As COVID-19 numbers increased before Thanksgiving, Hannah Gonzales, a patient service representative at Bend South Immediate Care, began to notice a change in her colleagues and their workplace.

“I could see the tsunami coming and the pressure mounting. COVID was demanding more of our days and there wasn’t as much time to talk and to interact on a personal level,” Gonzales said, “So I sat there thinking, ‘What can I do to counter this?’”

Her goals were simple: To make people smile. To make them laugh. To give them a break from the day-to-day stress of doing health care work in late 2020.

The idea Gonzales came up with was not as simple, so she recruited her kids and husband to help her. Together, they printed out 60 drawings of elves, cut them all out, colored them in festive reds and greens and attached printed-out heads of all the caregivers who work at Bend South.

All told, the job took several hours nightly for about two weeks. Then, one night when the clinic was empty, Gonzales went to her office and stuck them all over the walls for her colleagues to discover in the morning.

When they did, the positive effect on the team was immediate, said Dr. Tom Allumbaugh, who practices at Bend South.

“To see the joy and community as people walked in that first morning after all the elves were placed – all due to the selflessness of Hannah and her family – is a true reflection of the season,” he said.

Erika Harvey, operations manager for the clinic, echoed those thoughts:

“I am truly amazed by the time it took and the amount of effort Hannah put into such a gracious act of kindness,” she said. “When we opened clinic on Friday morning there was such a sense of happiness and joy from the entire team.”

Gonzales has worked for St. Charles for four years, but she’s been practicing acts of kindness for much longer, she said. When she worked at Providence Health in Portland, she was on the “Sunshine Committee,” which was tasked with making the workplace fun and engaging. Before that, she grew up as the child of a pastor whose work with the less fortunate instilled in Hannah a heart for all people, she said.

“One of the things I hear at St. Charles is ‘our strength is in our people,’ and I agree with that 100%. Your strength is in your people, and that’s what drives me – people’s overall wellbeing and trying to make sure they feel valued,” Gonzales said. “The elves were just a little thing, but many times it’s the little things that make people feel valued, and feeling valued is such a huge part of feeling good and being happy about where you are and what you’re doing.”

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For as long as St. Charles has been paying for people to swim at the Madras Aquatic Center, Dr. Shilo Tippett has seen the benefits of the program firsthand.

There was the man with severe anxiety whose nighttime swims helped quiet his unease. And the decades-long smoker who went to the pool to replace her habit, which helped her re-envision herself as a healthy person engaged in healthy behaviors.

Tippett remembers a handful of kids who felt hopeless because, unlike many of their peers, they weren’t into sports. Trips to the MAC always lifted their mood, she said. And she smiles when she recalls a group of women who, individually, felt self-conscious about going to the pool on their own.

“We gave them all passes and now they all go together – or at least they were before the pandemic,” said Tippett, a clinical psychologist at St. Charles Family Care Madras. “We have an endless number of stories like that.”

Those stories are the direct result of the St. Charles swim voucher program, which gives providers across Madras the ability to refer patients to the MAC, a popular pool and recreation center on the east side of town. There, the patient can turn in their referral, and St. Charles will pay the fee to swim – currently $7 for two hours – out of its Community Benefit budget.

The program has existed in some form for several years, but St. Charles started tracking usage more closely in July of 2019. Since then, 112 different people have visited the MAC on referral from a health care provider, said Carlos Salcedo, manager of community partnerships for the health system.

“That’s 112 individuals who, through St. Charles, have been encouraged to exercise, to improve their health and to engage with the MAC and with their community,” Salcedo said. “The cost to engage in your own community is a huge hurdle for some people, and this eliminates that and gets them out of the house and into an active and social environment.” (Note: The MAC is currently closed until at least Dec. 18 because of COVID-19. Its reopening plan is available on its website.)

According to Tippett, the swim voucher program started about six years ago, shortly after she shadowed a provider in Redmond who was referring patients to the Cascade Swim Center there. She teamed up with Dr. Jinnell Lewis, a family care physician at the Madras clinic and avid swimmer, and the two approached the MAC with their idea.

“We went in and said, ‘We want to give swim passes to people,’” Tippett said. “The MAC’s director at the time was totally open to it, and the program just took off.”

Referrals to the pool are especially useful for patients who are overweight, who struggle with other forms of exercise, or who deal with chronic pain, depression and/or anxiety, Tippett said. By eliminating the cost of MAC access, the program makes it easier for many people to exercise, to interact with others and even just to leave their home. For residents of Warm Springs, the pool also offers a replacement for the hot springs and soaking pool at Kah-Nee-Ta Resort, which closed two years ago, Tippett said.

“It’s just so hopeful,” she said of the program. “I go to the pool, too, and I’m regularly running into people who tell me what a difference it has made in their lives. It’s amazing every time.”

St. Charles also sponsors the MAC through a $5,000 contribution from the St. Charles Foundation, said Marcus Thompson, St. Charles’ community advocate in Madras, and that allows the health system to hang a banner at the pool. But for Tippett, the swim voucher program is “where the rubber meets the road” in the partnership between the two organizations. “This gives us a way to directly help a patient who’s dealing with something that feels insurmountable,” she said. “What we’re actually doing here is improving people’s lives with this program.”

That’s also the goal of the Madras Aquatic Center Recreation District, which owns and operates the pool, said the group’s interim executive director, Courtney Snead.

“The MACRD is focused on holistic health, how we can be a good partner in the community and looking at our health outcomes as a whole – not just trying to get people into our pool and signed up for our programs,” Snead said. “I think this is just the beginning of a more robust conversation about health in our area and lots of opportunities for partnership, which is really exciting.”

That outlook aligns with Salcedo’s hopes for the swim voucher program. He has already expanded it to include non-St. Charles providers at Mosaic Medical and Madras Medical Group, and he is talking with MACRD officials about extending the program beyond the pool, into other rec district programs.

“What we want to do is move it out of the clinics and into the community,” he said. “We want to make this bigger and open it up more and make it even more inclusive, because the more attention it gets, the more people will use it.”

At St. Charles, the oft-repeated organizational vision is “Creating America’s healthiest community, together,” and it’s that final word – together – that is exemplified by the swim voucher program, said David Golda, vice president and administrator of St. Charles Madras.

“I have no doubt that St. Charles and the MAC recreation district have very similar missions as far as improving the health of the Madras-area community,” Golda said. “It’s certainly a natural partnership that’s already paying off, and this program is a great example of how something that seems so simple can have such a huge effect on people’s lives.”

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