It is with mixed emotions that I share with you today my decision to step down as president and CEO of St. Charles Health System.

Having served in this role for nearly eight years, I feel deeply connected to Central Oregon and the communities St. Charles has the privilege to serve. This is not an easy decision.

At the same time, after leading through more than two years of a global pandemic and the corresponding recovery I feel it is time for me to step aside, recharge and provide the opportunity for new operational leaders to guide St. Charles forward.

To that end, I’m happy to announce that Dr. Steve Gordon has agreed to step into the interim CEO role as I transition to a role of strategic advisor to the organization. Steve has an extensive background in health care leadership and served on the St. Charles Board of Directors from 2014 until earlier this year. His knowledge of the organization, along with his deep understanding of health care issues at the state and national level, will be a great benefit to our team. I will work closely with Steve, providing input and assistance in my capacity as strategic advisor.

All of this is to say that St. Charles is in good hands. I know how much you, our patients and community members, rely on St. Charles to be here when you need us. While we – like health care organizations across the nation – face significant challenges, I have every confidence that St. Charles will weather this storm and continue to be your trusted choice for health care well into the future.

When I joined the organization in 2014, I was drawn here by the bold vision statement: Creating America’s healthiest community, together. And during my tenure I am proud to say that our caregivers have done tremendous work to lead us toward that goal including:  

• Implementation of a Lean management system focused on a culture of continuous improvement
• Construction of a new patient tower, including state-of-the-art ICU, at St. Charles Bend
• Transition to the Epic electronic health record platform
• Expansions and remodels of both St. Charles Madras and St. Charles Prineville campuses
• Expansion of services in Redmond including robotic surgery
• Opening of additional outpatient clinics in La Pine and Bend South
• A long list of patient safety and quality awards for hospitals and clinics throughout the system

We also met the unprecedented challenge of COVID-19 head on, providing care to critically ill patients, supporting their families, vaccinating hundreds of thousands of people, offering novel therapies – and so much more.

Please know that these accomplishments are inspired by and in service to you.

Thank you for your support, encouragement, readership and engagement.

Sincerely,
Joe

March 17, 2022

Network issues throughout St. Charles Health System

Starting at about 3 a.m. today, St. Charles experienced an unexpected disruption of service from its major internet provider. The outage is resulting in a loss of access to many critical systems on an intermittent basis. The outage is system-wide affecting all St. Charles facilities. 

Our Information Technology team is working to troubleshoot issues with our internet service provider. At this time there is no known cause of the outage. It is not believed to be malicious in nature. 

Thank you for your patience as we work to address the issue with our internet service provider.   

Two years ago today, I sent out a message letting our community know that we had identified the first presumptive positive case of COVID-19 in Central Oregon. It was only the second community message related to COVID we shared -- which has been a critical communication channel between St. Charles and the people we serve for more than 700 days.  

As I reflect on all that has happened and in the many ways our world has changed over the past two years, I wanted to stop and thank you for being engaged. Every time one of these messages goes out, I am inundated with responses. It has been wonderful to know that you are reading, listening, learning and taking action based on the information we have shared.

In many ways, it is thanks to you that we have come so far.  

While we still have COVID-19 patients in the hospital, the number of positive cases continues to decrease dramatically, and it feels as though we are finally putting the Omicron variant wave behind us.   

Now that the state indoor mask mandate is lifted and we all start working our way back toward a new normal, I have just a few reminders to share:  

• For the time being, masks will still be required in health care settings. This is for your protection and the protection of our caregivers. Please be prepared to follow our masking policy when visiting any St. Charles facility.
• While COVID numbers remain low, people will have the choice to wear a mask in other indoor environments like movie theaters, grocery stores and restaurants. Please be respectful of everyone’s individual choice and comfort level with masking. You never know when someone is immune compromised or simply feels safer with the mask on.
• The state mandate for health care workers to be vaccinated against COVID-19 has not changed. St. Charles will continue to follow state and federal law.
• If you have not yet been vaccinated or boosted for COVID-19, it's not too late. Vaccination continues to be the most important tool in keeping people from being hospitalized or dying from the virus.
• If you are feeling sick, stay home. Check our St. Charles website for current information and resources that will help you determine when a laboratory test for COVID-19 is necessary. Guidance on COVID-19 testing continues to change as we have more access to COVID-19 therapies and home testing kits.

Thank you, again, for taking the time to read and understand how your actions make a difference to our health care community. Although we’ll continue to keep the door open for further messages from the health system, it is my hope that we are entering a phase of the pandemic where the need for communication on COVID is much less frequent.   

For a behind-the-scenes look at how our caregivers have endured the past two years, please watch this short video. If you can, thank a health care worker and remind them that two years later they are still the heroes of this pandemic.  

Sincerely,  

Joe

As we head into the holiday season, I’ve been thinking a lot about civility.

For many, the holidays are for spending time with friends and family, sharing meals and conversation, connecting with loved ones and reconnecting with those we don’t see often enough.

As you gather over the next couple of months, I hope you will join me in reflecting on the state of civility in our world. The COVID-19 pandemic has taken quite a toll on us, and I believe one of the things that has been eroded is our collective sense of civility. We see it in the news, we see it on television, and I can assure you we are seeing it at our St. Charles hospitals and clinics.

According to Thomas Spath and Cassandra Dahnke, the founders of the Institute for Civility in Government: “Civility is claiming and caring for one’s identity, needs and beliefs without degrading someone else’s in the process.” The organization’s website goes on to say:

Civility is about more than just politeness, although politeness is a necessary first step. It is about disagreeing without disrespect, seeking common ground as a starting point for dialogue about differences, listening past one’s preconceptions, and teaching others to do the same. Civility is the hard work of staying present even with those with whom we have deep-rooted and fierce disagreements. It is political in the sense that it is a necessary prerequisite for civic action. But it is political, too, in the sense that it is about negotiating interpersonal power such that everyone’s voice is heard, and nobody’s is ignored. And civility begins with us. 

A confluence of factors seems to have brought out the worst in us: The pandemic has pushed us past our limits. Our leaders practice incivility in public, modeling it and normalizing it for the rest of us. The internet allows some to hide behind their keyboard and anonymously spew hatred toward others.

We are more divided than ever, for many reasons. The pandemic and the politicization of our response certainly has not helped us grow closer, despite a promising start in the spring of 2020.

There is no doubt COVID-19 has made life difficult and caused stress. But I also see a nation that has lost its focus. We’ve allowed our differences in opinion to push us apart, when we should be using them as a starting point for dialogue, understanding and solutions. We should be accepting and embracing our differences, because it is our differences that will make us stronger.

Enough is enough. If our leaders can’t figure this out, then we must do so for ourselves.

This holiday season, I have a call to action, and it’s simple: Talk to people. Talk to people who see the world differently than you do. Explore your differences. Seek to learn from them and to understand each other. And do the same thing when you’re online. If you’re on social media, be sure you’re contributing something constructive to the conversation. Better yet, be sure you’re listening and seeking to understand before you demand to be understood.

And in all your interactions, I would encourage you to practice civility. Only then will we grow as individuals and grow closer together as people.

It begins with us!

Sincerely,
Joe

As much as I hate to say it, the delta variant of COVID-19 is increasing in our communities.

Over the past two weeks, wastewater samples throughout the state of Oregon show an increase from 5% to 40% of this more transmissible variant of the virus. We believe our current vaccination rate in Central Oregon is not high enough to provide herd immunity against the delta variant in part because it spreads more easily than earlier versions of the virus. In fact, studies show that delta appears to be much more transmissible than the original version of COVID-19.

Keeping all of this in mind, we expect to experience a new spike in COVID-19 cases among unvaccinated individuals in the near future. And although our counties have worked so hard to make vaccines available, we still have large numbers of people who have not received the vaccine. Children under the age of 12 remain ineligible for any of the vaccines and are at a high risk of contracting the new variant and spreading it to others.

Throughout the country we are seeing huge spikes in COVID-19 in areas with low vaccination rates. Daily reported cases in the U.S. rose by 43% in the past week and hospitalizations rose by 33%. In some states, hospitals are once again being overwhelmed.

Honestly, I’m worried.

At St. Charles, we continue to have hospital bed capacity and staffing challenges that have been exacerbated by the global pandemic. We are working so hard to ensure we can care for you if you need us.

But please know you have a part to play as well. You can help by taking actions that reduce the spread of the virus.

For example, I still choose to wear my mask in some indoor public places and hope that you are doing so as well. I wear a mask to protect those who can’t be vaccinated and the most vulnerable among us.

In addition, I think it’s prudent at this point to avoid large indoor gatherings where you don’t know the vaccination status of those in attendance. The vaccines are highly effective at preventing serious illness and hospitalization from COVID-19, but we have had a handful of cases in vaccinated individuals where hospitalization was necessary.

It’s OK to continue being cautious regardless of your vaccination status. In fact, I would encourage you to do so.

More than anything, if you haven’t done so yet please get vaccinated. Talk to your health care provider about which of the three available COVID-19 vaccines is right for you. All of them are free and available through individual health care providers, pharmacies and our local county health departments. You can find information on vaccine availability at www.CentralOregonCOVIDVaccine.com.

Also, consider talking with your friends and family members who have been vaccinated about their experiences. These videos show familiar faces from Crook and Jefferson counties sharing their thoughts on why the COVID-19 vaccine is important. Give them a watch and share them with others.

Sincerely,
Joe

I want to wish each and every one of you a very happy Fourth of July. I hope you have an opportunity over the next few days to celebrate the independent spirit of this great nation of ours.

Perhaps your ideal Fourth includes some grilled burgers and leisure time with loved ones. Maybe you are planning to float the river or hike a favorite trail. However you choose to celebrate this weekend, I want to encourage you to please do so safely and responsibly so you don’t have to come see us at St. Charles. Right now, we are navigating a number of staffing and capacity challenges, and the more people stay safe and stay away from our hospitals, the better.

Here are a few specific things to keep in mind:

Stay cool. If you've been in the Northwest over the past several days, you know we have experienced a record-breaking heat wave, with temperatures in Central Oregon exceeding 110 degrees in some places. Over the past five days, our caregivers have seen 19 people who came to St. Charles with a heat-related medical condition.

Temperatures have dropped a bit, but we are still forecasted to be over 90 degrees in the coming days. Please be sure to stay hydrated and take steps to avoid becoming overheated. If you need somewhere to cool off, the Central Oregon Homeless Leadership Coalition is operating cooling centers throughout the region, and the Deschutes Public Library has suspended its time limit for visits to its air-conditioned facilities.

Play safe. The weekends around the Fourth of July are some of our busiest when it comes to trauma patients arriving at our Emergency Departments. With locals out recreating and visitors here in huge numbers, more people will get hurt or experience a medical emergency and they will end up at St. Charles.

Wherever you are and whatever you are doing: Slow down. Be patient. Be courteous. Wear a helmet if appropriate. Recreate in areas you know well. Follow applicable laws and regulations. Celebrate responsibly. Get home in one piece!

Be smart. As you likely know, we are experiencing a severe drought and conditions are very dry across the High Desert. We have already had a scary fire in Redmond and another in a neighborhood park in Bend. For these reasons, local governments in Bend, Redmond and Deschutes County (so far) have banned the use of fireworks beyond July 4.

I understand the appeal of fireworks. I enjoy them myself. But there are plenty of other ways to celebrate the Fourth of July that do not come with the risk of an accidental fire. Whether they are banned in your area or not, I encourage you to skip the fireworks this year, for your safety and the safety of our communities.

Thanks so much for keeping these things in mind this weekend. Again, I hope you enjoy a safe, fun holiday.

Sincerely,

Joe

Nearly 15 months into this pandemic, our health system is facing a crisis.

Our hospitals are full, thanks to a surge of COVID-19 patients and an influx of people who are sick because their care has been delayed for a variety of reasons over the past year. At the same time, history tells us to expect a significant spike in trauma patients during the upcoming holiday weekend.

We have canceled surgeries, transferred patients to other hospitals and expanded patient care into spaces normally used for other things. We've brought in emergency nurses and requested more help from the state. And still, we are concerned that if someone comes in on Saturday with a severe injury or suffering from a heart attack, we may not have space to admit them to the hospital. All our beds are full. We are treating patients on gurneys in the hallways. Today, we have 15 people in the Emergency Department who are waiting for a bed to open up.

There is a line out the door at your local hospital, and it's likely to get longer.

We really need your help:

• If you haven't yet received the COVID-19 vaccine, you should continue to wear a mask and practice physical distancing, no matter what federal or state regulatory agencies have said. They are reacting to what's happening elsewhere. Here in Central Oregon, the pandemic is not over. COVID-19 is spreading rapidly and it's making younger people very sick. If you are unvaccinated, it is important for your health and safety that you distance and wear a mask. (Also, please get vaccinated. It's safe and effective. Of the 500+ COVID-19 patients at St. Charles since March 1, about 98% of them have not been fully vaccinated.)

• If you are vaccinated against COVID-19, please discuss with your unvaccinated friends and family the continued importance of masking and physical distancing, and encourage them to get vaccinated as soon as possible. At this point, you - a trusted friend or family member - is probably our best bet at convincing people to get the vaccine.

• Everyone: Be smart and be safe this weekend. Minimize risk. Avoid activities that could potentially cause injury. Skip the ATV ride or the ambitious hike and enjoy the holiday close to home. I assure you, now is not the time to get hurt and have to come visit us.

• If you have an emergency, of course, do not delay care. You should still come to St. Charles, and we will do everything we can to take care of you.

On Thursday, Debbie Robinson, our chief nursing officer in Bend, said we are currently the busiest we've ever been in her time with the organization. She has worked for St. Charles for 26 years.

Again, we need your help. We appreciate anything you can do to try to ease the pressure on the health system.

Sincerely,
Joe

If you’re feeling whipsawed by the COVID-19 headlines as of late, you’re not alone.

At the same time guidelines for mask wearing and physical distancing are being relaxed by the Centers for Disease Control and Prevention (CDC) and Oregon Health Authority (OHA), some hospitals—like ours—are still treating very high numbers of COVID-19 patients.

Today, we have 45 people with COVID-19 who are hospitalized in Bend, a number we haven’t seen since mid-January. To put that number into more context: Central Oregon, which represents just 5.9% of the state’s population, has 13.6% of the state’s occupied COVID-19 beds, according to our data scientists.

Even as we struggle as a health system to manage this surge—we’ve had to once again limit elective surgeries, care for hospitalized patients in areas of our hospitals where we ordinarily wouldn’t and shuffle caregivers throughout departments to ensure we have adequate staffing—the OHA announced Deschutes County will be considered “low risk” as of Friday since 65% of the 16 and older population has been vaccinated.

So, what’s going on?

Nationally, we’re seeing the number of positive COVID-19 cases and deaths trend downward at the same time we’re seeing vaccination rates slowly tick up. This is good news, and it is what prompted the CDC and some state public health agencies like the OHA to change their guidance on masks.

But locally, we’re not consistently tracking with these trends, and we think there may be two reasons why.

One, there are variants of COVID-19 circulating in our community that are more easily spread and have the potential to make people more ill. And two, a disproportionate number of people who live in Deschutes County are 50 or younger and are still unvaccinated. So, while the county boasts a 65% vaccination rate, the bulk of those vaccinations have occurred in the 50 and older population.

That means there are more than 100,000 Central Oregonians who are still vulnerable and could still be hospitalized with COVID-19. If you follow St. Charles on Facebook (and if you don’t, you should) you’ll recall seeing the below graph, which shows that between January and April, we saw a 13-year drop in the average age of our hospitalized COVID-19 patients.

So, what does this mean for you?

In the short term, it means your surgery may be cancelled. Every day our hospitals are making tough decisions to cancel surgeries to replace joints, remove cancers and fuse spines. The reality is we simply can’t afford to offer our hospital beds to anyone who isn’t very sick or injured.

In the long term, it means we need your help to end this pandemic. If you haven’t already, please—get vaccinated. Every Central Oregonian who is 12 and older is now eligible, and there are more places than ever offering vaccines, including our very own St. Charles Family Care clinics. And until more of us are vaccinated, I encourage you to keep wearing those dang masks a little longer. I know I will.

It isn’t just me asking this of you. It’s also our many caregivers who are tired, but who continue to work tirelessly to care for our community. They know you want this to be over, and believe me, so do they. In this recently released video, one of our ICU nurses said it so well:

We may be over COVID, “but COVID isn’t over us.”

When you look at what has happened in our community over the last two weeks, it’s easy to feel frustrated.

Based on the spread of the COVID-19 virus, Deschutes County has once again moved into “high risk” territory, an Oregon Health Authority designation that triggers certain precautions like limiting capacity in restaurants. The change was based on the two-week period from March 21 through April 3, when the county reported 139.9 cases per 100,000 people.

Here at St. Charles, hospitalizations are also slowly ticking up. About two weeks ago, we had just three people in the hospital with COVID-19. Today, we have 13.

So many of us are heeding the “wash, mask and distance” mantra and have even been vaccinated. We are tired and we just want to know, “when does this end?”

I’m not sure anyone can reliably predict that, but I do want to share with you some encouraging news: while we are seeing an increase in COVID-19 cases, we are also seeing about 20 percent fewer hospitalizations than we’d expect due to the virus.

We think our vaccination campaign is starting to work.

As of today, almost 91,000 people have been vaccinated in Central Oregon, including more than 82% of our residents who are 80 and older. This is significant because in the early days of the pandemic, this group represented a disproportionate number of hospitalizations and deaths.

While this is certainly a move in the right direction, we must not let up on our efforts to get ourselves, family, friends and neighbors vaccinated. To achieve what we call “herd immunity,” we need at least 70% of our community to get vaccinated.

The good news is starting next week, it becomes easier and more straightforward than ever to schedule your appointment. On Monday, April 19, everyone in Oregon who is 16 and older is eligible to get a COVID-19 vaccine. There are no more complicated eligibility rules to decipher. If you’re 16 and older, it’s your turn. Please, sign up. To do that, go to centraloregoncovidvaccine.com. If you don’t have access to the internet, call 541-699-5109, but be prepared to wait, as call volumes are sometimes high.

The latest on the Johnson & Johnson COVID-19 vaccine

On the topic of COVID-19 vaccines, I also want to share with you what I know about the one made by Johnson & Johnson.

If you haven’t been following the news, the U.S. Food and Drug Administration (FDA) and Centers for Disease Control and Prevention (CDC) jointly announced that out of an abundance of caution, they are pausing the use of Johnson & Johnson’s COVID-19 vaccine. As a result, the community vaccination clinic at the Deschutes County Fair & Expo Center has stopped offering it.

In a joint media call Tuesday, officials from the agencies said they made the decision after six cases of a rare and severe type of blood clot occurred in women between the ages of 18 and 48 who also had low levels of platelets in their blood. One of the six women died and another is in critical condition.

Officials recommended the pause to allow them time to work together to understand these events and to provide more information to health care providers and vaccine recipients.

“These events appear to be extremely rare,” said Janet Woodcock, the acting FDA commissioner. “However, COVID-19 vaccine safety is a top priority of the federal government, and we take all reports of adverse events following vaccination very seriously.”

The Advisory Committee on Immunization Practices (ACIP)—an independent scientific expert committee that reviews immunization matters—convened Wednesday to review data on these initial cases but stopped short of deciding whether to resume use of the vaccine, citing the need for more information. The committee plans to meet again sometime within the next 10 days.

So, what do you do if you’ve already received the Johnson & Johnson vaccine?

For those of you who received the vaccine within the last two weeks, call your health care provider if you experience severe headaches, abdominal or leg pain and shortness of breath. These symptoms are different from the mild symptoms many people experience within a couple days of receiving the vaccine.

FDA and CDC officials have also stressed they are not seeing the same blood-clotting issue with the other two vaccines made by Pfizer and Moderna. So, if you’ve already scheduled your appointment for a vaccine, we strongly encourage you to keep it.

Widespread vaccination is still our best hope to end this pandemic.

Sincerely,
Joe

With the news this week that Deschutes County is moving back into the High Risk category for COVID-19, I wanted to send you all a note and ask you to please hang in there just a little while longer.  

Wearing your mask in public places, washing your hands regularly and continuing to physically distance are all critically important. Our local, state and national health care systems are in a race to vaccinate as many people as possible before the more contagious variants of COVID-19 push us into a fourth surge of infections. 

St. Charles and Deschutes County are vaccinating people quickly against the virus – more than 80% of residents ages 65 and older have received at least one dose of the vaccine here. Our partners in Jefferson and Crook counties are also vaccinating as quickly as vaccine supply allows – and they have stayed in the Lower Risk category for another two-week cycle, which is fantastic news. 

Unfortunately, with case counts up in Deschutes County, many of our local businesses will again feel the pain of scaling back their operations. I can’t imagine how difficult it is for our restaurants, gyms and other businesses to continually adjust their staffing in alignment with the latest COVID-19 restrictions. I’m grateful for their perseverance through it all.  

And, I want to encourage you to do what you can to help.

• First – Make sure you have registered for your COVID-19 vaccine appointment at centraloregoncovidvaccine.com. It only takes two minutes to complete the registration process. Every Oregonian over the age of 16 will be eligible for the vaccine as of April 19. That means, RIGHT NOW is the time to register. Once you are registered, you will be contacted to make an appointment as soon as a dose is available to you. 
   
• Second – If you have already been vaccinated, encourage others to do the same. All three vaccines, which are authorized by the FDA for emergency use, are safe and highly effective at reducing death and hospitalizations due to COVID-19. They also greatly reduce transmission of the virus – meaning the more people we vaccinate the quicker we can return to a more normal way of life.
   
• Third – Support our local businesses in safe ways by ordering take-out, choosing to socialize outside or buying gift cards to be used at a later date. Your actions can make a difference in ensuring our Central Oregon communities not only survive the pandemic but continue to thrive when it is over.
   
• Fourth – I’ve said it many times before and I’ll say it again – mask, wash and distance. We simply aren’t yet at a point where we can stop doing the things that we know reduce illness.

Every eligible Central Oregonian should be jumping at the chance to be vaccinated and help end this pandemic.  

Be sure to take your turn.  

Sincerely,

Joe