These are interesting times here at St. Charles, and in the world of health care as a whole. We're facing historic upheaval in an industry that was already fundamentally broken and needs to change in a way that benefits our patients.

At the same time, however, I see incredible opportunity as a result of COVID-19, which has forced health systems like ours to rethink and transform the way we do things in a matter of days or weeks. Without the push of a pandemic, those kinds of changes might have otherwise taken months or even years.

Because those changes have come so rapidly over the past few months, now is an excellent time to analyze what we've done, how it has worked and how we can sustain the progress we've made.

That's where you, our community, comes in.

In last month's St. Charles newsletter, we rolled out a new survey focused on innovation in health care and I'm happy to announce that nearly 1,100 people have responded. If you were one of them, please accept my sincere thanks.

In the survey, we asked a handful of questions about our current health care system and we solicited ideas for improvement. We are still working through the responses, but we're already seeing some trends in the feedback that will help guide the way we think about the services we provide as we go forward.

For example, we know that about two-thirds of respondents have already had a virtual visit with St. Charles in the past six months. And generally speaking, they liked the convenience and safety of meeting with a physician by email, phone or video. More than half said they would consider continuing virtual visits even after in-person visits are an option again. Said one respondent: "It's about time we're doing this!"

Not everyone agrees, of course. There are many of you who believe a virtual visit can never provide the same kind of experience you get in a face-to-face meeting with your physician. Understandably so.

This is just a tiny sliver of the data we'll be able to glean from our innovation survey, and I look forward to sharing more about the results in the future. In the meantime, we're meeting with virtual focus groups made up of survey respondents to have more in-depth discussions about the future of health care in Central Oregon.

Those are exactly the kinds of discussions that I and other leaders at St. Charles love to have. We are in this field for a reason. We are passionate about providing people with the care they need in the most efficient and affordable way possible. And each and every one of us is committed to making St. Charles a better place to receive care.

Sometimes, though, we get so caught up in the day-to-day operations of the health system, we don't have as much time as we would like to think about the future from a big-picture perspective.

I'll bet at least some of you out there can relate.

So as we move forward through this process, I'm choosing to be grateful that, for all its negatives, COVID-19 has brought transformation to St. Charles. We're excited to see where it goes from here.

Sincerely,
Joe

Shari Petersen had just been in Central Oregon visiting her father, Jerry, when she received a worrisome call from her stepmother.

“She said she didn’t know what was wrong with him, but that she was taking my dad to the ER,” Petersen said in a telephone interview from her home in California. “I just thought to myself, ‘I was just up there. Why couldn’t this have happened when I was up there?’”

But it didn’t, which means Petersen was in a position that many people find themselves in every day: Far away from a loved one dealing with a health scare, desperate for information and unsure how to get it.

“I didn’t know if he was going to survive. I didn’t know what was wrong with him. It’s too far to start heading that way, even if I could fly,” she said. “I couldn’t reach my stepmom and I couldn’t get anything from the ER. I just felt so helpless.”

So Petersen did the only thing she could think to do: She called St. Charles in hopes of filling out and filing forms that would allow caregivers to provide updates to her and her siblings.

That’s where she connected with Kristy Hasbun, manager of St. Charles Medical Group’s centralized call center, One Call.

“She was in tears by the time she got to me, and I know that feeling – that feeling of helplessness. I was out of town one time when my father had a heart attack. I was unable to get information and it was extremely hard,” said Hasbun, who has worked for St. Charles for six years.

“I’m an empathetic person and I hate to hear people struggling,” she continued. “I could tell right away that she needed me that day.”

Petersen expected a standard answer: “Go to our website. Print out this form. Fill it out and send it in.”

What she got instead still chokes her up.

“She volunteered to print the forms, fill them out for me and then go over to the ER on her lunch break. It makes me want to cry just thinking about it,” Petersen said. “So I was already overwhelmed by her kindness, and then she called me and said, ‘Hey, I know your mom has been in the ER for a long time. Do you think she’d like a sandwich and a bottle of water?’ And jeez, I just about fell on the floor.”

Says Hasbun: “I was getting myself lunch, so I thought, ‘Why not grab her lunch, too?’ There’s no food down there except for a vending machine.”

That sums up Hasbun’s approach to not only this particular interaction, but also her job and her department of 25 caregivers who talk to patients and families all day every day.

“That’s just my personality. I don’t do it to get kudos. I just believe in treating people with compassion,” she said. “When we train our staff here at One Call, I like to say, ‘Pretend it’s your mom or your dad or your grandparent or your kid on the phone. How would you want them to be treated?”

Ultimately, Petersen’s stepmom got her sandwich, and Petersen got her forms filled out and filed. Her dad is doing “much better,” she said, and she sent flowers and balloons to Hasbun to thank her for her efforts. She also hopes to meet up with her next time she’s in Bend.

“Even though I was a total stranger and she had never spoken to me before, she went 100 miles above and beyond,” Petersen said. “She was awesome on a day when I needed awesome.”

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After you are tested for COVID-19, your provider will 

• take samples and talk to you about next steps
• send your samples to the Oregon State Public Health Laboratory (OSPHL) or an authorized lab for testing

The lab will

• test for COVID-19
• give your health care provider and your local health department the results of your test

While you wait for your results, take steps to avoid spreading the virus:

• Stay home, except to get medical care
• Stay away from other people in your home
• Don't share dishes, cups, eating utensils or linens with others
• Cover your coughs and sneezes
• Wash your hands often
• Clean and disinfect common surfaces like phones, doorknobs and counters regularly

If your test shows you have COVID-19:

A positive COVID-19 test means you currently have or recently had the virus. Monitor your symptoms and seek medical help right away if you have trouble breathing, confusion or bluish lips or face.

• Your health care provider will decide if you are sick enough to be in the hospital
• Your county public health department will contact you
• You will be asked to stay home for a period of time
• Follow steps listed above to avoid spreading the virus

If your COVID-19 test is negative:

If your test is negative, the health care provider that ordered your test will contact you to let you know. If your test is negative, you probably didn't have the virus at the time of the test. But you an still get sick later.

• Follow distancing guidelines and wash your hands often
• Your provider may ask you to continue staying home.

"I texted my mom at the end of the first week: 'Mom, college is finally paying off!' I'm seeing so many interesting things and applying all these different models that I learned in college. It's pretty amazing, after thousands of hours of study, to now be seeing it in real life. Even sitting in on huddles and listening to the caregivers talk about their work is fascinating to me. It's been really eye-opening, and a total blast."

- Annika, an intern who is spending the summer at St. Charles working on a program to determine what barriers keep women from seeking breast cancer screening

It’s been an interesting few weeks of ups and downs on the COVID-19 front. Our hospitalizations have stabilized somewhat from a high of 11 earlier this month, but positive test results in all three of our counties continue to climb.  

Sadly, we also experienced the first two deaths of Central Oregon residents from the virus, one in Crook County and one in Deschutes County. Our thoughts go out to the families and friends of these individuals and all those suffering due to impacts from the ongoing pandemic.

In addition, Deschutes County reported the first known outbreak in a local memory care facility. Our team was happy to provide testing and other support as part of the response effort and has been proud of how Mt. Bachelor Memory Care has handled the difficult situation. Again, we hold those dealing with these infections in our hearts.  

Explaining the numbers

As of this morning, we have seven patients hospitalized with COVID-19 and five of them are in the Intensive Care Unit. Since we started releasing this information to the public regularly, we have had a lot of questions that show we need to put the numbers into context.  

In order to best group and care for COVID-19 patients, we made the decision early on to treat all positive cases at the Bend hospital and we are continuing to follow this practice. We have 24 ICU beds in Bend and six in Redmond for a total of 30 throughout the health system. So, while having five COVID-19 patients in the ICU may seem like it’s not too big of a deal, it is important to remember that many patients need ICU care for other reasons like heart attacks, strokes or car accidents.

Today, 20 of our 30 ICU beds in the system are occupied.

When virus numbers climb, we do become concerned about the long-term impact on our patients, caregivers and community. This is where your actions continue to make a huge difference in our success. We appreciate all those of you who are doing your part to stay home when possible, wear a mask when in public, wash your hands frequently and physically distance from those not in your immediate households.

Just like you, we at St. Charles are learning how to live in this next phase of our reality. We must manage an ongoing response to the pandemic while also providing critical preventive care services, much-needed surgical services and more to our communities.

It is a never-ending balancing act – with the top priority being to keep our patients and caregivers safe.

Thank you for your ongoing support throughout this very difficult journey.  

Sincerely,  

Joe

What happens next in the COVID-19 pandemic is up to us. 

That was Gov. Kate Brown’s message yesterday to our news media here in Central Oregon, where the number of COVID-19 cases is on the rise.

At St. Charles, COVID-19 hospitalizations rose dramatically last week, nearly doubling from six to 11 in a 24-hour period. We have been preparing for such a surge for months and have capacity to treat many more COVID-19 patients while still caring for anyone who might come through our doors. But the concern is the exponential growth. Prior to this month, we saw at most 40 new cases in a week. In the most recent seven-day period, we saw 106—and there is no sign of it slowing.

We know we can curb the transmission of the virus by wearing face coverings, maintaining our physical distance from others and washing our hands. But this concerning rise in cases and indeed the number of COVID-positive patients in our Bend hospital tells us that too few people are heeding this public health advice. (You can now check our number of hospitalizations daily here.)

Some people believe that the dropping mortality rate of COVID-19 is evidence that the virus is not as serious as we once thought. The reality is the mortality rate now is lower than what we saw earlier in the pandemic because the most recent uptick in cases is among the very young and healthy—folks in that 20 to 40 age group. As the number of cases go up, however, there is reason to believe the virus will find headway into our more vulnerable populations. 

In an interview with The Bulletin Monday, the governor stressed that we are at a critical juncture in our response. If we don’t act now to minimize our risk of exposure, she’ll have no choice but to close businesses once again.

“Behavior needs to change,” she told the newspaper. “If it doesn’t change, it will overwhelm our health care system. My tools are limited. I can close businesses down. I can close medical and dental clinics. I don’t want to do that.

“If we can work together to slow the transmission, to slow the number of cases, I won’t have to take more restrictive action. It’s up to all of us.”

Let me say it, too: behavior needs to change, or we will look no different than Arizona or Texas where health systems are being overrun and COVID-19 is taking more lives.

In a video posted to our social media channels over the Fourth of July weekend, Dr. Nathan Ansbaugh, one of our Emergency Department physicians, issued an urgent plea to the community: “In the last several days in the Emergency Department, I’ve taken care of half a dozen or so of new diagnoses of COVID,” he said. “My goal is not to point fingers; my goal is not to scare everyone. But my goal is to communicate an honest, somewhat desperation about what’s happening here and to ask that everyone who lives in this community takes care of this community.” 

St. Charles makes COVID-19 inpatient data available on website

BEND, Ore. – To help keep the news media and public informed, St. Charles Health System is sharing its COVID-19 inpatient data on its website at stcharleshealthcare.org/covid-19.

The data, which will be updated daily Monday through Friday, include:

• Number of hospitalized patients with COVID-19
• Number of COVID-19 patients in the Intensive Care Unit (ICU)
• Number of COVID-19 patients on ventilators

St. Charles continues to remind the public to wear a mask, as well as practice physical distancing and good hand hygiene, as the number of the COVID-19 cases in Central Oregon continues to rise.

The health system has been preparing for a surge of COVID-19 patients since January, ensuring its hospitals and clinics remain a safe place for care of any kind. Individuals who experience a medical emergency should not hesitate to seek care.

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, 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 4,200 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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With COVID-19 hospitalizations increasing, St. Charles Health System urges community to celebrate Fourth of July at home, limit interactions to a small group of people

BEND, Ore. – At St. Charles, COVID-19 hospitalizations have nearly doubled in the past 24 hours, and our data modeling shows that we are heading for a bigger surge than the one we experienced in April.

The bottom line is if behavior doesn’t change in our community, we will overwhelm our health system’s capacity in the coming weeks.

We know people are looking forward to celebrating the holiday weekend with family and friends. However, we are not in a position to celebrate in the ways we’re used to. After Memorial Day weekend gatherings, COVID-19 cases accelerated. This virus does not take holidays off, and our actions now will determine where we stand later in July.

To keep you, your loved ones and your community safe, we urge you to:

1. Stay home if you feel sick.
2. Think hard about your Fourth of July plans. Please strongly consider celebrating at home this year, and limiting your interactions to a very small group of people.
3. If you go out in public, it is absolutely vital that you wear a mask at all times.
4. Follow physical distancing guidelines.
5. Wash your hands. Wash your hands. Wash your hands.

St. Charles Health System has been preparing for a surge of COVID-19 patients since January, and our facilities remain a safe place for care of any kind. If you experience a medical emergency and need to seek care, please do not hesitate to visit a St. Charles hospital.

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, 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 4,200 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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As a health system and the largest employer in Central Oregon, we want you to know we stand with our communities for equity and inclusion of all.

Our nation is hurting – and we know that many of you are hurting as well.

We can’t stay silent and simply watch the news of the past week. It is critical that you know we do not tolerate racism. We do not tolerate violence. We do not tolerate ignorance of these issues.

It is time to do better.

St. Charles has a more than 100-year legacy that started with a brave group of nuns declaring they would care for all or care for none. However, although we strive to provide health care to all those in need – we know disparities continue to exist for many of the populations we serve.

The global pandemic of COVID-19 has put a spotlight on this issue by disproportionately affecting communities of color throughout the nation. In Oregon, our African American, Hispanic and American Indian populations have been hit as well – we are not immune.

St. Charles should be a safe place for all regardless of race, religion, color, gender, sexual orientation or ability to pay. While we have taken some positive steps – including our cultural care programs in Madras and our sexual orientation and gender identity workgroup – we know it is just the beginning of an ongoing journey to learn and to improve upon our own understandings and practices.

We as a St. Charles leadership team vow to investigate where our organization may be falling short, to engage in conversations with our diverse populations, to listen, learn and improve. We also commit to educating ourselves to better understand these issues through diversity training and will continue to look for opportunities to better reflect our communities.

We owe it to the communities we serve — and ourselves — to do the important work of really understanding each other. Now is the time to see our differences from one another and not fear them, but instead embrace and learn from them.

We must do better.

Please, take this moment to check in with your fellow caregivers. Ask them how they are doing and what they are feeling. Connect with and support each other through these turbulent times.

Remember, when people are in pain, our job is to heal.

Sincerely,

St. Charles Executive Care Team

Joe Sluka, Chief Executive Officer
Jeff Absalon, Chief Physician Executive
Jenn Welander, Chief Financial Officer
Iman Simmons, Chief Operating Officer
Darren Binder, Chief Legal and Risk Officer
Rod Marchiando, SVP Improvement and Strategy
Jim Guyn, SVP Population Health
Pam Steinke, Chief Nursing Executive
Rebecca Berry, VP Human Resources

Bend is a town that loves its beer, and the production and consumption of alcohol is a prominent part of the Central Oregon lifestyle.

Still, no one is immune to the dangers of alcohol misuse. That’s why St. Charles Health System has chosen alcohol misuse prevention as its community benefit focus for the 2020-2022 funding cycle.

“Our previous priority focus was suicide prevention, and we partnered with local organizations and individuals to provide QPR (Question, Persuade and Refer) suicide-prevention training to more than 2,500 people throughout Central Oregon over the past three years,” said Carlos Salcedo, manager of community partnerships for St. Charles. “Through that work we learned that engaging with the community is an effective way to help St. Charles meet its vision of creating America’s healthiest community, together.”

The American Academy of Family Physicians defines alcohol misuse as a spectrum of behavior, including risky (excessive) alcohol use, alcohol abuse or alcohol dependence. According to the 2018 Oregon Health Authority State of Health Assessment there has been a 38% increase in the overall rate of alcohol-related deaths in Oregon since 2001. Oregon also ranks third highest in the country for deaths related to alcohol.

“Alcohol misuse is a root cause of many chronic health and societal problems – liver disease, fetal alcohol syndrome, child abuse, domestic violence and the cause of many auto accidents that damage lives,” says Dr. Jeff Absalon, chief physician executive for St. Charles. “If we can reduce binge drinking, increase identification and interventions for alcoholism, and ensure that the norm for community gatherings that include alcohol is to drink responsibly, then Central Oregon will be healthier and safer.”

St. Charles leadership believes alcohol misuse prevention is a major health need in Central Oregon. As part of the Community Benefit program, the health system will partner with local organizations that are working to address this need in an effort to capitalize on the energy that surrounds the subject, and it will no longer sponsor events where alcohol is the primary focus, including fundraising events where alcohol is prominently featured in the title or promotional materials. “We hope that together with our community we can develop innovative ways to improve access to care where needed, increase educational and awareness offerings and reduce the negative impacts associated with alcohol misuse to the health of our communities,” says St. Charles’ 2020-2022 Regional Health Implementation Strategy.

The Community Benefit program will also provide financial support to groups that are trying to stem the tide of alcohol misuse in communities across the region. Exactly how that looks will be up to the individual communities, Salcedo said.

“Our hope is that each community will choose where to focus their time and energy around this issue. Maybe one will focus on teen drinking while another may want to focus on supporting parents who talk to their children about alcohol misuse,” he said. “St. Charles may find itself supporting communities in a variety of ways, such as offering financial assistance for projects identified by the community or providing medical experts and relevant research to enable community members to move forward in preventing the misuse of alcohol.”

Alcohol misuse prevention was identified as a priority based on the 2020-2022 Community Health Needs Assessment, which brought together population health data, input from community members, community survey results and analysis of available community resources to address health needs. St. Charles and the Central Oregon Health Council collaborated to conduct the research and develop the CHNAs.