Throughout much of the spring, Central Oregonians stepped up and supported St. Charles Health System in a variety of ways: by donating money for caregivers on the front line of the fight against COVID-19, by delivering a bounty of food and drinks to essential workers at the organization’s hospitals and by hand-crafting more than 10,000 cloth masks to supplement the system’s supply of medical-grade masks.

So when it came time to thank the community through action, St. Charles leadership zeroed in on Gov. Kate Brown’s plan to place paid and volunteer contact tracers in each Oregon county. Ensuring adequate contact tracing, Brown has said, will allow the state’s public health system to effectively identify and treat new cases of COVID-19, trace contacts to identify those at risk of infection and contain new outbreaks before community spread can occur.

“Throughout this pandemic, our health system has been buoyed by an outpouring of community support,” said Dr. Jim Guyn, senior vice president of population health. “Offering some of our caregivers to help with contact tracing felt like one way we could give back to Central Oregon. We want people to stay well and for local businesses to stay open.”

After discussions with public health officials in Crook, Deschutes and Jefferson counties, St. Charles identified six Community Health Educators from family care clinics in Bend, Madras, Prineville and Redmond to take the Oregon Health Authority’s online contact tracing training. Those six caregivers have not yet started working with the counties – that’s expected to start in July, after a few final details are nailed down – but they’re ready when the call comes, said Maggie O’Connor, manager of community health strategy for St. Charles.

“Everyone on this team was so willing to sign up for the training session and to get going,” she said. “It’s definitely a great opportunity for us to serve the community in a new capacity.”

The CHEs who’ll take on contact tracing work are Nancy Burham in Redmond, Molly Christopher in Madras and Sisters, Catalina Gibson and Molly Olheiser in Prineville, and Gabrielle Gilmore and Rachel Nelles in Bend. The six are uniquely qualified to do contact tracing because of the parallels to their normal daily duties, which include serving as an extra layer of social support for patients who are struggling with housing, food insecurity, transportation, finances, domestic safety and so on.

“If our providers or behavioral health counselors have a concern about a patient, we get pulled in to help wrap around them in the context of those social needs,” said Olheiser. “The really cool thing about our job is that we’re able to establish relationships with people, and we’re with them through some of the most stressful times of their lives as a resource and a source of support.”

CHEs work with patients both in the clinic and at their home, and they are trained to communicate with patients in a way that makes them feel comfortable talking openly about their lives. That skill should translate seamlessly to contact tracing, said Gilmore.

“We’ll be getting names of people who have come into contact with someone who has COVID-19, and we’ll interview them and follow up with them to make sure they understand the disease and what they should be doing,” she said. “That extended interaction with them will give us an opportunity to assess their resource needs and make sure they’re being met. And that’s obviously something we’re used to doing on a daily basis.”

In other words, both community health education and contact tracing require not just specific health-related knowledge, but also people skills, cultural competency, compassion and empathy.

“It’s a little nerve-wracking because I know COVID-19 can be a really scary thing for people, but we’re trained to deal with delivering that type of news and information,” Olheiser said.

Burham concurred: “You need to be able to think on the fly and to know what resources are available. We’re all highly trained and well-connected within Central Oregon.”

No one is sure how long the CHEs will assist the counties with contact tracing, but the aim is to have them in place well ahead of flu season, when COVID-19 could surge, O’Connor said.

Until they are asked to stand down, contact tracing will be the CHEs’ top priority, she said. And that’s OK with them.

“I’m excited because I really think that this is a way our team can help the community by helping to curb the spread of the virus and keep it contained,” Burham said. “We know COVID-19 spreads from one person to another to another, and if we can cut off some of those connections and slow the virus, that’s a great thing to be a part of.”

The COVID-19 pandemic has forced health systems like St. Charles to make rapid changes in a matter of days that previously would have taken months or years – and that’s a good thing.

“We know the health care industry needs to change,” said Joe Sluka, president and CEO of St. Charles. “People should have the right to access care the way they want to and at a price they can afford.”

Yet, the ability to change quickly has often been difficult in a complex, highly regulated system that doesn’t control most of its own costs or how it is paid for services. Because health systems, like other businesses, had to adapt quickly during the COVID-19 pandemic, now is a good time to evaluate the changes made, focus on what worked and on sustaining positive forward momentum.

To that end, St. Charles is asking patients and community members for help redesigning health care. The organization has put together a short survey and is asking for feedback on the current health care system and ideas for improvement.

“I hope we hear from thousands of Central Oregonians with their thoughts on how we can improve,” Sluka said. “We want all your wildly creative ideas along with information on your specific experiences to help us reframe the way we think about the services we provide.”

Those who are willing could also have the chance to participate in a virtual focus group to provide more detailed information and discussion on the topic of health care improvement.

Take the survey  Encuesta española

When St. Charles Health System put out an urgent call for personal protective equipment (PPE) donations in March, communities throughout Central Oregon rallied. Where the health system wasn’t able to get critical supplies like N95 masks and nitrile gloves, dentist and veterinarian offices, and many other businesses stepped forward to help.

Within a week, St. Charles’ received more than 14,000 items, including N95 and droplet masks, lab coats, gloves, safety goggles, bottles of hand sanitizer and rubbing alcohol, bouffant caps and face shields.

Now that the global supply and distribution of such items has improved, ensuring St. Charles is able to comfortably meet the Oregon Health Authority’s PPE requirements for hospitals, the health system is working with Crook, Deschutes and Jefferson counties to re-distribute some of the donated PPE to those businesses that may need it.

“So many individuals and businesses generously spared what they could to make sure our frontline caregivers were able to care for patients during a time when PPE was incredibly difficult to get,” said St. Charles President and CEO Joe Sluka. “It was inspiring to experience that outpouring of support, and now we’re happy to give back and help those businesses that may need PPE to stay open.”

With the help of the Deschutes County Emergency Operations Center, which was able to distribute the PPE, St. Charles was able to give each county 7,000 latex gloves, 225 KN95 masks, 400 shoe covers, 1,500 surgical masks, 1,000 clear face shields and 150 isolation gowns, said Deschutes County Emergency Services Manager Nathan Garibay.

Local dentists, who needed PPE to reopen but did not meet the Oregon Health Authority’s priority criteria for PPE, received most of the supply.

“The county had to prioritize the distribution of PPE we did have to certain medical providers, so St. Charles’ donation allowed us to help other users who didn’t fall into those priority categories,” Garibay said.

In Jefferson County, Emergency Services Manager David Pond said the PPE has already been divvied up among BestCare Treatment Services, dentist offices, food banks, veterans’ services and a number of other nonprofit organizations. Any supplies that were left, he said, were added to the county’s mass casualty incident stock.

“It’s great that St. Charles is able to give these supplies back to the community,” Pond said. “Many of these items are still somewhat difficult to get and are an additional expense to businesses, many of which are experiencing financial stress.”

In Crook County, the Emergency Operations Center still has available thousands of nitrile and latex gloves, sizes extra small, small and medium. Some of the boxes have already been opened, so some of the gloves may not be suitable for use depending on the business, said Emergency Services Manager Michael Ryan. Those businesses that are in need of gloves may request them from the Prineville-Crook County Chamber of Commerce.

Kids and concussions: How to play it safe |  Jan. 31, 2022

Every year, hundreds of thousands of school-aged children get concussions, a mild form of traumatic brain injury. But while concussions are common, the health impacts can be serious. Two concussion experts, Drs. Sondra Marshall and Viviane Ugalde, share information about concussions—what they are, how they happen and how local health care providers and schools are teaming up to better identify and treat children who experience one.

Prostate Cancer  |  Nov. 15, 2021

November is “Movember,” a month when global fundraisers focus on the important issue of men’s health, including prostate cancer. In this latest video, Dr. Cora Calomeni and Dr. Michael Wahl discuss the latest research and advancements in the treatment of prostate cancer. Learn more about the importance of screening and early detection, and lifestyle changes that can lower your risk of disease.

COVID-19 Variants and Vaccines  |  Sept. 20, 2021

The Delta variant is tearing through Oregon, fueling a record-breaking number of positive cases, hospitalizations and deaths. Join St. Charles Health System’s leading infectious disease expert, Dr. Cynthia Maree, to learn more about what distinguishes the Delta variant from its predecessor, why more breakthrough cases are occurring and what vaccine developments could lie ahead.

Originally from Corvallis, Ore., Dr. Maree is a graduate of the University of Oregon and the Stanford University School of Medicine. She has more than 15 years of experience in infectious diseases with special interests in hospital medicine and transplantation. She is a member of the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America.

Where there's fire, there's smoke  |  May 17, 2021

In Oregon, a single lightning strike can spell disaster, setting ablaze thousands of acres of forest and choking nearby communities with thick blankets of smoke.

When the smoke rolls in, what does it mean for your health? And what steps can you take to protect yourself?

St. Charles Pulmonology Clinic nurse practitioner Kathleen Prussian and critical care physician, Dr. Mark Bradford, explore the potential health effects of smoke and air quality, especially if you have a history of lung or heart disorders. They explain terminology used by the federal government to describe air quality and will show you how to access the air quality forecast online. They also spend time reviewing strategies for how to protect yourself—both at home and in the car—when there are changes in air quality.

Every second counts: Stroke care in Central Oregon and beyond  |  May 17, 2021

In the United States, someone has a stroke every 40 seconds. Every four minutes, someone dies of stroke.

Steven Goins, MD, a board-certified neurologist and co-founder of Stroke Awareness Oregon (SAO) covers the visible signs that a person is having a stroke, how to spot them using the F.A.S.T. method, and how to respond to give the person their best chance at a positive outcome. Dr. Goins also shares improvements to stroke care in Oregon, including increased advancements in medication, 24/7 interventional stroke care coverage at St. Charles Bend, cutting-edge technology that's saving lives and a new outreach program that's extending high-quality stroke care to people in rural areas throughout the region.

Breast cancer in 2021: Diagnosis to survivorship  |  March 29, 2021

If you’re a woman, you have a 1 in 8 chance of developing breast cancer in your lifetime.

So, how do you know your risk for breast cancer and how often should you be screened?

Dr. Kelly Hewitt, Central Oregon’s only fellowship-trained breast surgeon, answers your questions about what has become the most common cancer globally. Among the topics she addresses is how breast cancer is diagnosed, advancements in treatments and options for surgical management.

Hope on the Horizon: COVID-19 Vaccine  |  Jan. 11, 2021

In response to the COVID-19 pandemic, the world’s scientific community raced to develop an effective vaccine in record time. In just a matter of months, most people should be able to get it. St. Charles Health System’s leading infectious disease expert, Dr. Cynthia Maree, teaches us more about the vaccine—how it works, who will receive it first and what you can expect if you get it.

Why me? Cancer risk factors, prevention and the "bad luck theory"  |  Nov. 16, 2020

Confronted with a cancer diagnosis, every patient faces the "why me?" question. In this talk, Dr. Christina Fitzmaurice, a St. Charles Cancer Center hematologist and oncologist, explores the great knowns and unknowns of cancer risk and prevention strategies. She explains well-known common risk factors, but also explores exciting new insights into less-known determinants of cancer risks like the human microbiome.

Have you had the talk?  |  Sept. 22, 2020

It’s not fun to talk about health care choices at the end of life, but in this time of COVID-19, it may be more important than ever. The talk can help you know your loved one's wishes before you have to make a difficult decision. Dr. Laura Mavity, clinical director of St. Charles’ Advanced Illness Management program, teaches you how to start a conversation and why it matters.

Nothing to sneeze at!  |  July 22, 2020

A conversation about pelvic floor dysfunction

Everyone has a pelvic floor. As many as one in five – including a third of women – also experience pelvic floor dysfunction, or the inability to correctly relax and coordinate the muscles that support the bladder and rectum, the uterus and vagina in women, and the prostate in men. Symptoms include constipation, urine or stool leakage and frequent need to pee.

St. Charles OB-GYN, Sarah Hellmann, DO, helps remove the stigma around discussing PFD and gives you advice on what can be done about it.

The sugar poisoning of America  |  May 18, 2020

Understanding the link between your diet and your health

Board-certified cardiologist Dr. David Guarraia help you better understand our troubling consumption of sweetened food and learn more about the steps you can take to prevent chronic conditions like diabetes and heart disease, and improve your overall health. Dr. Guarraia is the director of cardiac rehabilitation at the St. Charles Heart and Lung Center. Guarraia joined St. Charles Health System in November 2018. He is currently the principle investigator of a low-carb diet study at St. Charles Bend.

The Vape Unknown  |  Jan. 13, 2020

What we do (and don't) know about vaping

Dr. Ryan Nelson, a St. Charles pulmonologist, explains what is currently known about vaping-associated pulmonary illness (VAPI) and its potential health consequences.

A University of Chicago Pritzker School of Medicine-trained physician, Dr. Nelson spent a full year doing research on lung disease. At St. Charles Bend, Dr. Nelson splits his clinical time between the pulmonary clinic and Intensive Care Unit, allowing him to diagnose and treat vaping-associated pulmonary illnesses along the entire spectrum of severity.

Grand Rounds - June 19, 2020
"Antibiotic Update"

Speaker: Steven T. Park, MD, Assistant Clinical Professor, Department of Medicine, University of California, Irvine

Objectives:

1. Understand the extent and harm of inappropriate antibiotic use.
2. Describe the components of Antimicrobial Stewardship Programs
3. Understand the methods that Antimicrobial Stewardship Programs utilize to encourage appropriate use of antibiotics

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. The period to claim credit for this activity expires one year after its original publication. 

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].

Pictured are Darren Binder (right), his husband Dave and their two children.

On June 15, 2020, the U.S. Supreme Court issued a 6-3 decision holding that Title VII of the Civil Rights Act of 1964 prohibits an employer from firing an individual merely for being gay or transgender. Title VII makes it “unlawful ... for an employer to fail or refuse to hire or to discharge any individual, or otherwise to discriminate against any individual ... because of such individual’s race, color, religion, sex or national origin.”

For many people, including myself, this decision from a fairly conservative Supreme Court was a very welcomed surprise.

The significance of this ruling for LGBTQ+ individuals cannot be overstated. While Oregon has prohibited employment discrimination based upon sexual orientation and gender identity since 2007, many people do not realize that prior to this ruling it was perfectly legal in 27 states to fire someone simply for being gay, and in 29 states for being transgender. In fact, polling had consistently found the vast majority of Americans (sometimes as high as 90%) thought LGBTQ+ individuals were already protected from workplace discrimination.

This isn’t just about numbers, though. The Court’s decision gives workers the right no matter what state they live in to be free to come to work as their true selves. That is, they will not have to fear putting a picture of their same sex partner or spouse on their desk or coming to work in a manner aligned with their gender identity. Fortunately, St. Charles has taken steps over the years to create an inclusive environment, including protecting LGBTQ+ caregivers and patients from discrimination in the workplace and in receiving care. In fact, due to the dedicated efforts of the IDEA (Inclusion, Diversity, Equity, Acceptance) Council and our SOGI (Sexual Orientation Gender Identity) workgroup, St. Charles has moved forward on initiatives to address LGBTQ+ health care disparities and to provide an affirmative environment for LGBTQ+ patients and employees. As a result of these efforts, we expect each of St. Charles’ hospitals to be listed on the 2020 Healthcare Equality Index as a “Top Performer” in promoting LGBTQ+ health care equality.

As June is the time we typically recognize LGBTQ+ Pride, it is also a good time to reflect on how much in the legal landscape has changed over the last 17 years for members of the LGBTQ+ community. It was as recently as 2003 when the Supreme Court eliminated sodomy laws in the U.S. that were often used to harass and persecute members of the community. In 2010, Congress repealed “Don’t Ask, Don’t Tell” allowing LGB people to serve openly in the military. In 2013, the Supreme Court struck down part of the 1996 Defense of Marriage Act that defined marriage as a “legal union between one man and one woman as husband and wife.” And, also of great significance, in 2016 the Supreme Court prohibited LGBTQ discrimination in marriage and federal benefits. By no means has equality for the LGBTQ+ community been fully achieved (e.g., discrimination in housing, banning transgender service in the military, violence against members of the community, in particular against Black and transgender people, and recent efforts to eliminate anti-discrimination health care protections for transgender people), but we have made tremendous progress.

When my husband, Dave, and I were considering moving to Bend with our twins from the East Coast, it was important to us to come to a supportive community. After a year here, we would definitely say that our experience here has been very welcoming both in Central Oregon and here at St. Charles. Thank you for making us feel at home and for helping to make St. Charles an inclusive community. Also, Happy Pride Month!

Darren T. Binder
SVP/Chief Legal and Risk Officer

Grand Rounds - June 12, 2020
"Hospital Acquired Infections and COVID-19"

Speaker: Thomas C. Cesario, MD

Objectives:

1. List at least three preventable healthcare acquired conditions
2. Categorize healthcare acquired infections vs. community-acquired ones
3. Identify symptoms for CAUTI, CLABSI, C-Diff
4. Implement strategies to prevent healthcare acquired infections
5. Take cultural-linguistic factors into account when pre-screening patients for infections before surgery and when discussing infection risks and prevention strategies

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].

Epic Third-Party App Vendors (July 2021)