Hello and happy autumn! It’s a busy time of year at St. Charles, and I want to make sure you’re aware of a few things that might otherwise slip past your radar:

We’ve welcomed a new member to the St. Charles Board of Directors: Jon Bullock, a resident of Redmond and co-founder and executive director of the Redmond Proficiency Academy. Before he founded RPA, he worked as an administrator with the Redmond School District and the Bethel School District in Eugene and served as a high school teacher and coach in Corvallis and Salem. In addition to his work at the K-12 level, Jon has also taught courses at the college and university level and currently serves as a member of the Southern Oregon University Board of Trustees. He is also a former member of the Redmond City Council and the Economic Development Central Oregon board.

I am excited to have a member of the board with such extensive experience and a career-long focus on education, not to mention deep roots in Redmond. Jon joined us to help St. Charles as we work to ensure the people of Central Oregon get the care and support they need and deserve.

"Access to high-quality, affordable health care is essential for our community,” he said. “Serving on the St. Charles Board of Directors provides the opportunity to directly and positively influence our community's future.”

Please join me in welcoming Jon to the board and thanking him for his service!

Being up to date on your COVID-19 vaccinations and boosters is still the best way to protect yourself against severe illness and hospitalization as a result of the virus, and experts say October is a great time to get the booster (and a flu shot, too). St. Charles has the new bivalent boosters, which are emergency authorized by the FDA. Appointments are available for those 12 and older at any St. Charles Urgent Care clinic. If our schedule doesn’t work for yours, please check out the many options for vaccination in our community.

At St. Charles, we are cautiously returning to in-person events and, like you, enjoying spending more time with others – both in our facilities and in the communities we serve.

In recent weeks, our caregivers have attended the Bend Health Fair, the Latino Fest in Madras and Prineville and the Jefferson County Senior Center Health Fair, with more stops on the horizon. If you’re out and about and you see our blue tent or tablecloth, please stop by and say hi!

This Sunday you’ll find many of us at St. Charles Foundation’s annual 5K run/walk fundraiser, Heaven Can Wait, which returns to an in-person format after two years as a virtual event. Heaven Can Wait raises money for Sara’s Project, which provides education, early detection and support services to ease the challenges of breast cancer for people in Central and Eastern Oregon. And this year, the event moves to Redmond! It’s a fun time for a good cause and a celebration of life, survivorship and those who have passed on.

Finally, you may have noticed the American flag flying at half-mast at our hospitals in Bend, Madras, Prineville and Redmond. We lowered them to show our respect for Atwai Wasco Chief Alfred Smith Jr., who passed away earlier this week. St. Charles Health System sends its heartfelt condolences to his family and the Confederated Tribes of Warm Springs.

Sincerely,
Steve

After two years of limited travel because of COVID-19, Americans are getting back to going overseas.

And in St. Charles’ new Infectious Disease (ID) clinic, Central Oregonians have a trusted and robust resource to help them stay healthy and safe during international travel.

The clinic is staffed by two infectious disease specialists: Dr. Cynthia Maree, who helped oversee St. Charles’ COVID-19 response, and Dr. Laura Selby, who is new to the health system. Selby’s arrival earlier this year allowed the health system to expand its ID program and open a dedicated clinic.

The physicians’ duties include managing complex infections for pre- and post-operative patients, hospital inpatients, immunocompromised people and others, as well as caring for patients with HIV, hepatitis, tuberculosis and sexually transmitted diseases. Additionally, they are available for consultation about medications, vaccinations and other health and safety issues for people traveling out of the country. (Traveling families are welcome at the clinic, too.)

“A lot of doctors are capable of doing pre-travel assessments,” Selby said. “But as ID specialists, we’re actually trained in pre- and post-travel counseling, diagnosis and treatment, from immunization to just-in-case prescriptions for diarrhea to fever evaluation after you return.”

Travel to Africa, Asia, South America and Central America comes with specific travel medicine recommendations, Selby said. People going to those areas of the world should see an ID physician before they travel – ideally four to six weeks before departure, though Selby said they will see people who are closer to their travel date.

If you are traveling and are unsure if you need a travel medicine consult, you can call the clinic for guidance, Selby said.

“We don’t just talk about infectious diseases,” she said. “We also discuss topics such as water and altitude safety. We look at embassy recommendations and make sure people are aware of any potential health or safety concerns in the country they’re visiting.”

The clinic can provide a number of commonly needed preventive drugs such as malaria prophylaxis, as well as an array of vaccines, including yellow fever, typhoid, hepatitis, influenza and COVID-19.

The pandemic did not spur St. Charles to launch the clinic, but the timing is fortuitous, Selby said.

“Most travel was on hold for the past couple of years, but people are traveling again and I think there’s a need for this kind of service – especially having providers who are trained to manage post-travel concerns. I think that’s a big plus,” she said, “and it’s exciting to offer this to the people of Central Oregon.”

Over 34 million people in the U.S. have diabetes and another 88 million are prediabetic. That means 1 in 3 people in America struggle with some form of the disease.

Two years ago, the Central Oregon Health Council awarded St. Charles a grant to purchase several continuous glucose monitors, which give diabetics an easy way to keep an eye on their blood sugar levels. (No more pricking fingertips!)

We launched a pilot program with 55 patients, and the results have been truly life-changing. Today, there are more than 200 St. Charles patients using the devices.

Heaven Can Wait: In-person, now in Redmond

The popular 5K walk/run raises money for Sara’s Project

After two years in a virtual format due to COVID-19, Heaven Can Wait – the popular annual 5K walk/run and fundraiser for Sara’s Project – will return as an in-person event at 10:30 a.m. on Sunday, Oct. 2.

And that’s not all that’s new: This year, the event will start and end at Redmond High School’s stadium, with a course that takes participants through Redmond’s scenic Dry Canyon.

“It is our hope that bringing Heaven Can Wait to Redmond will provide a more central location for community members who have been touched by breast cancer to come together, wherever they are in their cancer journey,” said Anna Contreras, events and development specialist with St. Charles Foundation. “The Central Oregon community has been steadfast supporters of this event and St. Charles Foundation and event volunteers are thrilled to be bringing the walk to Redmond.”

Heaven Can Wait raises money for Sara’s Project, a fund of the St. Charles Foundation that helps provide vital support services to people in Central Oregon who are battling breast cancer. Over its 23-year existence, the event has raised approximately $100,000 annually for assistance to under-insured patients, as well as integrative therapies such as therapeutic massage, acupuncture, yoga, and reiki.

Heaven Can Wait has also become an important opportunity for the community to come together and celebrate cancer survivors while also remembering loved ones.

“It has been almost three years since the community last gathered to support this powerful event,” said Mari Shay, administrative director of cancer services for St. Charles. “This will be my first Heaven Can Wait, and I look forward to meeting more cancer survivors and our community partners as we stand together to support those who are battling breast cancer.”

To participate or volunteer in the 5K walk/run, register at HeavenCanWait.org. For questions related to the event, contact Anna Contreras at 541-788-2940 or [email protected].

Answers to 5 FAQs about monkeypox

The infection is spreading, but has not reached Central Oregon

Monkeypox is an infection caused by a virus that has historically been most common in some African countries. However, outbreaks have occurred in other areas, and the current outbreak is spreading monkeypox across the world.

Monkeypox has not reached Central Oregon, but St. Charles is seeing an uptick in questions about this disease. Here are answers to five questions we’re hearing most frequently:

1. How concerned should I be about monkeypox?

“As always, a good position on something like this is: Be aware, but don’t panic,” said Dr. Cynthia Maree, head of St. Charles’ Infectious Disease department. “The bad news is monkeypox is spreading. The good news is it doesn’t spread as easily as COVID-19, and right now, the risk of spread in public settings is very low.”

In July, the World Health Organization declared monkeypox a global health emergency, and last week, cases rose 20%. As of Aug. 17, there were more than 35,000 confirmed cases of monkeypox in 92 countries, and 12 deaths related to the disease, with 68 confirmed cases (and 48 presumptive cases) in Oregon.

2. How does monkeypox spread?

Monkeypox spreads primarily through close physical contact – specifically skin-to-skin contact with the rash or sores of an infected person.

It can also spread through:

• Contact with contaminated bedding or clothing
• Contact with bodily fluids
• Respiratory droplets during extended face-to-face contact (more than three hours)

So far, the spread of monkeypox during the current outbreak has been driven primarily by close physical contact during sex between men. However, it is important to know that it can spread in other ways and among other communities.

3. Who can get monkeypox?

It has been erroneously reported that monkeypox only spreads among men who have sex with other men. This is not accurate. There is nothing about that specific community that puts its members at higher risk for contracting monkeypox. It just happens to be the first community affected by this particular outbreak.

“There is a lot of misinformation out there, so I want to reiterate: Monkeypox is not limited to one community or another,” Maree said. “Anyone can contract it, and anyone can spread it.”

4. How serious is monkeypox?

People with monkeypox get a rash that may be located on or near the genitals or anus, and could be on other areas like the hands, feet, chest, face or mouth. The rash can initially look like pimples or blisters and may be painful or itchy. Other symptoms can include fever, chills, swollen lymph nodes, exhaustion, muscle aches, back ache, headache and respiratory symptoms.

The U.S. Centers for Disease Control has more information, including photos of monkeypox rashes and sores, here.

Most people who contract the disease recover within two to four weeks, but it can be serious, especially for immunocompromised people, children, pregnant people and people living with HIV that is not virally suppressed. Twelve people have died during the current outbreak.

If you develop a new rash, bumps or sores, ask your health care provider about testing for monkeypox, especially if:

• You’ve been in close contact with anyone with a known or suspected monkeypox infection.
• You’ve had close physical contact with someone in a social network known to be experiencing the spread of monkeypox.
• You’ve traveled in the past month to areas of the world where cases have been found.

5. Is there a vaccine for monkeypox?

JYNNEOS is an FDA-approved vaccine against monkeypox for those 18 years and older. Because supply is limited, vaccines are currently being offered to those with a known exposure and those who are most likely to be exposed.

Deschutes County has some vaccine available. Learn more here.

Pushed beyond their limits by increasing demands for services and a nationwide shortage of nurses, hospitals across the state are struggling more than at any other point in the pandemic to meet their communities’ need for health care.

According to Oregon Health Authority epidemiologist Dr. Dean Sidelinger, St. Charles Health System has been especially hard-hit, KTVZ reported last week.

But, “this is not a St. Charles problem. This is an Oregon problem,” said Dr. Doug Merrill, St. Charles’ chief medical officer. “One hundred percent of the hospitals in Oregon are in the same situation we are, and it’s worse than it was during some of our better-known surges over the past two years.”

The problem is two-fold: Hospitals have “shrunk,” Merrill said, because lack of staff is forcing them to close beds. The labor crisis is the result of many factors, including health care workers fleeing the industry, staff who are temporarily out because of COVID-19 illness or vacation, and a nationwide shortage of nurses that has been brewing for years due to an aging workforce, the impact of the aging Baby Boomer population’s increasing need for health care services and a nursing education system that has not grown fast enough to meet demand.

“The industry has seen this coming, and now it’s here,” said Joan Ching, chief nursing executive for St. Charles. “Retirement is a factor. Pandemic stress and burnout is a factor. But beyond all of that, we as a country are not producing nurses fast enough to keep up with the increasing health care needs of our aging population.”

The nurse shortage affects organizations across the spectrum of health care, not just St. Charles, which leads to the second part of the problem: St. Charles hospitals discharge many patients who need additional care to facilities known as SNFs, which stands for skilled nursing facilities – long-term acute care hospitals, inpatient rehab clinics, memory care facilities and other specialized services. But SNFs and other such post-acute facilities across Central Oregon are short-staffed and also at capacity, which means there is nowhere to send hospital patients who are being actively treated for acute injury and illness, including those who present to a St. Charles Emergency Department and are medically stabilized but require additional treatment as a hospital inpatient.

Meanwhile, St. Charles’ Emergency Department in Bend is busier than ever due to the usual increase in injuries and alcohol- and drug-related visits that come with summertime recreation and visitors to the region, as well as population growth. The Bend ED’s average daily census in past summers has been around 126 patients per day, said Michelle Brenholdt, the health system’s director of emergency services for Bend and Redmond. This summer, that number has jumped to 145 patients per day. Without appropriately staffed beds available in the hospital, some patients must stay in the ED – known as “boarding” patients – sometimes for days or weeks, using space, staff and other ED resources that are otherwise dedicated to people who present to the Emergency Department with medical emergencies.

“Every hospital in Oregon is boarding patients in the ED. Every hospital is backed up with patients awaiting transfers to post-acute care beds,” said Daniel Davis, senior director of patient flow for St. Charles. “We’re getting transfer requests from the coast and other places that are much farther away than usual. The situation is reflective of the challenges across the state.”

All of these bottlenecks – in the EDs, on hospital floors and in the SNFs – are exacerbated by the current surge of the Omicron BA.5 variant of COVID-19, which is highly contagious and prevalent in Central Oregon. The U.S. Centers for Disease Control has classified Deschutes, Crook and Jefferson counties as “high” transmission areas and is recommending that people wear masks when in crowded indoors settings to prevent the spread of the virus.

Following that recommendation would help slow the spread of COVID-19 and, in turn, help ease the pressure on Oregon hospitals. But it will not solve all the issues.

“Across the state and the country, health care is experiencing a crisis with regard to taking care of the communities we serve,” Merrill said. “This is a complicated mess we’re in, and there is no easy way out.”

Since we sent our June newsletter, we've experienced a significant change at St. Charles Health System: Joe Sluka, our President and CEO for the past eight years, decided to step down and transition to a role of strategic advisor to the organization.

I joined the St. Charles Board of Directors the same year Joe came to the health system, and I have enjoyed working closely with him. I can tell you from experience that Joe cares deeply about the future of health care in Central Oregon. I want to thank him for his friendship and leadership in a time of tremendous growth and, in the past two years, unprecedented uncertainty.

Now, please allow me to introduce myself: My name is Dr. Steve Gordon, and I've stepped into the role of interim President and CEO of St. Charles. I'm a primary care and internal medicine physician by training, and I've worked as a health care management consultant since 2016. Before that, I served in executive leadership roles for PeaceHealth in Vancouver, Wash., Providence Health and Services in Portland and Salem Health.

As I mentioned, I served on the St. Charles Board of Directors from 2014 until earlier this year, so I bring to this role extensive knowledge of the health system in addition to my understanding of health care issues at the state and national level. The health care industry faces many unique challenges, and I am excited about the opportunity to lead St. Charles as the organization works to navigate those challenges and build toward a bright future.

In my first month on the job, I have spent time speaking with many individuals and groups across our organization and hearing their concerns. After more than two years of pandemic response, they are exhausted. Now that we are dealing with significant staffing and financial difficulties, they are worried about the future of this great organization. To ease their minds, I have committed to three main goals for the next 12 months:

• Create a better experience for St. Charles patients, caregivers and physicians.
• Improve the health system's financial situation. (Also, in case you’ve been hearing rumors: St. Charles is not for sale.)
• Find and hire an inspiring new president and CEO to lead us forward.

In the coming months, these three goals will drive everything we do at St. Charles, for one very simple reason: We are committed to being here for the people of Central Oregon, just as we have for more than 100 years.

Thank you for reading and for your support.

Sincerely,
Steve

A Bend couple’s $100,000 gift to the St. Charles Foundation will help fund education and training for nurses in St. Charles Bend’s Intensive Care Unit.

Chris and Laura Crownover said they made the donation because of the high-quality care Chris received during a stay in the ICU last year.

“We wanted to do something that would encourage (the nurses) and give them something special,” said Laura, who has been married to Chris for 35 years. “The nurses we had showed us a lot of compassion and kindness, just by talking with us and visiting with us, and the time and attention they gave us.”

Crownover spent 17 days in the hospital – including 15 in the ICU – last summer after undergoing emergency surgery to drain blood from his brain after one of his blood vessels burst.

“I get headaches,” Chris said. “I threw up one night and then the next day I felt better. But that afternoon, my headache came back and it was so bad, I told Laura I needed to go to the hospital.”

At St. Charles Bend, a CT scan revealed the bleeding, Laura said, and caregivers quickly began to prepare him for surgery. “I barely was able to bring my four kids in to see him and then they whisked him right away,” she said. “It was pretty scary.”

Chris was in surgery for more than two hours, and his prognosis afterward was good. Over the next couple of weeks, however, he experienced a number of complications, including a seizure and more bleeding, said Laura, who stayed at the hospital from 8 a.m. to 9 p.m. every day Chris was in the ICU.

“It was a lot of days with a lot of different (caregivers), and I felt like we got very good care,” she said. “They were attentive and kept us pretty well-informed.”

Because of COVID-19 restrictions, Chris was limited on how many visitors he could have, so a couple of times, nurses wheeled him out to the front of the unit so he could see his adult children. It was those kinds of efforts that motivated the Crownovers to make a donation.

“I’m just so grateful to be alive,” Chris said. “We had the money to do it, so we did it.”

The Crownovers’ gift comes at a time when St. Charles is facing significant financial challenges, and the money will fund important educational efforts.

“Our nurses are the best of the best, and St. Charles is committed to making sure they get the education and training they need to continue to practice at the highest level,” said Joan Ching, vice president and chief nursing executive for the health system. “This money will definitely help us do that, and we are so grateful to the Crownovers – and to hear that Chris is doing well.”

Indeed, Chris said he’s feeling great. “I’m pretty much perfect now,” he said with a laugh, before pausing and continuing. “Other than the scar on my head. It looks like someone did brain surgery on me.”

St. Charles Foundation provides scholarships to nurses and other caregivers through several special funds, including one recently set up in memory of Dr. Doug Lowery-North. An emergency physician for more than three decades, Doug highly valued the nurses he worked with and the nursing profession as a whole. Through donations to that fund, nurses and certified nursing assistants at St. Charles will continue to have access to scholarships and continuing education.

“Gifts from community members like the Crownovers allow St. Charles Foundation to continue to support the nonprofit St. Charles Health System in providing top-notch care,” said Michelle Solley, philanthropy officer for the foundation. “We so appreciate their generosity.”

If you would like to make a gift to St. Charles Foundation to support health care in Central Oregon, go to stcharlesfoundation.org or call 541-706-6996.

Like many of you, I have lived in Central Oregon long enough to know that we cannot count on consistently warm, sunny weather until (at least) the middle of June. I've spent too many Memorial Day weekends bundled up at an outdoor event to be fooled by a mild stretch in March or April.

Sure enough, it has been another chilly spring, and this one has felt particularly rainy, too. Happy hunting, mushroom enthusiasts!

According to the forecast, it looks like temperatures will soon rise into the 70s and 80s and they'll mostly stay there for the next few months. For many of us, that means it's time to get outside for walking, running, hiking, biking, rock climbing and other fun activities on Central Oregon's trails, rivers, lakes and backcountry.

No one likes a killjoy, but as the leader of the region's largest health care provider, it is my duty to tell you this: Summer is the busy season at St. Charles' Urgent Care clinics and the Emergency Departments in Bend, Madras, Prineville and Redmond. And the folks who manage those facilities tell me we are already seeing high volumes of patients, even before the weather has really turned.

This is not like the past two summers, when I asked you to stay home in hopes of reducing strain on our clinics and ERs as they took care of COVID-19 patients. I am not asking you to skip that ascent up Smith Rock or the ATV ride through the Ochocos this year.

What I do want to do is encourage you to recreate safely and responsibly so you don't have to come see us at St. Charles. Wherever you’re going and whatever you're doing, please slow down, be patient and courteous, wear protective gear (including a helmet) if appropriate and follow all applicable laws and regulations. I'd rather you head home after having fun – not to one of our facilities.

If you do need care, by all means, visit one of our clinics or, in an emergency, your nearest ER. We'll be here if you need us and we will take care of you.

Have fun and be safe out there this summer!

Sincerely,
Joe

For the second time, all four St. Charles hospital campuses have been recognized by the annual Healthcare Equality Index for their policies and practices related to the equity and inclusion of LGTBQ+ patients, visitors and employees.

The 2022 Healthcare Equality Index named St. Charles Bend, Madras, Prineville and Redmond each as a “Top Performer” in its annual report, which has been published by the Human Rights Campaign Foundation for the past 15 years. They are four of 251 health care providers nationwide to receive “Top Performer” designation.

The four St. Charles hospitals also made the list in 2020.

“At St. Charles, we are striving to create America’s healthiest community, together. And when we say ‘together,’ we mean together – with everyone having a seat at the table,” said St. Charles President and CEO Joe Sluka. “Across our health system and Central Oregon, we are committed to being a place where people feel welcome and accepted, whether they are receiving care or providing care. We still have work to do, but this recognition by the Healthcare Equality Index is evidence that we are on the right track.”

The HEI is a national benchmarking tool that evaluates and scores health care facilities on detailed criteria falling under four central pillars:

• Foundational policies and training in LGBTQ+ patient-centered care
• LGBTQ+ patient services and support
• Employee benefits and policies
• Patient and community engagement

Facilities are evaluated and scored on a scale of 100. Each of the four St. Charles hospitals received a score of 90 on the strength of their non-discrimination and staff training, their patient services and support and their employee benefits and policies.

Over the past few years, St. Charles has taken many steps to create an inclusive environment, including protecting LGBTQ+ caregivers and patients from discrimination in the workplace and in receiving care. Earlier this year, the health system hired a manager of caregiver inclusion and experience, Dr. Shilo Tippett, who oversees the organization’s work to establish and grow a culture of inclusion, diversity, equity and acceptance (IDEA).

Alongside the caregivers on St. Charles’ IDEA Council, Tippett is working on developing programs to educate managers and physicians on inclusivity, incorporating IDEA concepts into the health system’s orientation for new caregivers and annual education for all caregivers, and investing in IDEA training for key roles within the organization.

And in 2019, several members of St. Charles’ executive leadership group completed a three-part training on LGTBQ+ patient-centered care, while more than 350 caregivers went through the health system’s Sexual Orientation and Gender Identity Class.

“We’re doing more than just talking about this stuff,” Tippett said recently. “We’re taking action.”