Each year, when the holidays roll around, I like to begin reflecting on the year that will soon come to an end.

This year, that reflection will happen in the massive shadow of COVID-19.

For most of us, it’s been a long, hard year for a lot of reasons. That’s true at St. Charles, too, where planning for and responding to the pandemic has taxed our caregivers, from the front lines of patient care to the administrative and support departments that help keep the health system running as smoothly as possible.

COVID-19 has changed the way we do our work. It has rewritten our policies and procedures and forced many of our people to work from home. It made us plan for the unthinkable in ways we couldn’t have envisioned just a year ago. It took a bite out of us financially.

And it is not done.

But behind the scenes, the silver linings shine brightly. Throughout the first half of the year, I was blown away by our caregivers’ openness to change, even when it came quickly and without warning. Day after day, our teams adapted to rapidly evolving circumstances, often putting in late nights and/or extra hours to do so.

Faced with shortages of masks, gowns and other protective equipment, our caregivers scoured the global supply chain for more, and our community hand-sewed and donated over 10,000 masks to us when we needed them most. Faced with concerns about our ability to care for a surge of COVID-19 patients, our caregivers quickly assessed our facilities and our workforce and built a plan to expand our capacity if needed.

With those issues addressed, we were able to get back to the business of caring for our communities. In 2020 alone:

We improved access to care in Prineville by expanding and upgrading the Family Care clinic and outpatient rehab facility there, and opening a new Immediate Care clinic.

We started offering virtual visits (via video, phone or electronic message) at many of our clinics, allowing patients to see their provider safely and in the comfort of their own home.

We opened the new Short Stay Unit in Bend, a state-of-the-art recovery space that will shorten wait times, increase safety and improve patient flow at the busy hospital.

We earned a spot on the 2020 Healthcare Equality Index as a “Top Performer” in promoting health care equality for our LGBTQ+ community and continued expanding our outreach to the local Spanish-speaking population.

We partnered with Portland’s Oregon Health & Science University to create what is believed to be the first graduate medical education program in Central Oregon, with residents based in Madras.

We continued our commitment to playing an active role in the communities we serve by providing health education, support for those who need it, scholarships for students and events that put the “fun” in fundraising.

We revived our efforts to envision the future of our Redmond hospital campus and to give it a more defined role within our health system so that it can fulfill its tremendous potential.

We identified our next priority focus for St. Charles’ community benefit efforts - prevention of the misuse of alcohol - which will drive some of our partnerships and education work in the coming years.

We were named one of the nation’s “Most Wired” health care organizations for our use of technology to help analyze health data and achieve meaningful clinical outcomes.

And finally, we redoubled our efforts to give back to the community and support local businesses after we received so much support during the early days of our COVID-19 response.

I can assure you, that’s just a portion of the amazing things that happened at St. Charles in 2020, even in the face of a global pandemic. And I hope it gives you an idea of why I am so proud to lead this organization and its 4,500 caregivers - now more than ever.

Around here, “creating America’s healthiest community, together” isn’t just a vision statement. It’s what we do every day.

Thank you for being a part of it.

Sincerely,
Joe

The College of Healthcare Information Management Executives (CHIME) has recognized St. Charles as “Most Wired” in both the acute and ambulatory fields.

The CHIME Digital Health Most Wired program conducts an annual survey to assess how effectively health care organizations apply core and advanced technologies into their clinical and business programs to improve health and care in their communities.

St. Charles earned the 2020 CHIME Digital Health Most Wired recognition in the acute and ambulatory fields for having deployed technologies and strategies (such as population health and cost-of-care analytics, as well as patient portals) to help analyze data and achieve meaningful clinical and efficiency outcomes.

A total of 30,091 organizations were represented in the 2020 Digital Health Most Wired program, which this year included four separate surveys: domestic, ambulatory, long-term care and international. The surveys assessed the adoption, integration and impact of technologies in health care organizations at all stages of development, from early development to industry leading.

Nov. 24, 2020

During one of our St. Charles COVID-19 Incident Command calls last week, the dire situation we face became increasingly clear. On that day at that time, our Bend hospital was the only hospital in the state with any available ICU beds.  

Suddenly, the refrain I’ve been hearing from colleagues throughout the nation hit incredibly close to home. Our health care workers can no longer be considered the front line of this fight. We are now your last resort.  

You are on the front line.  

Your actions and choices can make the difference for yourself, your families and your loved ones. Because we simply may not have the beds and staff to care for you if we don’t stop the spread of the virus now. 

Please watch this latest message and share it with your friends and family. 

Your actions are more important than ever as COVID-19 is more prevalent in Central Oregon than at any other time during this pandemic. 

You can make a difference by choosing not to gather for Thanksgiving this year. Follow the advice and ideas we have received from several of our community members and have a virtual meal – share recipes with your loved ones and cook together from a distance. Make a new tradition by taking a piece of leftover pumpkin pie on a hike and eating it at the end of your climb. Take time to remember how much we still have to be grateful for – even in a year that has been fraught with challenges.  

More than anything, we need you to stay safe, stay home, wash your hands and if you do need to go out, wear a mask.  

And know that hope is on the horizon. Statewide, our hospitals are working on plans to distribute the first COVID-19 vaccines to health care workers and first responders in the coming weeks. We are starting to see the light at the end of this very long fight.  

Help us stay strong through the finish line.  

Sincerely,  

Joe  

"My life has always been an active one. I was born and raised on a farm in Iowa and have participated in sports regularly and, in my later life, I have walked at least two miles most days. Since age 43, I have been an avid downhill skier. In 2011, I moved to Bend, Oregon where there is, in the city limits, a butte (Pilot Butte) that is 500 feet high. I saw this as a challenge and was soon climbing the butte every day. It is one mile up and one mile back down. That is darn good exercise!

It was also 2011 that I heard the shocking news, “you have lung cancer, stage four.” I was 92 years old. The diagnosis was later changed to stage three, however, lymph nodes along my sternum were involved and surgery was no longer an option.

My treatment consisted of seven weeks of chemotherapy and radiation. The radiation was administered five days a week for the seven weeks; each visit I was zapped five times from different angles. During the seven weeks of treatment, I climbed the ol’ butte 14 times; I climbed to the top seven times; I could make it just halfway another seven times. The main side effects of the treatment for me was fatigue. I did my best to ignore this; Looking back, I think my positive attitude certainly helped me in my treatment.

The nine years since the completion of treatment, have been the best years of my life. There is something about having to go through the diagnosis and treatment of cancer that awakens a desire to make each day the best day of your life. Today and every day I say life is good and the best is yet to be. In the time since treatment, I have accomplished things that I never thought of doing in the past. In the past nine years since treatment, I have had the privilege of visiting Europe four times for at least a month each time. My desire to know Paris better has been fulfilled having lived on the left bank for an extended period. During these visits, I have spent more than five weeks in Italy. I also found time to paint an eight foot by seven foot mural on our dining room wall.

During my long, boring sessions of chemotherapy, I wrote a book; the story of my life. The book is titled, “How I Chose to Live My Life,” is 256 pages and includes more than 100 illustrations. I had a printer produce enough copies so that my grandchildren and great grandchildren could each have a copy.

My lifelong hobby has been wood carving. Somehow it felt necessary to do something fairly large. So, I carved a life-size carousel horse. I later carved another one that was made part of the “Art in Public Places” here in Bend. It hangs today at the entrance of the downtown parking structure.

Also since completing my treatment, I have had a season pass for our local ski mountain, Mount Bachelor. One year, I skied 44 days.

These accomplishments made me realize that life is not over when you are diagnosed with serious cancers. Rather, it is a time to take a new view of life and to make the most of it. My life is not over.

This year, I celebrated my 101st birthday by piloting a glider down from 5,000 feet (I have a pilot’s license)."

- Art Vinall, Bend resident, cancer survivor and World War II veteran

Nov. 10, 2020

I know you are really tired of talking about COVID-19.  

Trust me, so am I.  

But what’s happening right now is highly concerning. We have 15 patients hospitalized with COVID-19 today, and over the weekend at times the number matched our previous record.  

It appears we have officially hit a third wave. But unlike the last two, we never reset back to zero hospitalized patients. Our number of inpatients has held steady in recent weeks until last Friday when it essentially doubled overnight.

We need to act now 

With the upcoming holidays, we are concerned that if people don’t act NOW to change their behavior our hospital system could become overwhelmed. As of today, we have the beds and the staff to take care of you, but your actions make a difference in helping to keep it that way.  

The virus is clearly still here and our choices are making a difference in how the disease finds places to thrive. We are seeing a fear-fatigue cycle of behavior. When we feel more afraid that the virus is circulating broadly in our communities, we pull back, isolate more and are better about wearing our masks.  

Sooner or later, fatigue sets in and we relax our standards, spend time with more people outside our normal bubbles and maybe don’t remember to wash our hands as frequently. It is becoming predictable. And while we are all exhausted by this pandemic, we know these next few months will be a crucial time to stay strong.  

Statewide, the highest number of cases continues to be in people ages 20-29. We also know from the Oregon Health Authority that most cases can be traced back to small, indoor social gatherings.

While we all know how difficult it is to remain isolated – especially now that the weather is turning colder and it’s harder to spend time together outdoors – it is still critically important.  

We have some advice as you start to make plans for the holidays:

• Keep it small – indoor gatherings should be immediate family only

• Keep it safe – if you choose to gather with those outside your immediate family, ask everyone to isolate for 14 days before the holiday and not to attend if they are feeling sick

• Make it special – use this time to create new traditions (hiking or snowshoeing instead of a big meal, making porch deliveries to those in need) and focus on the positives (no giant grocery bills or piles of dishes)

We understand that asking people not to gather for their traditional holiday celebrations is really hard. But we also know that Central Oregonians are strong. We will get through this by pulling together.

Please watch the latest from our #staystrongCO campaign featuring many of our local St. Charles providers to better understand what you can do to stay safe. We also encourage you to share these messages with your friends and family.

And if you’d like to know more about St. Charles’ ongoing response to COVID-19 along with other health system updates, we invite you to participate in our Town Hall event coming up on Nov. 19. You can register here. 

Sincerely,

Joe

Last fall, St. Charles leaders held in-person Town Hall events in La Pine, Madras, Prineville and Redmond. We served breakfast and encouraged community members to join us as we shared the latest St. Charles news and opened it up for conversation, questions and dialogue.

As always, it was fun and inspiring to get out and meet people – to hear your thoughts about your health care first-hand and to be able to share our story.

This year, of course, things look a little different as in-person gatherings are highly discouraged due to the pandemic.

While COVID-19 continues to impact the way we do things, we still believe in the importance of community conversations and are using the lessons we’ve learned from the pandemic to try something new.

It is our hope that you will join us.

At 5:30 p.m. on Nov. 19, we will hold a virtual town hall. The beginning of the program will include a brief presentation from me, Dr. Jeff Absalon, our chief physician executive, and Jenn Welander, our chief financial officer. We will review the current “state of St. Charles,” along with our COVID-19 response and recovery and some general health system financial information.

Then, we’ll move into several virtual break-out rooms. You will have the chance to register in advance and decide which community you are most interested in learning more about. Sessions in each break-out room will be led by St. Charles caregivers from Bend, Madras, La Pine, Redmond, Prineville and Sisters with time for questions and discussion.

We want to hear how you are doing, what you need from your local health care system and how we can best serve you. We also want you to understand the challenges the health care industry faces and how the pandemic has increased some of those challenges.

Please register for this event today and encourage your friends and family to join us as well.

We are looking forward to a fun, informative and community-building night.

Sincerely,
Joe

St. Charles Foundation’s annual Saints Gala is going virtual this year, and you’re invited to attend!

Please join us for a free live webcast at 6:30 p.m. on Friday, Nov. 13. Register early and then log on to participate in live and silent auctions, plus a “choose your vacation” raffle.

The virtual gala is raising funds for a St. Charles Behavioral Health program called “Stop the Revolving Door” that would provide extra support to patients and potential patients of all ages as they move through the behavioral health care system.

The event theme is “Virtual Tropical Vacation,” and participants can win prizes for taking creative selfies in tropical gear and then posting them with #saintsgala2020. Make an evening of it and order a catered dinner to be delivered to you the day before the event.

For more information and to register for the event, visit the Saints Gala site.

You can also follow the Saints Gala Facebook page.

St. Charles Cancer Center’s new Pulmonary Nodule Clinic – set to launch next month – will contribute to the health system’s mission: creating America’s healthiest community together.

That’s because the clinic’s primary goal is simple but life-changing, said Dr. Linyee Chang, a radiation oncologist at St. Charles and medical director of the cancer center.

“We’re trying to catch cancers earlier,” Chang said. “In looking at our practice patterns for lung cancer, we’re actually diagnosing cancers earlier than the national average. But we can do better.”

She continued: “When we identify cancers earlier, that leads to improved cure rates with less treatment and fewer side effects, less overall cost to the health system and, ultimately, better outcomes for the patient and the community.”

Lung cancer is the leading cause of cancer death in Central Oregon, Chang said. The new clinic will create a formal process to follow patients with lung nodules, some of which may progress to become lung cancers.

In the past, there was no established process in place to ensure someone followed up on a pulmonary nodule discovered while the patient received acute care, Chang said. As a result, they sometimes went untreated until the patient came back to the hospital later with advanced cancer.

“We all have those cases where we look at a scan and say, ‘Ugh, there it was a couple years ago,’” Chang said. “Those are opportunities.”

The Pulmonary Nodule Clinic addresses this gap by using Central Oregon Radiology Associates software to identify imaging reports that note a nodule of concern and to add a note that the patient is eligible for referral to the clinic by telephone call or via Epic, the health system’s electronic health record.

Once the Pulmonary Nodule Clinic is operational, patients will see a pulmonary nurse practitioner on their initial visit and will receive education regarding the significance of pulmonary nodules, lifestyle strategies to reduce the risk of lung cancer, appropriate follow-up imaging on any identified abnormalities and an appointment with a smoking cessation counselor if they are a smoker. Even if the patient doesn’t have cancer, enrollment in this clinic provides an educational opportunity to improve health by encouraging healthy behaviors, Chang said.

“Providers who don’t have the time to follow lung nodules can be assured their patients are in good hands,” Chang said. “And for this patient population, we’re coming alongside them and saying, ‘Here’s what’s happening with you and how we can help you get healthier. We’re here for you.’”

St. Charles Cancer Center developed the Pulmonary Nodule Clinic in partnership with Central Oregon Radiology Associates, St. Charles Thoracic Surgery, St. Charles Pulmonology and Summit Medical Group. For more information, call 541-706-6729 or visit https://www.stcharleshealthcare.org/services/cancer-care.

As veterans’ transition to the end of life, they can be jarred by some of their most traumatic experiences of war.

St. Charles Home Health and Hospice Care Bereavement Coordinator Sue Coyle has watched them struggle. She recalled one patient who was highly distressed and agitated.

The patient’s nurse knew about his military service history, that he had post-traumatic stress disorder, that he was averse to any physical touch. She skillfully coached his other caregivers to approach him quietly, and use soft, gentle language.

“That comes from experience with working with veterans and being educated,” Coyle said. 

And it is why St. Charles Home Health and Hospice Care is a partner of We Honor Veterans, a nationwide program aimed at caring for and honoring those who have served when they reach the end of life. 

A program of the National Hospice and Palliative Care Organization in collaboration with the Department of Veterans Affairs, We Honor Veterans recognizes the unique needs of America’s veterans and their families. The program provides educational tools and resources to organizational partners such as St. Charles, increasing their capacity to serve veterans.

“We recognize there are so many veterans who die in our community and aren’t connected with the VA at time of death,” Coyle said. “So, how do we as a community make sure we care for them in our health system?”

There are five levels of partnership in We Honor Veterans, and for many years St. Charles Home Health and Hospice Care was a Level 1, Coyle said. Recently it achieved a Level 2 designation, which means “the organization is beginning to develop a program directed towards veterans that involves intentionally educating our staff and intentionally educating our volunteers.”

That includes using the We Honor Veterans Military History Checklist at admission to St. Charles Home Health and Hospice Care. The checklist prompts a conversation about veterans’ backgrounds, including the branch of military and war era they served in and whether their service included combat and dangerous or traumatic assignments. It also helps identify whether they’d prefer their caregivers have a military background and the VA benefits they may be eligible to receive.

“It’s a very simple document,” Coyle said, “but it opens the door to better understand our veterans and where they served, and importantly, what VA connections do they have and what VA connections are they able to take advantage of?”

For those veterans who desire it, their service can also be honored with a ceremony in the comfort of their home, Coyle said. Usually presented by a social worker and chaplain, the “beautiful, simple but lovely service” includes a certificate thanking the veteran for his or her service and an American flag pin.

“To the extent the veteran wants recognition, we make sure we fulfill that,” she said. “We’re giving them the respect they’ve earned. Some people don’t want a lot of show, but we make sure they know that we know so we can be most respectful to them. And that respect translates into more compassion for them.”

Wes Moldogo, a St. Charles’ hospice chaplain and inpatient liaison, said a significant number of the patients he sees are veterans from the Korean, Vietnam and Cold War eras. 

Many did not access VA counseling services like some of the younger veterans do and share “unique spiritual themes” related to their time in the service.

Moldogo, who also actively serves as a captain in the U.S. Army and is a chaplain for the 2-162 infantry regiment based in Springfield, Ore., said not only do some of the veterans still suffer from PTSD, but also they feel their service was undervalued once they returned to the United States. 

“Many Vietnam veterans were told they didn’t win and therefore undervalue their service,” he said. “And many Cold War veterans undervalue their service because they weren’t in combat like other campaigns.”

Through its partnership with the We Honor Veterans program, St. Charles Home Health and Hospice Care’s goal is to make veterans feel appreciated, he said.

“It really is valuing [their] service and coming to a sense of closure with that, and our hope is that it’s positive. Sometimes they don’t get that, but the fact they get something meaningful in their lives—that’s what we’re going for here,” Moldogo said.

Laurie Jackson, St. Charles Home Health and Hospice Care administrator, said as St. Charles’ partnership with We Honors Veterans matures, the more broadly the program will be implemented throughout hospitals and clinics and the more tightly linked the health system will be with other community organizations that serve veterans. 

The hope is that expanding the program will further benefit veterans, she said, as studies have shown that on average veterans spend one more day in the hospital than non-veterans due to complicated diagnoses and insurance coverage.

“The more we can work as a system to respect and engage with our veterans and recognize we have a veteran who is a patient, the quicker we can address those issues and move the bar so the veteran is spending fewer days in the hospital than the non-veteran,” she said.

Ultimately, Jackson said, it is St. Charles’ goal to achieve a Level 5 We Honor Veterans designation by 2026, an acknowledgement that the organization has integrated best practices for providing end-of-life care to veterans.