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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

 

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

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

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

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

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

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

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

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

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

What she got instead still chokes her up.

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

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

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

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

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

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

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

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

The lab will

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

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

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

If your test shows you have COVID-19:

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

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

If your COVID-19 test is negative:

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

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

 

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"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

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

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

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

Explaining the numbers

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

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

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

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

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

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

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

Sincerely,  

Joe

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Grand Rounds - July 17, 2020
"Telemedicine"

Speaker: Jesse Pines, M.D., MBA, MSCE, Director of the Center for Healthcare Innovation & Policy Research, Professor of Emergency Medicine and Health Policy, The George Washington University School of Medicine & Health Sciences

 

 

Objectives:

  1. Describe the overall landscape of telemedicine and use cases
  2. Analyze the shift that has occurred in the past few months with the Covid-19 pandemic
  3. Explain what the future of telemedicine will look like in the short-run and long-run

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].

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Grand Rounds - July 10, 2020
"Ventilator Associated Pneumonia"

Speaker: Antonio Anzueto, M.D. Chief, Pulmonary Disease Section, The South Texas Veterans Health Care System Professor of Medicine University of Texas Health Sciences Center at San Antonio

 

Objectives:

  1. Discuss the incidence, etiology and risk factors for ventilator-associated pneumonia

  2. Describe symptoms, pathophysiology and diagnostic tests

  3. Review effective strategies for prevention & treatment based on clinical guidelines

  4. Recognize that preventing ventilator-associated pneumonia improves patient care outcomes & decreases healthcare costs

  5. Appropriately care for patients with increased risk of VAP, such as the elderly patent and very young patient

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].

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

About St. Charles Health System

St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,200 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

 

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

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

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

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

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

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

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

About St. Charles Health System

St. Charles Health System, Inc., headquartered in Bend, Ore., owns and operates St. Charles Bend, Madras, Prineville and Redmond. It also owns family care clinics in Bend, Madras, Prineville, Redmond and Sisters. St. Charles is a private, not-for-profit Oregon corporation and is the largest employer in Central Oregon with more than 4,200 caregivers. In addition, there are more than 350 active medical staff members and nearly 200 visiting medical staff members who partner with the health system to provide a wide range of care and service to our communities.

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