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.

Grand Rounds - Oct. 23, 2020
"Stress Management and Physician Wellness"

Speaker: 
Alan Rosenstein, MD, MBA, Private Practice, Internal Medicine ‐ Medical Consultant, Health Care Management

Objectives

1. Define and describe burnout and resilience among physicians.
2. Identify “red flags” that may indicate when a physician or colleague is at higher risk for burnout.
3. Implement methods to control and manage stress while treating patients and interacting with team members.
4. Prevent or manage physician stress and related disruption and impairment.
5. Utilize available resources, when needed.
6. Recognize the varying levels of stress and burnout among different sub-specialties and identify cultural considerations in stress management.

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].

Oct. 20, 2020

Our opinion: This election, vote for healthy communities

Last week in Oregon, ballots were mailed to our homes, providing registered voters with an opportunity to have their voices heard on many important issues.

St. Charles Health System is endorsing two of those issues that we think are in alignment with our vision of “creating America’s healthiest community, together,” and I would like to share with you our reasons why.

Measure 108: Tobacco and e-cigarette tax increase for health programs 

We support Measure 108 because research has shown us that the single best way to reduce vaping and smoking is to increase the cost. If vapes and tobacco products are taxed more and thus cost more, we expect fewer people will use them, saving lives. 

As it stands now, Oregon doesn’t tax nicotine vapes one penny and has some of the lowest tobacco taxes in the country. We find this concerning since youth vaping in our state has increased 80 percent in the past two years alone. Tobacco companies are targeting kids with candy-flavored vapes that taste like gummy bears or cotton candy and are selling them for as little as 99 cents. According to the Journal of American Medicine, young people who vape are nearly three times more likely to start smoking cigarettes. 

Measure 108 was also written so that the dollars raised can only be used for tobacco cessation and prevention programs and to fund the Oregon Health Plan, which serves one in four Oregonians (including more than 400,000 children in our state), and nearly 56,000 people in Central Oregon. Measure 108 will protect this vital coverage, ensuring people continue getting the care they need, when they need it.

Measure 9-135: Bonds for traffic flow, east-west connections, neighborhood safety improvements

As a health care organization, we recognize that the path to good health starts outside of the walls of our hospitals and clinics. It involves not just the work of St. Charles, but also our cities, our schools, our nonprofit partners and our many wonderful local businesses coming together to ensure people who live here are safe and well-supported.

We support Measure 9-135 because it would allow the city of Bend to issue $190 million in bonds and invest that money in an increasingly stressed infrastructure. Passing the measure would help create safer street crossings and build a new network of sidewalks, bike lanes and bus pull-outs. These improvements would make it safer for our kids to get to school, for pedestrians and cyclists to get around and make navigating town easier for drivers.

Passing Measure 9-135 would also help fix dozens of intersections to reduce bottlenecks, build a bridge at Reed Market and upgrade traffic signals to improve traffic flow. It would improve east-west connectivity by building new links between existing roads, ensuring we can all get across town safely and smoothly however we travel.

As Bend grows, we think it’s important to protect our quality of life and our burgeoning economy. We need to preserve the vitality of our neighborhoods, improve the safety of our streets and help our local businesses thrive. For all of these reasons, we’d like to see this measure pass.

Make your voice heard

Whatever your opinion on these and other issues, I encourage you to vote and make your voice heard. As Americans, it’s one of our great privileges and responsibilities.

Remember, the last day to safely return your ballot by mail is Oct. 27. 

Be well,

Joe

Grand Rounds - Oct. 16, 2020
"Acute Pain Prescribing Guidelines - Emergency and Immediate Care"

Speaker: 
Stephen Leffler, MD, FACEP, President & Chief Operating Officer, The University of Vermont Medical Center

Objectives

1. Learn techniques to manage opiate prescribing.
2. Understand how data affects prescriber behavior.
3. Develop techniques to develop local best practices around prescribing opiates.

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].

Stay strong Central Oregon 

In the past seven months, 22 people have died in Central Oregon because of the COVID-19 pandemic. 

Since March, 1,598 Central Oregonians have been struck ill with this virus – many of them have had significant health impacts and some have had a protracted illness with long-lasting symptoms. 

So far, 150 people have been discharged from a St. Charles hospital after needing care related to COVID-19. Of those, 31 have spent time in the ICU. The average length of stay for an ICU patient with COVID-19 is more than 15 days. 

This past week, we had another 97 positive COVID-19 cases in Central Oregon. That number is higher than it has been since early August. 

And yesterday marked the highest number of positive COVID-19 cases in the state since the pandemic began. 

All of this is to say that COVID-19 continues to be a real and very serious threat. Our numbers are up, which translates to people needing costly intensive care that could result in a lifetime of health-related struggles. 

Families throughout our region are mourning the loved ones they have lost. 

No matter how fatigued you may be by the restrictions in place and changes to our lives, we can’t give up. In fact, now is the time to continue staying strong and fighting even harder to protect ourselves and our loved ones. 

Several medical providers in our Central Oregon communities have messages to share with you about why all of this remains important. Please take a moment to listen to Dr. Natalie Good from Prineville, Dr. Alwin Borgmann of La Pine and Dr. Shiloh Tippet of Madras.

They understand that COVID-19 is serious. And they care about your health and the health of our communities. I hope you will listen to them. That you will continue to wash your hands, wear a mask, physically distance yourself from others and stay home whenever possible. 

I also hope you will take the advice of our medical professionals and be sure to get your flu shot as soon as possible. Dr. Sanaz Askari shares why this year the flu shot is more important than ever. 

Stay strong Central Oregon. Together, we will get through this. 

Sincerely, 

Joe 

Grand Rounds - October 9, 2020
"Alcohol Use Disorder"

Speaker: Michael Levine MD, FACEP, FACMT. Director of Toxicology, Department of Emergency Medicine, University of California Los Angeles

Objectives

• Describe the epidemiology of Alcohol Use Disorder (AUD) and outline current and evolving diagnostic criteria.
• Describe challenges to the successful identification of patients with AUD.
• Identify the treatment modalities currently available for management of AUD and apply them to patient cases using evidence-based medicine.
• Develop strategies for recognizing and improving therapeutic adherence in patients treated for AUD.

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].

BEND, Ore. – St. Charles Health System is hosting a medication take-back event on Saturday, Oct. 24, from 10 a.m. to 2 p.m. at its St. Charles Bend hospital campus at 2600 NE Neff Road.

The take-back event is intended to help households dispose of medications that could be ingested by someone other than the person for whom they were prescribed and to prevent medications from ending up in the water table.

In 2019, the second year the event was held, St. Charles collected 327 pounds of medication from more than 300 people.

No questions will be asked. Individuals can drive through the parking lot and drop off medications right from their car window. Bend police officers will accept the medications, then give them to the Drug Enforcement Administration (DEA) to dispose of safely.

Any medications will be accepted. Liquids, pills, powders, patches, creams, prescriptions or over-the-counter medicines can be dropped off. Oncology medications will also be accepted.

Representatives from St. Charles pharmacy will also be on-site to answer questions.

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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