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Grand Rounds - Oct. 2, 2020
"Implicit Bias in Medicine"

Speaker: Clinton Coil, MD, MPH, FACEP, Chief Quality Officer, Associate Medical Director for Quality and Safety, LA County Harbor‐UCLA Medical Center; Assistant Clinical Professor of Medicine, Division of Emergency Medicine, David Geffen School of Medicine at UCLA

Objectives:

  1. Define implicit bias and the evidence supporting its existence

  2. Identify Implicit bias in healthcare and how it affects quality and safety

  3. Implement strategies to provide safe, high quality care to all patients, despite biases

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

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Early in the summer, 10-year-old JC Lacks of Bend looked at his mom, Lori, and dad, Jon, and told them he wanted to do something to help with the fight against COVID-19.

“This was not prompted at all,” said Lori, a school teacher. “I looked at him and said, ‘What do you mean?’”

Her son was already dreaming big.

“‘What about all the doctors? Maybe we can do something for them,’” JC remembers asking his parents. “‘Or maybe we could come up with a cure for COVID.’”

Lori can’t help but smile when she remembers the conversation.

“I told him, ‘Yes, that would be nice, but let’s keep thinking about this,’” she said.

With shortages of personal protective equipment making headlines earlier in the pandemic, the Lacks ultimately decided to try running a fundraiser, with a goal of donating money toward the purchase of gloves, masks and other gear for frontline caregivers. They called it the Outdoor-A-Thon St. Charles Frontline COVID Fundraiser.

“We wanted it to be purposeful for the kids, to get them outside and to encourage them to be active,” Lori Lacks said. “Rather than just asking people for money, we decided to have the kids do whatever they want outdoors -- hiking, biking walking -- and log the miles, and we asked people to make a donation in a lump sum or per mile.”

JC wrote a letter explaining the idea and sent it out to neighbors, friends and family. Lori created a Facebook group to organize the effort. Word of the fundraiser spread and JC’s buddies started joining in and clocking their miles and posting pictures of themselves on trails, atop bikes and even floating the river.

“It was great motivation to get us out and doing something as a family,” said Lori. “We’d be out somewhere and we’d say, ‘If we just go 10 more miles …’”

All told, a group of about 15 participants tallied more than 350 miles, with JC logging 135 on his own. They ended the fundraiser on Aug. 31, but money kept coming in until the total amount raised reached $1,155.

Earlier this week, JC and his friend Parker Sheppard, 10, got to present a check for that amount to Dr. Jeff Absalon, St. Charles’ chief physician executive, and Carlos Salcedo with the St. Charles Foundation.

“Do you know what you guys have in common with everyone who works here at St. Charles?” Absalon asked the boys. “They care about helping people, and you guys do, too. That’s a great quality to have.”

After making the donation, JC and Parker were beaming.

“This makes me so happy that we were able to raise all this money,” JC said. “And we had a lot of fun doing it.”

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Grand Rounds - Sept. 25, 2020
"Sexology 2020: beyond PLISSIT: addressing client/patient sexual concerns in the era of porn, polyamory and #metoo"

Speaker: 
Jane Guyn, PhD, RN, President/Founder of Pleasure Plan, Inc.; relationship/sex coach

Objectives

  1. Recognize the multiple barriers to healthy and satisfying sexual relationships including but not limited to: body image disorders, erectile dysfunction, early ejaculation, “spectatoring” during sexual experiences.
  2. Recognize the problem of vaginal pain during sex, environmental barriers to intimacy, uneven desire between partners, sexually related power struggles, conflict about porn use, “sexual addiction”.
  3. Recognize the impact of a history of sexual abuse, emotional conflict exhaustion, orgasmic dysfunction, faking it, distraction during sex, and conflict about request to open monogamous relationships to other partners.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

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I’m sure many of you who are reading this are doing everything you can to avoid contracting or spreading COVID-19.

But are you doing what you can to avoid the twin-demic?

If “twin-demic” is a phrase that’s new to you, you’re not alone. Only in the past couple of months have I heard health experts and medical professionals use it to describe a looming concern on our collective horizon: the potential collision of two viruses – COVID-19 and the seasonal flu – that cause some of the same symptoms.

As you probably know, flu season typically runs from October through April, and every year, the flu sickens millions of people and kills tens of thousands more. That’s the bad news. The good news is the impact of the flu can be markedly reduced by getting a flu vaccine.

Let’s be clear: The flu vaccine is safe and effective. Getting it can cut the risk of catching the flu by up to 60%, and for people who do get sick, it can diminish the symptoms and shorten the illness. That’s why the Centers for Disease Control recommends that anyone older than 6 months of age get the flu vaccine by the end of October.

If you are a person who normally doesn’t think about getting a flu shot, this is the year to make it a priority. Jill Johnson, communicable disease supervisor for Deschutes County Health Services, explained why in The Bulletin recently:

“It’s especially important this year because of the COVID-19 pandemic,” she said. “The seasonal flu vaccine can reduce the spread of respiratory illnesses. The danger is even in a mild flu year, there could be hundreds of thousands of hospitalizations, coupled with COVID-19, that could overwhelm the hospital systems.”

In other words, by getting the flu vaccine, you’ll protect yourself and your loved ones from the flu, and you’ll be helping our team at St. Charles by not inundating our hospital beds with flu patients.

The threat of COVID-19 is still very real in our community, and over the next few months, it is absolutely critical that we all work together to try to minimize its impact and the impact of the flu on Central Oregon. You can do your part by washing your hands effectively and regularly, practicing appropriate physical distancing, wearing a mask over your mouth and nose and getting your flu shot.

And get it soon, because health officials say it takes two to four weeks to become fully effective.

One last time: Get your flu shot. It may just be the simplest way you can help us avoid a twin-demic.

Thank you for doing your part to keep this community healthy.

Sincerely,
Joe

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Above, Dr. Katie Ruth looks over Lindsey Hutchinson of Klamath Falls during an office visit at the OHSU-Cascades East Family Medicine Center in Klamath Falls, 2019. Ruth performed her residency at Cascades East, a collaboration between OHSU and Sky Lakes Medical Center working to improve health access in rural Oregon. Credit: OHSU/Kristyna Wentz-Graff

Oregon Health & Science University is in the early stages of creating what is expected to be the first graduate medical education program primarily based in Central Oregon.

OHSU has received a $750,000 grant from the U.S. Department of Health and Human Services through the Health Resources & Service Administration’s Rural Residency Planning and Development Program. OHSU will use the grant to develop a new family medicine residency program in partnership with Bend-based St. Charles Health System. 

“Establishing a family medicine residency program in Central Oregon can help address health care gaps that occur too often in rural areas,” said Joe Skariah, D.O., M.P.H., M.B.A., who directs OHSU’s family medicine residency program and is leading the new program’s creation. “Knowing physicians often choose to stay and practice in the communities where they complete their residencies, this new program could also attract more skilled and compassionate health care providers to Central Oregon.”

Residents are new physicians who have recently completed medical school and receive advanced training in a specific medical field. This program will focus on family medicine, primary care that specializes in caring for the entire family.

After receiving accreditation, the program could welcome its first residents as early as July 2024. The program’s first year, known as an internship, would be based out of OHSU’s Portland campus. The program’s subsequent years would primarily bring residents to St. Charles Madras. Many of the program’s details are still being decided, including the number of residents involved.

The program will build on OHSU’s long-established rural medical education program. Every OHSU medical student completes at least one month of training in a rural setting, including in the Central Oregon communities of Warm Springs, Madras, Redmond, Prineville and Sisters. During OHSU’s last academic year, 42 medical students had clinical rotations with Central Oregon physicians, many of whom are associated with St. Charles Health System. Portland-based OHSU residents have also had rotations in Bend and Warm Springs. 

The new residency program is being organized through the OHSU School of Medicine’s Department of Family Medicine, which was recognized this year by U.S. News & World Report as the nation’s best family medicine program. OHSU is home to one of the oldest family medicine residency programs in the U.S., and the first family medicine residency program in Oregon.

“I am excited to grow our collaboration with OHSU and create an important avenue for medical education in Central Oregon,” said Robert Ross, M.D., director of provider academics research and clinical service at St. Charles Health System and a clinical associate professor of family medicine at OHSU. 

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Watching the many wildfires burning in Oregon over the past week has been terrifying, heartbreaking and exhausting – both physically and emotionally. Like you, I understand the concerns about the hazardous air quality and I’m worried about all those who have been displaced by this horrific natural disaster.

On top of all of that, we are still focusing on responding to the COVID-19 pandemic and are now preparing for our annual flu season. It’s a lot, but I want you to know that St. Charles is here for you and continuing to provide the community with information, resources and the care you need.

The good news, on the COVID-19 front, is that our hospitalization numbers remain low and because we have worked together in our communities to contain the spread of the virus many of our kids are able to return to school sooner than expected. We need to keep this up by continuing to wear masks, wash hands and physically distance. For some of our team’s latest understanding of the COVID-19 virus, please watch this video featuring Dr. Bob Pfister.

Wildfires and smoke

Now that we have wildfires causing people to seek emergency shelter across the state, we are concerned the virus could find new, vulnerable populations in which to spread. It is incredibly important that we do our best to support those in need during this time.

Here are several resources for ways to help put together by the Central Oregon Emergency Information Network:

In addition to these many resources, the Oregon Association of Hospitals and Health Systems has established a fund to specifically help the more than 100 health care workers in the state who have lost their homes. You can learn more about this effort here.

For those of you concerned about the health effects of exposure to the wildfire smoke, please watch this video featuring Dr. Nathan Ansbaugh, one of our emergency physicians. The main takeaway is to stay indoors if you are at high risk of having lung issues. We are all hoping for clearer skies going into this weekend.

The flu

While many of the things affecting our lives are outside of our control – a pandemic, wildfires and smoke – there is one action we can proactively take to help ourselves over the next few months and it’s actually quite simple.

Please, get your flu shot. 

If you are a person who doesn’t normally think about getting a flu shot, this is the year to make it a priority. You will protect yourself and your loved ones from the flu and you’ll be helping our team at St. Charles by not inundating our hospital beds with flu patients.

Thank you for doing your part to keep all of us as healthy as possible.

Sincerely,

Joe

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Grand Rounds - Sept. 18, 2020
"
Social Determinants of Physical and Mental Health: Black/African-American Physical and Mental Health in the 2020 COVID-19 and Racial Justice Era"

Speaker: 
Gena Cox, PhD, President, Feels Human, Inc. and Senior Consultant and Lead Researcher, Perceptyx, Inc.

Objectives

  1. Define the primary patterns of physical and mental health outcomes for Black/African-Americans in 2020 regarding COVID-19 and racially-defined stressors.

  2. Define the systemic patterns in income, nutrition, education, housing, health service access and socio-political factors that explain these outcomes.

  3. Share examples of effective local, regional, and national strategies for improving systems and policies that affect the social determinants of physical and mental health.

  4. Discuss research-based behaviors healthcare providers can use to understand the unique needs of Black/African-American patients.

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

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Grand Rounds - Sept. 11, 2020
"Collateral morbidity and mortality of the COVID-19 Pandemic"

Speakers: 
Archie Bleyer, MD, Clinical Research Professor, Radiation Medicine, The Knight Cancer Institute, OHSU
Dan Weinberger, PhD, Associate Professor, Epidemiology of Microbial Diseases and Public Health Modeling Unit, Yale School of Public Health
Whitney Schumacher, MPH, Suicide Prevention Coordinator, Deschutes County

Objectives

  1. To realize to what extent the pandemic is causing other morbidities and deaths

  2. To deliberate the causes of the excess mortality and disease burden

  3. To recognize that the age of those dying of Covid-19 is decreasing

  4. To anticipate an even shorter life expectancy in the U.S.

  5. To consider what should be done to reverse these all-time ominous trends

Accreditation: St. Charles Health System is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. St. Charles Health System designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)TM.

The period to claim credit for this activity expires one year after its original publication. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Claim Credit

Target Audience: Physicians, Nurses, Pharmacists, Allied Health Professionals

Accessibility/Program Questions: St. Charles Health System encourages persons with disabilities to participate in its programs and activities. If you anticipate needing any type of accommodation or have questions about the physical access provided, please contact Continuing Medical Education at [email protected].

Oher CME or Clerkship questions: also contact Continuing Medical Education at [email protected].

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Below, you can see the Medical Library subscriptions. Check the library blog regularly for help and tips on using the resources, and contact us if you have any questions. We also have a projector and screen available to borrow. 

If you need an article or other resource not on the list, email us, and we'll help! For hard-copy book suggestions, use this form.

Point of Care: 

Printed books:

Ebooks:

Databases:

Journals:


Other resources (not subscribed by the library):

 

 

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TARGET AUDIENCE: The St. Charles Medical Library provides physicians, advanced practice providers (NPs and PAs), and clinical pharmacists across Central and Eastern Oregon with direct access to the most up-to-date, evidence-based information available.

Location: St. Charles Bend Campus. The Library is located on the second floor (Bend Hospital) above the deli. Access is provided to all caregivers.

Medical Librarian: Javier Leiva.

Whatever your job responsibilities at SCHS, sometime during the year you will need information – to treat a patient, evaluate programs or services, educate staff or patients, or for your own health concerns. Do you know where to find the information you need?

The SCHS Medical Library is here to meet your knowledge-based information needs. Whether you come into the library or communicate via email, phone, or interoffice mail, the library has many information resources and services to help you.

Please check: 

Library resources      Library Blog

Do you need an article, a book chapter, or another document? Reach out for help at any time via email: [email protected].

If you want general consumer health information, please contact the Deschutes Public Library &/or Deschutes County Public Health.