At St. Charles, we work hard every day in pursuit of our vision: creating America’s healthiest community, together.

That last word – together – is a key component of our work.

As Oregon’s leading health care organization east of the Cascades, St. Charles plays a major role in the health of the communities we serve. But we can’t do it alone. We need an engaged constituency made up of people who are interested in health issues – the kind of people who not only open an email from their local health system, but also read the latest update from the health system’s CEO. (Thank you for doing so, by the way.)

We also need dedicated, knowledgeable community partners who share our vision for a healthier Central Oregon.

St. Charles is fortunate to work with many local organizations that fit that description. One of those is Stroke Awareness Oregon (SAO), which is expanding stroke education across the state and improving outcomes for stroke survivors.

By relentlessly focusing on stroke awareness and education, SAO is giving Oregonians the tools they need to do their part for stroke victims. That’s because stroke care is highly dependent on people who know the signs of stroke and can alert emergency responders quickly. For stroke victims, if a friend, family member, coworker or even a stranger doesn’t spot the symptoms and seek help, doctors cannot provide treatment.

At St. Charles, we’re doing our part, too. Led by a group of caregivers who are exceedingly committed to improving stroke care in our service area, the health system's stroke program has made some incredible advances over the past few years:

Number one, we have significantly increased our usage of t-PA, the best available medication to dissolve blood clots. At all four of our hospitals, this change is improving outcomes for stroke patients.

Number two, we now have 24/7 coverage of our Bend hospital by physicians trained in interventional stroke care. Using cutting-edge technology, these doctors are able to provide life-saving treatment as soon as a stroke victim comes through the door.

Number three – and this is a big deal – we are launching a rural outreach program. This will make our exceptional stroke care available to people in rural areas throughout Central and Eastern Oregon and, we hope, reduce the number of stroke victims being transferred out of state.

With a stroke, a rapid response is absolutely critical. For every minute treatment is delayed, 2 million brain cells will die. Every hour of delay leads to at least a 20% drop in recovery rates.

A rapid response is complicated, however, by the fact that St. Charles serves a huge, sparsely populated area. So we’re doing everything we can to ensure rural hospitals know about our stroke care program and we’re working with emergency responders across the state to get people the care they need as quickly as possible, including automatic deployment to stroke victims in rural and remote locations.

We’re also reaching out to our colleagues in towns like John Day and Burns to ensure we’re all working from the same modern playbook when it comes to stroke care. We believe this new program can serve as a model for similar areas and will save many lives.

There are other initiatives underway, too, all focused on one thing: Improving long-term outcomes for stroke victims in Central and Eastern Oregon. That’s our ultimate goal at St. Charles, and we’re proud to work with Stroke Awareness Oregon to get there together.

If you want to make sure you know the signs of a stroke – easily remembered using the acronym F.A.S.T. – please check out SAO's website for more information.

On the eve of the COVID-19 pandemic, St. Charles Health System posed a question to the Redmond community: What should the future of your community hospital look like?

At a January visioning session, caregivers and community members began a dialogue about how to realize the greatest potential of St. Charles Redmond, a hospital that is chronically underused despite sitting smack dab in the middle of one of the fastest growing regions in the country. On average, the hospital is only 48% occupied. Three of the five operating rooms there are only utilized about half of the time, and the remaining two aren’t used as operating rooms at all.

But the challenge for St. Charles isn’t just how to use the hospital more—it’s also, how can it be used better? How does the health system give a hospital that has a warm, relaxed care setting with committed caregivers and an excellent record for quality of care a more defined role that better meets the community’s needs?

“This is a challenge we’ve been wrestling with for a while,” said Aaron Adams, president of the Redmond hospital. “But this is also an opportunity. If we get creative and work collaboratively with our community, we can make some exciting changes that will improve access to services, improve the quality of care and benefit the local economy.”

To start, the visioning session participants were given four options: 1) Don’t change a thing; 2) Create a new service line, like cancer; 3) Transition St. Charles Redmond to a surgical hospital with an associated medical office building or 4) Convert the campus into a post-acute care facility (for example, one with an inpatient rehabilitation focus.)

When it came time to rank them, 85% of the respondents indicated options two and four were their top choices while still retaining the hospital’s general acute care status.

Growing existing services to meet demand: surgery and inpatient rehabilitation

One possibility, Adams said, is growing general surgery at the hospital, where five general surgeons already practice. St. Charles Redmond—which also recently added robotic surgery to its campus—could serve up to 200 additional patients from cities like Madras and Prineville who are currently referred to Bend.

The health system is also contemplating a new orthopedic trauma service, which would mean moving some surgeries currently done at Redmond to Bend. This would allow a dedicated, on-call orthopedic surgeon access to an operating room that is reserved exclusively for these kinds of cases, making it so patients can get surgery faster. 

Yet another option is to move St. Charles’ inpatient rehabilitation program to Redmond, where this vital service could double its capacity to 24 beds and expand into an outdoor space, allowing patients to go on walks and get fresh air during their sessions.

Research tells us that people who are admitted to inpatient rehab after experiencing a stroke, spinal cord injuries, brain injuries, burns and other conditions have better clinical outcomes and a higher quality of life. They have shorter hospital stays, lower mortality rates, fewer Emergency Department visits and are less likely to be readmitted. 

But the number of patients needing this service already exceeds St. Charles’ capacity to provide it, and demand is only projected to grow. 

What’s more, relocating inpatient rehabilitation to St. Charles Redmond would increase the utilization of the hospital to 75% (from 48%), adding 18 to 24 patients per day to the hospital census. For Redmond, this translates into $26.5 million in net revenue.

Before any expansion of inpatient rehabilitation services can take place in Redmond, however, Adams and other hospital leaders realized they’d have to first make room for them. A schematic design is already underway with the intent of remodeling and bringing back into service 17 patient rooms. 

Creating new services: a comprehensive cancer program

Yet another project on the horizon is a new medical office building, which would house a comprehensive cancer program.

St. Charles currently provides chemotherapy and other cancer treatments at a clinic a few blocks from St. Charles Redmond. Radiation treatments would be provided in the new building, which would be built on the hospital campus as part of an expansion approved by the St. Charles board of directors. Medical oncology and other support services would then be moved to the new building.

“This would represent a critical addition of services to Redmond and Central Oregon, making it easier for patients in our northern communities to access cancer treatments,” Adams said. 

Bringing a comprehensive cancer program to Redmond would result in an estimated 1,300 office visits and 6,300 treatments annually, Adams said, resulting in another $10.1 million in net revenue for Redmond.

“To be clear, all of these options are just concepts right now. There’s much we still need to learn before decisions are made,” he said. “But one of the overarching messages that we hope everyone will hear is that we are committed to continuing to provide the very personalized, quality care that our community has come to expect from us.”

An inside look at COVID-19 in our Intensive Care Unit

Many people have asked us what it’s like right now for our caregivers working on the front lines with COVID-19 patients. 

In this video, we give you an inside look at what goes on in the St. Charles Bend ICU when a patient with COVID-19 needs critical care. Even with the additional safety equipment, the stress and the fear of fighting this pandemic, our caregivers are proud to be here to serve our community and care for you and your loved ones.

Please take two minutes to watch the video and remember that you can help us by taking every precaution to avoid contracting and spreading COVID-19.

Our Central Oregon numbers are fluctuating – both inside and outside of our hospitals. But the trends continue to show that interventions like masking, physically distancing and practicing good hand hygiene do make a difference. Thank you to those of you who are taking COVID-19 seriously. Your actions are saving lives. 

Your safety, our priority

Throughout our hospitals and clinics, St. Charles has put many safety precautions into place in order to protect you and our health care workforce. 

Protecting the safety of our caregivers has been our top priority since the beginning of the pandemic. We care about our team’s health and safety and we know that keeping them well is critical to ensuring they are able to care for you. 

Still, this is a highly contagious disease, and we have had 17 St. Charles caregivers test positive for COVID-19 since the pandemic began in March. None of these cases have been confirmed as due to a workplace exposure and many have been related to known community exposures.

With more than 4,500 employees, this was to be expected. But I want you to know that our St. Charles caregivers are all required to adhere to our universal masking policy and to immediately report any COVID-19 symptoms to our Caregiver Health team. If they have symptoms, they are tested and not allowed to return to work until it is safe for them to do so. We follow testing and work restriction guidelines for our staff from the Centers for Disease Control and Prevention and the Oregon Health Authority. 

We take our responsibility to protect them and you very seriously. 

That’s why you will continue to experience screening questions at the entrances to our facilities. You'll notice plexiglass dividers protecting you and our caregivers from each other. And it's why this week we expanded and clarified our universal masking policy to ensure patients and visitors understand how it applies to them. Patients are required to wear a mask when inside any of our facilities unless they are asked to remove it by a health care provider. 

We greatly appreciate your help in adhering to our policies as we all continue to fight COVID-19 together.

Sincerely,

Joe

Billing Office closed to public access

Due to the shift from an onsite workforce to remote workforce, the St. Charles Single Billing Office no longer has public access.

Caregivers remain ready to help with any patient billing needs during business hours: 9:00 a.m.-4 p.m. Monday through Friday.

Answers to a few frequently asked questions:

How do I make a payment on my account?

1. If you have a MyChart account, you can make your payment, set up a payment plan, access your health information and set up an appointment with your physician. You can set up MyChart by following the instructions in the box in the lower right corner of your billing statement.
2. You can call us at 1-888-703-8401 to make a payment over the phone, as well as set up a payment plan.
3. You can also mail a payment to us at St. Charles Health Patient Payment, 29357 Network Place, Chicago IL 60673-1293. Please make sure the account number you wish to credit the payment to is written on your check and enclose the payment stub.

How do I request and receive billing information?

1. Call us at 1-888-703-8401 to request an itemized detail or a claim form. We will print it and mail it to the verified address on your account.
2. For other questions regarding your account, please call 1-888-703-8401.

How do I obtain a Financial Assistance Application and where do I return it?

1. You can request an application through MyChart.
2. Download the application on our website.
3. Call us at 1-888-703-8401 for questions regarding financial assistance.
4. Submit completed applications:
   
   By mail:
   St. Charles Health System, Inc.
   PO Box 6095
   Bend, OR 97708
   
   By fax:
   541-706-6707 or 541-706-2614.

We appreciate your understanding in helping us keep our community safe and healthy.

Grand Rounds - July 31, 2020
"COVID Update" and "Contact Tracing Strategies: Oregon and COVID-19"

Speakers: 

Shira C. Shafir, Ph.D., MPH, Director, MPH for Health Professionals Department of Community Health Sciences, Director of Field Internships Department of Epidemiology, UCLA Fielding School of Public Health

Jill Johnson, RN, Deschutes County Health Services Communicable, Disease Programs Supervisor

Video begins at approximately 0:14.

Objectives (COVID-19 update):

1. Describe the current state of the COVID-19 Coronavirus outbreak
2. Understand what is currently known and unknown from the rapidly evolving literature on SARS-CoV-19
3. Explain updated understanding on the pathophysiology of the virus and how it affects multiple body systems
4. Describe updates on drug and vaccine testing

Objectives (COVID-19 Contact Tracing Strategies in Oregon):

1. Discuss the Public Health role in preventing the spread of COVID-19 through case investigation and contact tracing.
2. Understand COVID-19 prevalence in the Central Oregon Region and contributing factors.
3. Describe how syndromic surveillance may provide an early indicator of changes in COVID-19 infections

Accreditation: St. Charles Health System is accredited by the Oregon Medical Association 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.

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 541-706-4680, [email protected]. For CME or Clerkship questions, contact Sheila Jordan, MMGT, CHCP, Manager of Continuing Medical Education at 541-706-6780, [email protected].

(Above, extra hospital beds sit in storage in the basement of St. Charles Bend's new patient tower.)

Earlier this year, in anticipation of COVID-19’s arrival to Central Oregon, St. Charles Health System set up a number of teams to prepare and support hospital operations for the possibility of a surge of sick patients at St. Charles Bend.

Under normal circumstances, the Bend hospital has 209 beds available for patient care, including 24 in the Intensive Care Unit, home to the most seriously ill. At the time, COVID-19 cases were spiking in Seattle and New York City, overwhelming hospitals in those areas.

So St. Charles' Incident Command team – a management structure used in times of crisis – tasked a group of caregivers with developing a “surge plan” to detail how the hospital could expand its patient capacity within the existing campus.

It was a monumental and multi-faceted effort that required collaboration and cooperation across the entire organization, said Jenn Clark, a manager on the health system's Value Improvement Practice team who was heavily involved in the work.

“The initial stage of the process was to assess our current resources so that we would be able to maximize our abilities in space, equipment, supplies, people and technology,” Clark said. “That assessment gave us a framework to design a surge plan in tiers, which would allow us to maintain a controlled execution of services.”

There are six tiers, from Tier 1 (normal operations) up to Tier 6, which projects capacity at 751 beds. More recently, better data and predictive analysis were used to create a special Tier 1.5, which would increase capacity to 283 beds (complete with privacy and infection control measures) and would be “easier” to launch if needed, Clark said.

The team increased the hospital’s capacity by doubling beds in rooms that are big enough to do so and combing the facility for areas where patients are not typically cared for, but they could be if needed.

“We looked at non-traditional care spaces such as family waiting rooms, conference rooms and office space and fabricated plans to transform them into viable places for patient care,” Clark said. “Our regulatory team helped draft these plans to propose for certification from Oregon Health Authority, and our workflows for patient care were redesigned to ensure functionality in this new environment.”

At the same time, Tony Arnold, manager of purchasing and strategic sourcing on St. Charles’ Supply Chain team, was working to secure the supplies needed to execute the surge plans, Clark said. When certain items became scarce because of competition, the team developed backup plans. All necessary resources are now on hand and triaged to allow the health system to serve a record number of patients.

“Some of the surge work you cannot see, such as the framework our IT team built, which allows us to leverage existing technology for patient safety measures,” said Julie Ostrom, senior director of perioperative and cardiovascular services, who was also involved in the planning. “The surge plans also outline when we would pull on state and national agencies for support if our system were to become overwhelmed.”

Ultimately, the surge planning process included all the key components that enable St. Charles to deliver safe and effective care, including food services and linens, demands on the health system’s laboratory and pharmacy, and, of course, staffing. Clark gave a special shout-out to Jessica Truson, a manager in the Information Technology department, for organizing the work to ensure all its moving parts worked together.

“The plan outlines specifics for each St. Charles hospital campus that will ease collaboration and benefit each of the communities we serve,” Clark said. “Education and cross-training were developed and executed to allow for blended nursing care models to support a potential surge.”

She continued: “We’re ready to turn this on if we need to.”

Even if they’re never needed, however, developing the surge plans was a “valuable exercise” for the organization, Clark said, and work to archive them for future reference is almost done.

“Through all this, I wanted to make sure our patients would feel like they were getting the same high-quality service and care that they would get on a normal day at St. Charles,” she said. “Our passion is our communities’ health, and it was inspiring to see our team come together to serve them in the face of an emergency.”

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.”

Download Flyer    Descargar folleto en español

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