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Earlier today, Deschutes County announced the first presumptive positive case of COVID-19 in Central Oregon.

I know many of you are concerned about the spread of this disease, but I want to let you know that St. Charles Health System has been expecting this moment for many weeks, and we have been preparing for just as long. We are ready.

Our excellent hospitals, clinics and teams care for patients with infectious illnesses every single day, and they know exactly what to do. I have no doubt that this patient – like all of our patients – is receiving the best possible care.

Now, I have a few messages I want to pass along to you:

Stay calm and resist misinformation
COVID-19 is a new illness, and new illnesses often lead to fear and concern for some. The glut of information online – some accurate, some inaccurate – can increase anxiety.

When you seek information about the virus, look to credible sources like Deschutes County Health Services and the Oregon Health Authority. I assure you the officials at both of those organizations are committed to keeping the public safe, healthy and informed. You can also find links to credible resources on our COVID-19 webpage.

And for those of you on social media, please resist the urge to speculate, share rumors or post misinformation. All of it makes it harder for the credible sources to cut through the clutter.

Unless you’re a patient seeking care, please avoid visiting St. Charles hospitals 
One of the threats presented by COVID-19 is the possibility of overwhelming our health care infrastructure. It is vitally important that we keep our hospitals functioning and our caregivers safe so they can take care of not only COVID-19 patients, but all the other people in our community with health issues.

As a result, this message is very simple: Do not go to a St. Charles hospital if you are not a patient with a reason to be there. This includes vendors, delivery services, business partners and other non-essential visitors. Even family members of current patients should consider whether now is the best time to visit. And if you are sick, please stay home and call your primary care physician or your local public health department to discuss your symptoms and next steps.

Signs and symptoms of COVID-19
After my last message, many of you wrote me to ask about the symptoms of this virus. They are pretty basic: fever, cough and shortness of breath. For more information, visit the symptoms page of the CDC’s website.

Lastly, we recently asked one of our physicians, Dr. Bob Pfister, to answer some of your most common COVID-19 questions. You can watch him do that in this video:

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Watch the press conference with Gov. Kate Brown, dated March 8, 2020.

 

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Our community is understandably concerned about the spread of COVID-19 disease, caused by a novel coronavirus. As the region’s safety net health care provider, St. Charles Health System is prepared to care for patients arriving with respiratory illnesses, including COVID-19.

It’s important to note that while Oregon has had 14 confirmed cases of COVID-19, there are currently no known cases in Crook, Deschutes or Jefferson counties. That doesn’t mean there is no risk, however, which is why St. Charles is working closely with local public health departments, the Oregon Health Authority and the federal Centers for Disease Control and Prevention to coordinate a regional response and contain the spread of the virus if it arrives in our communities.

What we’re doing now
St. Charles is working hard every day to be prepared.

Our patient access support specialists are asking symptom-screening and travel questions, and our caregivers are using that information to appropriately triage and isolate patients with respiratory symptoms.

Our health system has initiated its Hospital Incident Command Structure (or HICS as we call it), which is meeting daily to effectively manage our communications, logistics and planning efforts.

We’ve begun controlling access to our facilities to ensure the safety of our patients, visitors and caregivers. At each access point, we are requiring individuals to sanitize their hands, as well as put on a mask if they show up with a fever, cough or cold symptoms. Those who are visitors, and not patients seeking care, may be asked to leave.

We’re also part of the Central Oregon Emergency Information Network (COEIN), which has established a Joint Information Center where many local and state agencies (including us) are working alongside one another to deliver timely, accurate communication and debunk myths. If you’re not already following this group, I encourage you to do so.

We are taking these steps out of an abundance of caution and with the goal of being proactive in the protection of our community. As the situation with COVID-19 changes rapidly, our response will also evolve. As always, your safety and quality of care is at the forefront of all we do.

Helpful resources
We know you continue to have many questions, and our partners in public health have done a great job of putting together resources, including the Oregon Health Authority’s COVID-19: Frequently Asked Questions.

Up-to-date information is also available here:

I know it’s not high-tech, but the best way for all of us to prevent the spread of the new virus is the same as we prevent the spread of influenza and other viruses: Wash your hands, cover your coughs and stay home when you’re ill.

To stay informed about what we’re doing at St. Charles, keep an eye on our website or follow us on Facebook and Instagram.

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Grand Rounds - March 6, 2020
"Coordinated Care Organization 2.0
"

Speaker: Leslie Neugebauer

Objectives:

  1. Explaining the regional and state priorities and implications of CCO 2.0 for managing Medicaid over the next five years.

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.

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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"There's three other colleagues of mine who I worked with for 14 years that are going and I haven't seen them since the fire. So I'm really excited to get to spend time with them. But ultimately, I’m excited to help people. Isn’t that why we went into nursing? To help people. And I think it’s going to be healing for us, as well."

- April, a registered nurse in Wound Ostomy, on what she’s hoping to get out of her upcoming trip to the Marshall Islands, where a team of caregivers who worked for Adventist Health Feather River in Paradise, Calif., before the 2018 Camp Fire will distribute medical supplies salvaged from the hospital, which was partially burned and has not reopened. April moved from the Paradise area to Central Oregon last July and she started working for St. Charles in September 2020.

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FOR IMMEDIATE RELEASE   |   Feb. 29, 2020

St. Charles asks patients and visitors to take precautions when visiting hospitals and clinics

BEND, Ore. – With flu activity still considered high and the Oregon Health Authority’s announcement of the first presumptive case of COVID-19 coronavirus in Oregon, St. Charles Health System is asking patients and visitors to take precautions when visiting its hospitals and clinics.

Individuals experiencing fever, cough or difficulty breathing should put on a mask and sanitize their hands. Those who have traveled outside of the United States within the last 14 days or have been in close contact with someone with confirmed COVID-19 should immediately notify a St. Charles caregiver.    

“To protect our community and to reduce the risk of disease transmission, we’re following CDC recommended guidelines for preparedness,” said Dawn Azevedo, a St. Charles infection preventionist. “These simple steps go a long way to keep people healthy.”

Individuals who are ill and believe they have been exposed to COVID-19 should call their health care provider in advance of their arrival to help minimize exposure.       

Other simple steps for helping preventing the spread of germs include:

  • High quality and frequent hand washing with soap and water, or use of hand sanitizer
  • Avoiding touching your eyes, nose and mouth
  • Avoiding contact with sick people and staying home if you’re sick
  • Covering your mouth and nose with a tissue or sleeve when coughing or sneezing
  • Frequently cleaning high-touch hard surfaces, such as doorknobs, cell phones and tabletops, with a disinfectant wipe  

In addition to these steps, St. Charles is working daily with local public health departments and other key partners to coordinate preparedness efforts.

Be sure to follow St. Charles Health System on Facebook and Instagram for regularly updated information.    

 

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 winter transitioning into spring, all-season sports fans are left to lament the end of football and look forward to one of America’s great competitive events: college basketball’s NCAA tournament, also known as March Madness.

If you’re unfamiliar, March Madness pits 68 of the sport’s best teams against each other in a three-week pursuit of the national basketball championship. Win and you move on in the tournament. Lose and your season – and in many cases, your college playing career – is suddenly over.

The circumstances are different and the stakes are higher, but March Madness always reminds me of health care in a couple of ways.

First, there’s the fact that you cannot “take a day off” in the NCAA tournament. Where other sports use multi-game series to determine champions – a format that favors the better team – March Madness is a single-elimination event where underdogs routinely play the game of their lives and knock off a heavy favorite. One moment of sluggish play or lost focus can send you home, even against a team you might beat 99 out of 100 times.

Similarly, health care workers – including our top-notch crew at St. Charles – must bring their “A game” to work every day. That’s why everyone at our health system, from the frontline caregivers to our executive team, is constantly working to hone our policies, streamline our processes and improve our procedures, all in the name of better care. Our patients and their families expect nothing less, and neither do we.

The other parallel I see between March Madness and health care is the importance of excellent teamwork. Unlike in the NBA, where a couple of superstars can carry a team to a championship, the winner of the NCAA tournament is usually a collection of players with different skillsets who work closely together to accomplish a common goal.

That’s the beauty of the college game. It’s also the beauty of overseeing a health system, where every single person has a job to do, and every one of them should be doing that job with a common goal in mind: to best serve our patients. Certainly, our doctors and nurses get the most one-on-one time with patients, and their role in patient satisfaction is key. But your St. Charles experience starts with your first phone call or visit to our website, and it continues through registration, multiple visits to different departments and your post-procedural care. Your impression of our organization can be affected by your spouse’s visit to the cafeteria, or an interaction with our billing department, or the demeanor of the caregiver who arrives in your room to change your pillowcase.

The point is this: Any one person can provide great care, but it takes a team of great caregivers working together to be a world-class health care organization. I feel privileged to lead St. Charles in our pursuit of that goal.

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“Creating America’s healthiest community, together.”
- St. Charles Health System’s vision statement

Vision statements look good on boardroom plaques and at the top of websites.

But they look even better in action, as residents of Prineville have seen in recent months.

On March 2, St. Charles will open an expanded Family Care clinic, an expanded and upgraded outpatient rehab facility and a new Immediate Care clinic in Prineville, all located on the main level of St. Charles Prineville hospital.

The new facilities mean better access to providers, visiting specialists and rehabilitation services for members of the community, as well as – for the first time ever – same-day, walk-in appointments for anyone with unexpected health issues that are urgent, but not truly emergent.

“We’re so excited about what this means in terms of the community’s access to care,” said Todd Shields, vice president and hospital administrator of St. Charles Prineville. “Our Immediate Care clinic will be open every day of the week – including weekends – from 11 a.m. to 8 p.m. That means you can be seen in a clinic setting for your urgent needs rather than going to the emergency department.”

The effort to expand and improve Prineville’s facilities would not have been possible without a generous combined donation of $4.5 million from the Prineville Hospital Foundation and the Pioneer Memorial Hospital Residual Board – two legacy organizations whose main focus was to help ensure Crook County’s health care needs are met.

That donation formed the foundation of a two-year project that renovated 2,500 square feet of space and added another 5,890 square feet of space, including 12 new exam rooms. There’s now ample space for the clinics’ staff of 16 experienced providers and roster of visiting specialists, including cardiology, endocrinology, women’s health, orthopedics, podiatry, neurosurgery, preoperative medicine, urology and general surgery.

“We’ve been busy recruiting new doctors and new advanced care providers,” Shields said. “Opening day is close, and we’re excited to now have the personnel and providers to take new patients and truly meet the needs of our community.”

Meanwhile, Prineville’s outpatient rehab clinic has been expanded to include five private treatment rooms (up from three) as well as significantly more gym space, said Laurie McCall, manager of outpatient therapy services. The clinic serves Prineville by providing comprehensive interdisciplinary rehab services including speech language pathology, occupational therapy and physical therapy.

An additional physical therapist will join the facility in the near future to ensure patients have timely access to services, McCall said.

“I think this project stands as proof that St. Charles is committed not only to Crook County, but to prioritizing the health of this community,” said Dr. Maggie King, Prineville’s chief medical officer. “I couldn’t be more proud to be opening these facilities and services in Prineville, and I couldn’t be more proud of the team that has worked so hard to make today a reality.”

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Ask Hannah Boomer (Renzi) to name her favorite thing about being a certified nurse midwife, and she quickly offers an answer you might expect: “Delivering babies, of course!” she says, as a big smile lights up her face. “I always say, ‘I just had the most beautiful birth ever.’ And people are like, ‘You say that all the time!’ But it’s true, OK?”

It is a common misconception that midwives only deliver babies, but St. Charles Health System’s midwifery practice encompasses much more than the birthing process. For proof, just ask Boomer's colleague, Emily Ziegler, for her favorite thing about being a certified nurse midwife.

“For me, it’s being with our clients throughout whatever's going on in their lives,” Ziegler said. “I really like the clinic side of things and the time spent building a relationship with women and their families, and being there for them as they go through their journey.”

Boomer and Ziegler are two of St. Charles’ five certified nurse midwives, and in a way, their different answers mirror the diversity of experiences available through the health system’s midwifery practice, which is headquartered at the Center for Women’s Health in Redmond. Indeed, these women do deliver babies, and they also provide a full spectrum of services to meet women’s health care needs.

“We’re caring for women throughout their lifespan,” Boomer said, “from preventive medicine to annual exams, contraception and family planning, having a healthy pregnancy through to post-partum care. We take care of women from puberty through menopause.”

A healthy and full-term pregnancy was Hannah Block’s goal when she first visited the Center for Women’s Health. Block’s daughter, now 5 years old, was delivered at 33 weeks and spent a month in St. Charles Bend’s Neonatal Intensive Care Unit. When she became pregnant with her son in 2019, she knew she wanted “a whole different experience” leading up to birth, she said.

“I wanted something more natural, more low-key, not as invasive, but I also wanted to know that (obstetric physicians) were available as an option as well,” Block said. “After I met with the midwives the first time, I was pretty much sold. They were so open, and they let me know I could meet all the other midwives. I could meet with the doctors. Really, the ball was in my court.”

At first, Block thought midwives specialized in natural childbirth in the home. Soon, however, she learned that all five of St. Charles’ midwives – Jessica Nelson, Jessica Walsh and Jennifer Guthrie round out the group – have their Master’s degrees and work alongside physicians to deliver babies in the hospital. At the same time, she began to understand and appreciate the midwife experience, which extends far beyond the delivery room.

“Throughout my pregnancy, I never felt like they were rushing me. If I had any questions – or if my husband had any questions – we could be there for as long as we needed and it was fine,” Block said. “They always made sure I was comfortable. It was never, ‘We’re doing this. Here’s how it’s going to go.’ Everything was always, ‘How are you feeling? OK, we’ll roll with that.’”

Therein lies one of the big differences between midwifery and more traditional obstetrics, Boomer said. Whereas physicians are the experts in handling high-risk pregnancies, midwives are trained to handle normal, healthy pregnancies and deliveries.

“We’ll get women up out of the bed to try different positions and talk about what’s working best for them,” Boomer said. “We’re giving them all the information, risks and benefits and then coming together to decide what the plan will be.”

For most women, pregnancy is a low-risk condition up to and including delivery, and St. Charles’ certified nurse midwives can deliver those babies in the hospital. If complications arise, however, the midwives will consult with or transfer care to one of their physician partners until a baby is born or the risk subsides. If a physician takes over, the midwife can stay by the woman’s side to assist with procedures and offer a familiar face and emotional support through the process.

“We can help normalize and navigate the path to delivery for a woman, while at the same time respecting that this is still medical care and looking for things that are outside the range of normal and then co-managing that and getting a higher level of care when needed,” said Ziegler, a Bend High School graduate who came home to St. Charles last fall after a few years practicing in Washington.

Central Oregon’s midwives, nurses and physicians work together as a “close, collaborative” group that values open communication and cooperation when it comes to the health of area women and babies, Boomer said.

Block knows that all too well. Before delivering on Jan. 11, her son tried to show up early – at about the same time his premature sister had five years earlier. When that happened, Block was moved from low-risk to high-risk status, triggering the involvement of a physician until she passed the 36-week mark, which is considered full-term. At that point, her doctor let her switch back to a midwife for the rest of the process.

“The midwives ‘fired’ me,” she joked, “and then rehired me after about three weeks. I was so glad when I got rehired.”

The midwifery practice isn’t limited to Bend and Redmond. Midwives see patients in Prineville and Sisters, and they’re planning to expand to La Pine later this year. And after adding a couple of midwife positions last year, the five women are able to provide 24/7 coverage at St. Charles Bend.

It’s all part of St. Charles’ effort to provide the best care to the most women close to their home, Boomer said.

“I think it shows another layer of dedication and support for women in the region,” she said. “If a woman is fighting issues with transportation or language differences or a three-month wait list, it really impacts her ability to get the care she needs. We know there are a lot of barriers to care and our job is to decrease those barriers and meet women where they are.”

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Last May, St. Charles Bend opened a new Intensive Care Unit that was hailed as a major improvement over the hospital’s old, outdated ICU.

Nine months later, the space that held the old ICU has been completely renovated, and on March 2, it will officially become the home of a new Short Stay Unit (SSU). With 17 new patient rooms, shared space for recovery and a better location within the hospital, the SSU is expected to shorten wait times, increase safety and improve patient flow at St. Charles Bend.

“We’re excited to better serve our community,” said Justin Weber, nurse manager of the SSU. “It’s going to be so much more comfortable for everybody.”

The unit will take shape in two phases. Next week, the hospital’s current Same Day Unit (SDU) – which provides pre- and post-procedural care for the cath lab, interventional radiology and electrophysiology – will pick up its operations and move them to the new space, which is adjacent to the cath lab. The SDU will then become known as the SSU.

This relocation alone will eliminate a quarter-mile transport between the cath lab and the current Same Day Unit.

“Right now, we’re transporting patients on gurneys to procedures and then back to recovery. This work consumes about three and a half hours every day,” said Maggie Arnold Rabine, director of cardiopulmonary and vascular services for St. Charles. “This will be much more efficient. It will be safer. It will be more private and patients won’t wait as long. It’s going to be really nice to be right next door to the cath lab.”

The space itself will also be a significant upgrade from the current SDU, where seven crowded patient bays face each other and line of sight is blocked only by curtains. Today in the SDU, caregivers must slide past each other, equipment sits in the hallway, nurses have no centralized workstation and patients must often be placed in rooms “borrowed” from other departments.

By contrast, the SSU’s rooms are large and flooded with natural light. Many are private. There is ample storage space for supplies, nurse workstations with visibility into patient rooms and offices for physicians and unit managers. Several rooms are fitted with lifts for heavy patients, which will reduce caregiver injuries. Future plans include a nutrition station stocked with snacks for hungry patients, Rabine said.

The SSU will also have a radial lounge where multiple patients can recover sitting up, she said. When patients recover sitting up, studies have shown they tend to feel better and discharge sooner.

Once the SDU moves into the SSU, Weber and his team will work to analyze patient volume and optimize how they move through the unit. Then, a workgroup will take that information and start planning how to best use the rest of the new space. Generally speaking, Rabine said, the group will look at cardiac patients who qualify for a short stay which will help capacity.

“Currently those patients are going upstairs to the Intermediate Care Unit and other floors, taking up precious inpatient space,” she said. “The planning team will develop tools that optimize patient flow by diagnosis in order to provide the best care for patients who require a stay of less than 24 hours.”

Besides providing a much-improved experience for outpatient cath lab, interventional radiology and electrophysiology patients, the opening of the SSU will enhance specialty care for all of St. Charles’ cardiovascular patients.

“Having more space and a unit designed to appropriately care for patients and filling it with our team of highly skilled caregivers and providers will only improve the standard of care,” Rabine said. “It’s going to be a great thing, not just for our patients, but for the whole community.”

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