. Charles. These problems are the result of many factors, chief among them short staffing and the inability to discharge patients.

Our state’s hospitals are as strained as they were at the peak of the Delta and Omicron surges. Patients are returning for much-needed care at the same time organizations can’t fill positions fast enough. This lost balance between supply and demand isn’t unique to health care, but it has the most serious consequences. This is especially true in Oregon, which has the lowest number of hospital beds per capita in the country. In “normal” times, this kind of efficiency is good. Right now, it’s disastrous.

As I write this, approximately 493 patients statewide are waiting to be moved from hospital beds to skilled nursing or assisted living facilities and another 224 are boarded in Emergency Departments, jeopardizing hospitals’ ability to admit patients who urgently need care. Recently, Salem Health—which has operated at more than 100% [BS1] capacity for more than a year—put ambulances on divert for the first time since 2008. In an interview on OPB’s Think Out Loud, CEO Cheryl Wolfe said the health system has since been “very, very close (to going on divert) multiple times because of the impact of not just the COVID patients, but also the number of ambulances coming to our Emergency Room.”

These aftershocks of the COVID-19 pandemic are rattling Oregon’s hospitals, demanding that we work with intensity and pace to find solutions. At St. Charles, we have a number of teams focused on initiatives to improve patient flow, bolster staffing and recruitment and ensure our caregivers have what they need to care for our patients.

We’re also partnering with the Oregon Association of Hospitals and Health Systems to ask the state of Oregon and the governor’s office to invest in short- and long-term solutions that will decompress the system. These include:

  • Declaring a staffing crisis in the state of Oregon
  • Expanding licensure both short- and long-term
  • Urging the state to join interstate staffing compacts, allowing nurses who are licensed in other states to work here (Oregon is one of only a handful of states not participating)
  • Allocating finances that will increase the availability of secondary care 

I know health care workers’ jobs are harder than they’ve ever been, which is why I take this work so personally and so seriously. These are challenges we have to overcome, for the good of our people, our organization and the communities we are proud to serve.

Sincerely,
Steve

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After two years in a virtual format due to COVID-19, Heaven Can Wait – the popular annual 5K walk/run and fundraiser for Sara’s Project – will return as an in-person event at 10:30 a.m. on Saturday, Oct. 2.

And that’s not all that’s new: This year, the event will start and end at Redmond High School’s stadium, with a course that takes participants through Redmond’s scenic Dry Canyon.

“It is our hope that bringing Heaven Can Wait to Redmond will provide a more central location for community members who have been touched by breast cancer to come together, wherever they are in their cancer journey,” said Anna Contreras, events and development specialist with St. Charles Foundation. “The Central Oregon community has been steadfast supporters of this event and St. Charles Foundation and event volunteers are thrilled to be bringing the walk to Redmond.”

Heaven Can Wait raises money for Sara’s Project, a fund of the St. Charles Foundation that helps provide vital support services to people in Central Oregon who are battling breast cancer. Over its 23-year existence, the event has raised approximately $100,000 annually for assistance to under-insured patients, as well as integrative therapies such as therapeutic massage, acupuncture, yoga, and reiki.

Heaven Can Wait has also become an important opportunity for the community to come together and celebrate cancer survivors while also remembering loved ones.

“It has been almost three years since the community last gathered to support this powerful event,” said Mari Shay, administrative director of cancer services for St. Charles. “This will be my first Heaven Can Wait, and I look forward to meeting more cancer survivors and our community partners as we stand together to support those who are battling breast cancer.”

To participate or volunteer in the 5K walk/run, register at HeavenCanWait.org. For questions related to the event, contact Anna Contreras at 541-788-2940 or [email protected].

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, La Pine, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit 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.

 

                                                                        ###

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Heaven Can Wait: In-person, now in Redmond

The popular 5K walk/run raises money for Sara’s Project

After two years in a virtual format due to COVID-19, Heaven Can Wait – the popular annual 5K walk/run and fundraiser for Sara’s Project – will return as an in-person event at 10:30 a.m. on Sunday, Oct. 2.

And that’s not all that’s new: This year, the event will start and end at Redmond High School’s stadium, with a course that takes participants through Redmond’s scenic Dry Canyon.

“It is our hope that bringing Heaven Can Wait to Redmond will provide a more central location for community members who have been touched by breast cancer to come together, wherever they are in their cancer journey,” said Anna Contreras, events and development specialist with St. Charles Foundation. “The Central Oregon community has been steadfast supporters of this event and St. Charles Foundation and event volunteers are thrilled to be bringing the walk to Redmond.”

Heaven Can Wait raises money for Sara’s Project, a fund of the St. Charles Foundation that helps provide vital support services to people in Central Oregon who are battling breast cancer. Over its 23-year existence, the event has raised approximately $100,000 annually for assistance to under-insured patients, as well as integrative therapies such as therapeutic massage, acupuncture, yoga, and reiki.

Heaven Can Wait has also become an important opportunity for the community to come together and celebrate cancer survivors while also remembering loved ones.

“It has been almost three years since the community last gathered to support this powerful event,” said Mari Shay, administrative director of cancer services for St. Charles. “This will be my first Heaven Can Wait, and I look forward to meeting more cancer survivors and our community partners as we stand together to support those who are battling breast cancer.”

To participate or volunteer in the 5K walk/run, register at HeavenCanWait.org. For questions related to the event, contact Anna Contreras at 541-788-2940 or [email protected].

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