Catholic Health World - August 15, 2022

Mission-minded print shop 3 Centura invests in social justice 6 Parfum de mom 8 PERIODICAL RATE PUBLICATION

AUGUST 15, 2022

VOLUME 38, NUMBER 13

Catholic hospitals part of national effort to

Providence hospital’s perinatal increase organ donation among people of color program supports women with chronic mental health conditions

By JULIE MINDA

By PATRICIA CORRIGAN

The “baby blues” — mild depression that occurs in about half of new mothers — is well known, and post-partum depression, a more serious condition, has gained more attention in recent years. But what about care for pregnant women and new mothers who have been diagnosed with mental health disorders and who find their depression and anxiety worsening?

Providence Holy Family Hospital in Spokane, Washington, recently initiated an outpatient program to address the special needs of those women. Launched in March, the Perinatal RISE Program is the third facet of the hospital’s RISE Program, which has offered mental health services to teens and adults since 2018. “RISE” is an Continued on 3

Clinicians stand in silent tribute as an organ donor’s body is transported to a surgical suite for the organ removal. The March 2021 “hero walk” took place at St. Francis Medical Center in Monroe, Louisiana, part of Franciscan Missionaries of Our Lady Health System.

As a bedside nurse, Vernette Townsend has held the hands of transplant candidates as they learned that they had been matched to a donor organ and she’s cared for patients who would die waiting for an organ. “I will never forget those moments,” she says.

Now, as chief nursing officer for Trinity Health Of New England's Saint Francis Hospital, that experience motivates her as she works Townsend to build awareness of the profound impact of organ donation and the particular need to increase the number of donated organs.

This includes convincing more Blacks, Hispanics, Native Americans and Pacific Islanders to register as potential organ donors. Townsend educates audiences about organ donation at churches in the Black community.

People of color have higher rates of diabetes and high blood pressure than whites, a propensity the National Institute Continued on 4

Loyola Medicine Asylum Clinic opens doors for persecuted migrants

Adeia Hernandez says she learned how to emotionally ground herself in the Perinatal RISE Program. She enrolled after she gave birth to Arabella, who is now 10 months old.

The Loyola Medicine Asylum Clinic that opened this spring is helping migrants who fear harm in their home country make their cases for legal, protective residency in the United States.

The clinic relies on doctors who volunteer their time and expertise to conduct forensic medical examinations.

They document migrants’ claims of persecution in their homelands, recording physical evidence the patient has been the victim of human trafficking, torture, antiLGBTQ violence, religion-related mistreatment, female genital mutilation, sexual and gender-based violence or injury by gang members. The findings of the examinations go into affidavits that become part of the migrants’ asylum petitions, which may also contain assessments of mental trauma.

The clinic is at MacNeal Hospital in the Chicago suburb of Berwyn. The hospital is part of Loyola Medicine, which is based in Maywood, another Chicago suburb.

Continued on 2

John Lamparski/Sipa USA via AP Images

By LISA EISENHAUER

Migrants are detained while being processed by U.S. Border Patrol officers before boarding a bus to a detention center in June in La Joya, Texas. Studies show that migrants who apply for asylum based on persecution stand a better chance if a medical professional documents evidence of the mistreatment.

SSM Health clinic is partnership with Wisconsin city, school district Employer-funded clinic’s easy access, low cost and on-point services include ‘proactive wellness’ programs

“Whenever something comes up health related,

By LISA EISENHAUER

I think, ‘OK, can I do that through the wellness clinic?’ and if so, that’s where I’m going to go.”

— Michele Vollmer

Michele Vollmer with her sons Bryce and Braeden outside the SSM Health Dean Medical Group building in Sun Prairie, Wisconsin, that houses an employer-funded clinic available to city and school district workers and their families.

Michele Vollmer is a regular at the wellness clinic she has access to as an employee of the Sun Prairie Area School District in Wisconsin.

Vollmer, administrative assistant to the director of student policy and school operations, went to the clinic last fall for her annual wellness checkup. It included the hormone testing she needs to monitor her thyroid condition without the $100

lab fee her primary care physician’s office charges. She went to the clinic this spring for a sprained ankle. She has gotten a mammogram and seen a dermatology specialist for a skin cancer screening. She took her two sons to the clinic for flu shots.

“Whenever something comes up health related, I think, ‘OK, can I do that through the wellness clinic?’ and if so, that’s where I’m going to go,” she says.

The Sun Prairie Area School District and Continued on 7

2

CATHOLIC HEALTH WORLD August 15, 2022

Asylum Clinic From page 1

The hospital is a member system of Trinity Health. The hospital cares for a population that includes many Hispanic residents and many undocumented migrants.

The asylum clinic was founded by Dr. Yessenia Castro-Caballero and Dr. Amy Blair. Castro-Caballero is a pediatrician with Loyola Medicine and assistant professor at Loyola University Chicago Stritch School of Medicine. Blair is a family medicine physician with Loyola Medicine and assistant dean for health advocacy and assistant director of the Center for Community and Global Health at Loyola University Chicago Stritch School of Medicine.

‘A chance at the American dream’ Castro-Caballero says she started volunteering to do forensic examinations of immigrants after she learned in 2017 about the policy of separating children from their parents at the Mexican border under the Trump administration. She and other physicians asked staff at the National Immigrant Justice Center how they could help those families. The Chicago-based nonprofit that provides legal aid to migrants said there was a need for clinicians to Castro-Caballero conduct forensic examinations to assist asylum seekers in building their legal cases for protected immigration status.

“We went to them with the intention that we could do something at the border, but this kind of work can be done in our own hometown,” Castro-Caballero explains.

Even though President Donald Trump ended the highly controversial family separation policy by executive order in June 2018, Castro-Caballero and the other doctors pressed on with their efforts to aid asylum seekers.

In 2019, they were part of the inaugural group of clinicians in the Midwest Human Rights Consortium, a network of providers from many specialties including obstetrics

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and gynecology, pediatrics and mental health who are willing to perform traumainformed examinations for asylum seekers.

The Loyola Medicine Asylum Clinic and counterparts at the University of Illinois — Chicago and the Ann & Robert H. Lurie Children’s Hospital of Chicago are outgrowths of the consortium.

The consortium is under the umbrella of the Refugee Immigrant Child Health Initiative of the Illinois chapter of the American Academy of Pediatrics. That initiative started in 2017 with the goal of improving the quality of health care for migrants.

Castro-Caballero also volunteers with the Refugee Immigrant Child Health Initiative. As a first generation American of Mexican and Colombian descent, she says she can relate to the challenges refugees face in building a new life in the United States.

“I wanted to give others a chance at the American dream and all the opportunities that this country has given me,” she says.

Veteran examiner now trains Blair has been doing forensic examinations of asylum seekers for 15 years with Physicians for Human Rights. She started just after completing her medical residency and spending several months in Southern Africa, where her husband was doing refugee advocacy work.

“I was determined to continue to do something in the realm of human Blair rights with my time and my talents,” Blair says. “I felt a real call and a duty as a physician to volunteer my time toward the promotion of a new beginning for people coming from tragic and violent places sometimes.”

Blair got training on how to do forensic examinations through peer mentors. She now coaches other providers, who may be reluctant to jump into legal processes, and shows them how to document the findings of their forensic examinations.

“By and large, the providers do not need to be trained in the physical exam, they all were trained to do that,” Blair says. “They just need to be trained in the process of converting those skills to an affidavit for a legal case.”

The Loyola Medicine clinic provides only physical examinations. Mental health forensic exams are offered elsewhere.

Evidence bolsters cases At the Loyola clinic, the providers start by asking the asylum seekers to describe the persecution they endured and then the examiners document any evidence they find of that torment. Blair says it could have

2016 2017 2018 2019 2020

NEW ASYLUM CASES

INDIVIDUALS GRANTED ASYLUM

180,617 259,104 270.255 310,499 283,062

20,340 26,568 37,511 46,130 31,429

Source: Department of Homeland Security; numbers are by fiscal year

come in many forms, including beatings, genital mutilation and sexual abuse.

“These are difficult things to find and look for, but when it corroborates a story of past persecution and fear of future persecution then those are really powerful findings,” Blair says.

In fact, a study published in November 2021 in the Journal of Forensic and Legal Medicine found that having forensic medical evidence can be a major boost in asylum cases. Researchers analyzed 2,584 cases initiated by Physicians for Human Rights that included forensic medical evaluations. The researchers “found that 81.6% of applicants for various forms of immigration relief were granted relief, as compared to the national asylum grant rate of 42.4%.”

Blair and Castro-Caballero became acquainted through a colloquium held on a wintry Saturday in Chicago in 2019. The event was initiated by medical students and attracted more than 100 providers for forensic medical training.

When Castro-Caballero later did her first forensic exam, Blair was by her side.

“When Dr. Castro-Caballero and I spoke about our shared desire to do what we could for the refugee population and use our position as physicians to advocate, it sort of went from being a voluntary individual effort to a more collaborative, institutional mission-based initiative,” Blair says.

Blair credits Dr. Charles Bareis, chief medical officer at MacNeal Hospital, with shepherding the idea for the Loyola clinic through the lengthy administrative and regulatory approval process. She explains that any requested use of a clinical setting gets

intense scrutiny.

“I was just so impressed with Dr. Bareis’ ability to get everybody in the room and get everybody onboard,” Blair says. “Those pieces wouldn’t have been easy at all for Dr. Castro-Caballero and I to move by ourselves. It would have been too big of a lift.”

An early win Providers do the examinations after hours in clinical space at the hospital. The evaluations are done without charge and are scheduled through the Midwest Human Rights Consortium at the request of immigration lawyers. The clinic has a roster of providers with various expertise who can perform the exams. In its first few months, the clinic has done three.

Castro-Caballero conducted one of those first exams done at the Loyola clinic and she later learned that it led to an asylum grant for that person and their family. “It’s an incredible feeling to know that your physical exam skills contributed to the safety and the establishment of this welldeserving family here in our country and that they can move forward with their lives without living in fear,” she says.

Blair says a majority of the cases she’s been involved in over the years have gone in favor of asylum seekers. She believes Loyola’s clinic has the capacity to provide more examinations and help more migrants become legal residents. However, a shortage of lawyers willing to take on immigration cases, many of which are handled pro bono, and a backlog in the court system mean demand is relatively low.

“This is one way to engage in the immigration and migration crisis we’re in in a way that lends the expertise of health care providers.”

— Dr. Amy Blair Both Castro-Caballero and Blair say they are proud to have small roles in a wider effort to welcome to the United States people who have no safe option to live in their home countries. They also are grateful to have the backing of Loyola Medicine and Trinity Health.

Blair sees the clinic as an extension of the organizations’ Catholic mission and as in line with Catholic social teachings on the sanctity of every human life. “This is one way to engage in the immigration and migration crisis we’re in in a way that lends the expertise of health care providers,” she says. leisenhauer@chausa.org

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August 15, 2022 CATHOLIC HEALTH WORLD

3

CHRISTUS expands capacity of mission-minded printing plant

By LISA EISENHAUER

Del Shankle is particularly proud that the award given to CHRISTUS Print Services this summer by a trade organization wasn’t for a pretty brochure or for hitting a production milestone. The award his staff got from the In-Plant Printing and Mailing Association was “for outstanding contributions related to non-production activities within the parent organization.”

Shankle heads the printing and mail department as director of operations. He says the honor recognizes that the work at the printing plant he and his nine-person crew operate has a direct connection to CHRISTUS Health’s mission to provide the best possible care with dignity, integrity, excellence, stewardship and compassion in mind.

That connection has been apparent during the COVID-19 pandemic, as the staff has rushed through orders for signage about new policies and mailings to educate patients on how to stay well.

Shankle says the printing plant’s staff always is mindful that any cost savings they bring to the system means more money to buy MRIs or other critical equipment and that the patient mailings the plant produces must be handled carefully so as to comply with privacy laws.

“My team really come to work every day understanding their why,” he says. “We don’t have to talk about it.”

Room to grow Last fall the print shop moved to a 14,000-square-foot facility in Tyler, Texas, where CHRISTUS Trinity Mother Frances Health System is based. It's double the size of its previous shop in that community. The plant is attached to that regional ministry although it handles orders from across the parent system, CHRISTUS Health.

Shankle says the larger space allowed the plant to update some of its equipment and create a floor plan with a smoother flow between the massive machines that

Perinatal mental health

print, cut, assemble and output 67,000 print orders a year. It also gives the staff more room to navigate amid those machines.

The presses churn out business cards, brochures, letters, books, signage, banners and more. The products add up to 18 million impressions and nearly 28,000 square feet of materials annually.

Most of the plant’s orders come through its digital storefront. The online store has templates for items such as business cards and letterhead that can be personalized to reflect the three dozen or so brands within CHRISTUS with just a few clicks. After users select products, designs and colors, the system lets them see what the end result will look like before they hit the order button.

Shankle estimates that the number of orders the plant is handling has risen about 20% since its move in October. He says the plant could see a 50% increase in production in time based on its new capacity.

Del Shankle, director of operations, gives a tour of the expanded CHRISTUS Health printing plant in Tyler, Texas.

Environmental awareness The printing plant has storage space for

The CHRISTUS Health plant handles 67,000 print orders a year, including business cards, brochures, letters, books, signage and banners. The products add up to 18 million impressions and nearly 28,000 square feet of materials.

From page 1

orders, PTSD or other disorders, all conditions that were present prior to pregnancy and childbirth,” Reiter said.

acronym for resources, insight, support and empowerment.

Tamara Sheehan, Providence behavioral health director, began developing the perinatal mental health program about a year ago after repeatedly hearing that local medical professionals were struggling with how to treat pregnant women and new mothers with mental health conditions. No formalized program existed in Spokane Sheehan and the one offered in Seattle is 279 miles away.

“Some places here are starting to do screening, but cases in about 90% of these clients are going undiscovered or untreated,” said Kristin Reiter, manager of Providence’s RISE Program. “Often, the subject of depression is not discussed at all. These moms are not asked how they are doing and there is no follow-up — it’s a silent epidemic.

Reiter But now we have set up this niche service, and we know what to do.”

Holy Family is inviting women in Spokane County and nearby communities, such as Stevens County and northern Idaho, who are pregnant or up to one year postpartum to consider enrolling in the P-RISE program, which is covered by insurance. “We’re not targeting just postpartum depression, but women who are bipolar or have anxiety disorders, personality dis-

The meat of the program In groups of eight, participants 18 and older meet with Reiter, psychiatric providers, two therapists and a nurse practitioner, all certified in perinatal mental health. Women “come according to their level of need,” Reiter said, attending three and a half hours per day at least three days per week for six to eight weeks.

Treatment approaches are tailored to participants’ individual needs. Private sessions with therapists and the nurse practitioner are part of the program — and babies are always welcome.

“We set up a group room with a table, rocking chairs, portable cribs, blankets, baby toys and supplies such as diapers and wipes,” Reiter said. “It’s a very relaxed and open atmosphere. Moms can breastfeed there — we want them to feel comfortable meeting babies’ needs in the group setting.”

Early in each meeting, clients talk about their struggles and their successes and how they are using their skills to foster better mental health. They also learn about different topics specific to pregnancy, birth, feeding and infant care. Next comes socialization, “anything that gets them up and moving, engaging with others,” Reiter said.

That might mean yoga, a walk in the park or a game “to get the women laughing and talking, the opposite of what people do when they feel stressed or anxious.”

Learning coping skills through dialectical behavior therapy — “the meat of the program” — comes next. “We talk about

different situations, about emotions, and everyone gets a binder with materials they can review at home,” Reiter said. “These are skills the women can use indefinitely.”

After completing the program, participants receive information on additional resources for care.

Sparking hope Adeia Hernandez, who completed the P-RISE program in the spring, had high praise for it. “I loved it — it’s one of the best programs I’ve ever joined,” said Hernandez, 24. “They make you feel welcome and supported, and that’s so important when it comes to being a mom, whether it’s your first child or your fifth. What I loved most was being able to bring my daughter (Arabella) with me, to have her there while I worked on becoming the best version of myself so I can be the best mother I can be for her.”

Reiter said the program emphasizes that women have to meet their own needs first.

“We tell them not to feel guilty about that,“ Reiter said. “There’s so much guilt about everything involved in being a parent, and so much shame and guilt around mental health conditions — and we want them to feel less of that. If a mom isn’t taking care of herself, how can she take care of her child?

We want to help them feel more hopeful about handling motherhood.”

The program also provided an opportunity for the women to learn from one another and build relationships with one another. Another upside was the “baby parties,” watching the youngsters interact.

“It was fun to watch them grow together,” Hernandez said. “Arabella had never been around a lot of people or other babies, and

paper, acrylic sheets, ink and other materials that previously were stored off-site and trucked in as needed. Having those supplies on-site reduces production time and transportation costs as well as the plant’s environmental footprint because the supplies don’t have to be transferred among sites, Shankle says.

Shankle says almost all of the paper used at the plant is from sustainable sources. One of his goals is to have the Forest Stewardship Council certify that all of the Tyler plant’s paper stock are made with wood from forests that are managed responsibly.

He also plans to involve the plant in more group purchasing organizations that leverage their combined buying power to get better prices on materials and services and practice environmentally minded material sourcing.

The printing plant is offering its services to CHRISTUS subsidiaries in Chile and Colombia.

Community benefactor While most of the plant’s work is for CHRISTUS, it assists more than a dozen community organizations in the Tyler area with their printing needs. It creates products as in-kind donations or at cost for those groups, which include the Catholic Diocese of Tyler and the nonprofit Bethesda Health Clinic.

Over the last 18 months, Shankle says that donated or at-cost work equates to a community investment of $62,000. He expects his team to increase its output for community groups in their expanded space.

He sees the community work as another example of how the plant helps CHRISTUS further its mission to extend the healing ministry of Jesus Christ. “Our goal is to help drive down costs so that more resources will be available to our ministries and our sister organizations to do the things that matter for those that they serve,” he says. leisenhauer@chausa.org

she became even better about that.”

Hernandez said she initially enrolled in P-RISE because she noticed a shift in her emotions after Arabella was born. “When you’re pregnant, you’re on cloud nine and everything, but previously, I had struggled with depression and anxiety. After I had the baby, my hormones were raging and I was feeling isolated, and I could feel myself going back to how I was before. That’s when I started looking for help,” she said.

Skill building The program provides a lot of tools.

“You pick and choose what works for you,” she said. “There was a lot of emphasis on being able to recognize when you’re overwhelmed and stressed, and how to identify your feelings so you can ask for what you need. I also learned how to ground myself emotionally, and I’m doing a bit of journaling, too. If any new mom is struggling, I’d encourage her to give the program a try, ask for help, even if that takes you out of your comfort zone.”

The P-RISE program is still in the “soft opening stage,” Reiter said, and the model will be tweaked as time goes by. “So far, we’ve had pregnant women and moms with depression and anxiety and personality disorders that worsened with pregnancy or birth, and some have needed help with their meds,” Reiter said.

“This program is about stabilization.

These women need to get help in a short time, because individual therapy once a week is not going to work. When participants leave our program, they are stabilized, they have skills and they are feeling better. The sky is the limit in terms of how we can grow P-RISE to meet the need.”

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CATHOLIC HEALTH WORLD August 15, 2022

Organ donation From page 1

of Diabetes and Digestive and Kidney Diseases says puts them at higher risk for organ failure. Members of these minority groups are overrepresented on transplant waiting lists and underrepresented among donors.

African Americans have the proportionately highest need for organ transplant of all minority groups in the U.S., according to the Department of Health and Human Services Office of Minority Health.

There are multiple factors that go into matching a donated organ with a transplant candidate, including medical urgency and the most efficient use of the organ. Donors and transplant candidates of different races frequently match on organ donation.

According to the Health Resources & Services Administration, shared race or ethnicity is not a requirement for successful organ donation, but in rare cases it can determine whether a match is made.

Transplantation is more apt to be successful between donors and recipients

2021 MULTICULTURAL ORGAN RECIPIENTS AND DONORS* African American/ Black

9,253

Hispanic/ Latinx Asian Pacific Islander Multiracial Descent American Indian/Alaska Native

7,499 2,620

2,581 3,109

664 Recipients

304 153

Donors *Includes deceased and living donors

323 117

Source: Organ Procurement and Transplantation Network as of May 18, 2022

with similar immune cell markers. Since immune system markers are inherited, HRSA says having a diverse donor registry increases the chance of finding a good match for transplant candidates. Donate Life America, a nonprofit that promotes organ donation, says shared genetic background may increase the chance of longerterm survival posttransplant.

HRSA says tissue-type matches central to the success of bone marrow or cord blood transplants are most likely among people of the same race and ethnicity. The agency is working to increase marrow and cord blood donations from Native Americans, Blacks, Hispanics, Asians and Pacific Islanders.

41,000 20,300

More than organ transplants from

donors brought new life to patients and their families in 2021.

Source: Organ Procurement and Transplantation Network

Some Catholic hospitals are doing their part to encourage members of minority populations to register as organ donors.

Some of the campaigns are built around National Minority Donor Awareness Month, which originated in 1996 and runs through August.

St. Joseph's Health and its organ procurement partner hold a flag-raising ceremony at St. Joseph’s University Medical Center in Paterson, New Jersey, to mark National Donate Life Month in April. From left are Ryan Smith, clinical donation specialist, NJ Sharing Network; Veronica Myers, hospital services manager, NJ Sharing Network; Kevin Slavin, president and chief executive, St. Joseph's Health; Todd Brower, senior vice president and general counsel, St. Joseph's Health; and Tanwir Chowdhury, director of critical care nursing at St. Joseph's Health.

Donor disparity Donate Life America says there are more than 100,000 people waiting for transplants in the U.S., and nearly 60% of them are minorities. The Department of Health and Human Services Office of Minority Health says that 28.5% of candidates awaiting a

transplant are Black; 12.9% of organ donors are Black. There are similar imbalances for other minority populations.

Franciscan Missionaries of Our Lady Health System in Louisiana; Hospital Sisters Health System’s Wisconsin regions; St. Joseph’s Health in Paterson, New Jersey; and Trinity Health Of New England have workgroups coming up with ways to increase organ and tissue donations among all potential donor groups, with special attention to minority populations. The health systems commonly collaborate on these efforts with their local organ procurement organizations.

All these systems have hospitals engaging in community outreach throughout the year to educate and dispel misinformation.

They employ traditional and social media channels. When possible, they dispatch representatives, who have a similar cultural, racial or ethnic background as the intended audience, to churches, community events, community organizations, schools, barbershops and other venues.

Mark Brevard directs multicultural community outreach for New England Donor Services, the organ procurement partner of Trinity Health’s Saint FranBrevard cis Hospital in Hartford, Connecticut. He says his organization is being intentional in hiring representatives from diverse races and cultures to increase the chances that the people speaking to patients and their families about donation have a similar background to them.

They attempt to normalize conversations about organ donation.

HSHS’ Western Wisconsin region has organ donation experts staff a booth at community baseball games and hand out information at family movie events.

Steven Averhart, family services manager for New England Donor Services, says awareness-building Averhart and education are intended to get people thinking of organ donation — and signing on as donors — well before a

Compassion, not coercion, needed for organ donation decisions, ethicist says

By JULIE MINDA

Nearly three years after the Centers for Medicare & Medicaid Services finalized a rule intended to increase the supply of donated organs in the United States, some hospitals are seeing unintended consequences for families whose loved ones are candidates to donate organs.

Under the CMS rule, organ procurement organizations are under scrutiny to increase the number of organs they secure. And in some cases that is leading their representatives to exert a new level of pressure on families who are making decisions about the Meinert potential donation of their loved one’s organs. The situation is inviting fresh questions about the ethics around informed consent for donation, the family’s role in end-of-life-decision-making and organ procurement organizations’ practices, said John Meinert.

Up until recently Meinert was director of ethics for Mercy Fort Smith in Arkansas. He's now an associate professor at Benedictine College in Atchison, Kansas.

He presented a July 6 webinar, “Ethical Guidelines for Organ Procurement at the Bedside.”

The webinar was part of the complimentary ethics series, “Emerging Topics in Catholic Health Care Ethics.” CHA is presenting the series in collaboration with the Pellegrino Center for Clinical Bioethics at Georgetown University, the Neiswanger Institute for Bioethics at Loyola University Chicago, and the Albert Gnaegi

Center for Health Care Ethics at Saint Louis University.

Act of love Meinert explained that since organ transplantations began in the U.S. in the 1950s, the Catholic Church has defined organ donation as a gift of self and an act of love, but no person is obligated to give this gift, nor is a family obligated to designate a loved one as a tissue or organ donor.

Under this ethical line of reasoning, no form of coercion or pressure should be used to obtain permission from a donor or a family member, he said. And, he said, since organ donation is a gift, it is not just informed consent that is called for — a comprehensive dialogue is needed between organ procurement organization representatives and donors’ families, a dialogue that demonstrates that the procurement organization has a holistic view of donors and their families.

This ethical thinking is relevant to the concerns now arising in intensive care units in some U.S. hospitals for patients who are candidates for “donation after cardiac death,” the term for patients who are pronounced dead shortly after the cessation of mechanical ventilation and/or other artificial life supports. It is usual with such patients that their families decide when the mechanical life support is discontinued.

Source of contention After a family has made the emotionally harrowing decision to withdraw life support, Meinert said, if their loved one is a candidate for organ donation, they then are approached by a representative of the

hospital’s organ procurement organization partner. He said that he’s seen — or become aware of through research — multiple cases in the last year in which this process has become contentious.

In some of these cases, the organ procurement organization knew the patient declared their willingness to be an organ donor when they got or renewed a driver’s license. So, legally, the organ procurement organization had consent to secure the person’s organs, he said. However, in at least one case family members questioned the extent to which that consent also covered the clinical measures that clinicians needed to take to prepare the organs for transplant — measures that were of no clinical benefit to the patient.

Similarly, in some cases in which patients had not indicated they wished to donate their organs, and their families provided the authorization, the families sometimes regretted that decision because they were not made aware that their loved one would be kept on life support for several days and be subject to additional invasive procedures including biopsies prior to the donor surgery. The donor’s estate or family is not charged for procedures related to organ or tissue donation.

Meinert said in some extreme cases organ procurement organizations have gotten legal teams involved to argue that a patient’s driver’s license consent to donate an organ also constitutes consent to the clinical steps necessary to prepare that organ.

Meinert maintained the newly aggressive stance of some organ procurement agencies is directly linked to a revised rule issued by CMS in November 2020. It

requires organ procurement organizations to be transparent in their success at getting and deploying organ donations and compete on their performance. The organizations are then put into tiers, with organizations in the lowest tier being disqualified for recertification.

CMS said the rule change is intended to “support higher donation rates; help shorten transplant waiting lists; reduce discarded but viable organs; and increase safe, timely transplants that save lives.”

Meinert said after that agency’s ruling, many organ procurement organizations across the U.S. hired new leadership and revised their practices in an effort to increase the number of organ donations they secure. In some cases, that has led to the problems Meinert described during the webinar.

Need for compassion He said it is important for the organizations and people involved in organ donation and transplant to view families of prospective organ donors as integral decision-makers. Those who speak to them about their loved ones’ potential donation must be empathetic yet clear about the implications and consequences of authorizing organ donation. Spiritual and chaplain support should be offered to families as they contemplate their decision under conditions of extraordinary loss and stress.

“These are difficult decisions for families,” and those families should be compassionately supported, he said. jminda@chausa.org

August 15, 2022 CATHOLIC HEALTH WORLD

More than

100,000 people are waiting for livesaving organ transplants.

Nearly 60% of people on the national transplant waiting list are from multicultural communities.

28% African American/Black • 21% Hispanic/Latinx • 9% Asian Pacific Islander <1% American Indian/Alaska Native • <1% Multiracial Descent

Hospitals, organ procurement organizations partner to broach organ donation with families

By JULIE MINDA

Source: Organ Procurement and Transplantation Network as of May 18, 2022

critical life event.

Tammi Aidt is manager of supportive care services for FMOLHS’ Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana. She says FMOLHS and the organ procurement organization it works with do outreach and education in neighborhoods with concentrations of minority residents for the same reason — to start conversaAidt tions when there is time for calm discernment.

Our Lady of the Lake hosts community events that highlight the altruism of organ donors and their families. It puts donors’ names on its Silent Hero Wall and each April during Donate Life Month it invites the public to its drive-thru Path of Remembrance, where donors are honored with tribute signs and a butterfly release.

Generational divide Anne Pretasky, nurse manager and director of critical care services at HSHS Sacred Heart Hospital, Eau Claire, and nurse manager of HSHS St. Joseph’s Hospital — Chippewa Falls, says a lack of cultural familiarity lowers the comfort level and keeps organ donation rates relatively low among Hispanic, Native American and Hmong communities in her hospitals’ catchment areas.

She adds that older adults in these minority groups may be more uncomfortable with the concept of organ donation than their children and adult grandchildren.

Tanwir Chowdhury is director of nursing for critical care at St. Joseph’s in Paterson, which covers Chowdhury a diverse population and so directs much of its organ donation education efforts at minorities. Chowdhury says some individuals decline to check the organ donor box on their driver’s license because they believe that medical professionals will not try as hard to save the lives of people who are organ donors. Organizations that procure or transplant organs call this supposition a myth and work to debunk it.

When a patient being kept alive on life support has not indicated a willingness to be an organ donor by checking a box on their driver’s license, a spouse or family member with legal decision-making authority ordinarily is asked to make the organ donation decision.

Families of patients who are people of

color are less likely than white families to agree to organ donation, Chowdhury says.

He says those who decline often cite cultural or religious aversions to organ donation, though he says such concerns are not unique to people of color.

Saint Francis’ Townsend says the historical mistreatment of Blacks by the medical system factors into the reticence about organ donation.

Averhart observes that some people of color choose not to register as organ donors because they believe minority people are deprioritized as recipients.

There is evidence that has been a defacto result of a method of evaluating the severity of kidney disease used to rank order people awaiting transplants. In June, the board of directors of the Organ Procurement and Transplantation Network sought a remedy, eliminating an assessment criterion that led “to a systemic underestimation of kidney disease severity for many Black patients.”

Education first The ministry and donor procurement executives say recruiting more members of minority populations to become potential organ donors requires establishing trust and building a hospital culture that routinely promotes organ donation.

All the ministry executives say their facilities work with their procurement organization partners to educate hospital staff on the practical and emotional aspects of organ donation for donors’ families. The staff of hospitals where donations are made are the first line in building trust with families. In many hospitals staff demonstrate sincere reverence and honor for donors and their families by lining up in halls in silent tribute to the donor as his or her body is wheeled to the surgery suite where the organs will be harvested.

The executives say there has been a slow increase over time in organ donation, including among minority populations.

But, they say, much work remains.

HSHS’ Pretasky says, “We want to maximize the number who say yes to organ donation, and we look at every possible way to maximize that number. But it really comes down to developing great relationships with family members. Patients and families have a real connection with our staff, and those workers share themselves to make a connection on a human level,” and that is what makes a difference.

Visit chausa.org/world for more information. jminda@chausa.org

Fewer than 1% of people die in a way that allows for organ donation, says the United Network for Organ Sharing. In most cases, candidates for organ donation are patients on life support in intensive care units who are being assessed medically to determine whether they are brain dead. Their deaths may have been sudden and unexpected, the result of an accident, an assault, an aneurism or heart attack.

It is usual in these circumstances for a family member with legal decision-making authority to authorize organ and/or tissue donation, even when a patient has given their consent to become a donor in advance through a driver’s license registration process or other means.

Ethicists say it is incumbent on hospitals and the organ procurement organizations they partner with to ensure these consent conversations with immediate family members are handled delicately and with empathy, respect and compassion.

“The relationship-building and trust is established between the hospital staff and patient’s family from the moment they enter the hospital through the ER,” says Vernette Townsend, chief nursing officer for Trinity Health Of New England's Saint Francis Hospital. “Families need to feel heard, seen and recognized to trust in the care and treatment by hospital staff for their loved ones. Continuity of care is also important in developing trust and relationship-building.”

recipients — when both groups desire that connection.

Anne Pretasky, nurse manager and director of critical care services at HSHS Sacred Heart Hospital, Eau Claire, Wisconsin, and nurse manager of HSHS St. Joseph’s Hospital — Chippewa Falls, Wisconsin, says when critically ill or injured patients arrive at the hospital staff goes into “full treatment mode.” Still, there may be opportunities to speak with the patient and family members and learn about the patient’s life as staff discuss treatment options and prognosis.

If the time comes to discuss potential organ donation with the family, members of the care team meet with a representative of the hospitals’ organ procurement organization to discuss the family dynamics, cultural and religious considerations and other aspects important to the conversation on organ donation. They anticipate questions and concerns of the family.

Pretasky says that the people authorized to speak directly to the family receive training on the process of requesting donation in a manner that is candid and respectful.

To provide emotional and spiritual support to the family in case the conversation is especially difficult, the hospital usually has a bedside nurse and pastoral care or palliative care staffer in the room along with the individual leading the organ donation discussion.

Be a hero At Trinity Health’s Saint Francis Hospital, representatives with the organ procurement organization — New England Donor Services — have primary responsibility for discussing organ donation with family members.

“Our goal is to never have a family feel they have been pressured. For us, the most important thing is the interaction as opposed to the ‘yes’ or the ‘no’ a family provides,” says Steven Averhart, family services manager for New England Donor Services.

“There is a lot of learning in real-time during these interactions,” he says. “Our approaches are not always smooth — grief is powerful and can cloud the understanding, acceptance and judgment of a family member.”

Averhart says the objective of the conversation is to guide families to a place where “they can set aside their own grief, if only for a moment, and think about the opportunity of erasing future grief that a stranger in need and his/her family may experience if they die awaiting a lifesaving gift. More importantly, we want the family walking away with a clear understanding that their loved one can be a hero to someone.”

Understanding the patient Executives from Franciscan Missionaries of Our Lady Health System in Louisiana; Hospital Sisters Health System’s Wisconsin regions; St. Joseph’s Health in Paterson, New Jersey; and Trinity Health Of New England spoke to Catholic Health World about how they collaborate with organ procurement organizations in working with families.

Tanwir Chowdhury, director of nursing for critical care at St. Joseph’s Health in Paterson, says St. Joseph’s organ donation partner, NJ Sharing Network, has several people who can address families' spiritual or religious questions.

When it is time for a family to make the decision on organ donation, representatives from the NJ Sharing Network meet with them to answer questions. Chowdhury says, “They are well-trained professionals in communication.” NJ Sharing Network’s team includes a family service coordinator, clinical donation specialist and hospital service manager to support patients and families through the process.

Network staff stay in touch with the family after the donation to provide emotional support, link them with support groups and connect donor families and donation jminda@chausa.org

Government and organ-sharing organization aim to make organ distribution more equitable

T

he organization that links the professionals responsible for allocating donated organs among the many people who need them in the U.S. is restructuring the organ prioritization process. A goal is to make that process more equitable.

The Organ Procurement and Transplantation Network has been coordinating the connections needed for organ donation and transplantation in the U.S. since Congress established the network in 1984. A key role of the network is to prioritize people for receiving donated organs because viable organs are scarce.

Until recently, the network has been using a points-based system that considers each transplant candidate’s medical urgency, distance from the donor’s hospital, the candidate’s biological

5

compatibility with the donor and the candidate’s predicted posttransplant survival prognosis.

In response to concerns that have arisen about the fairness of the allocation system, a group of private and public organizations has been working to update the prioritization process. This group includes representatives of the National Academy of Medicine, the Department of Health and Human Services, members of Congress and members of the transplant community, among others, according to information from the Organ Procurement and Transplantation Network.

According to online resources from that network, it has been involved since 2019 in moving to a new organ allocation system called continuous distribution. The new system is expected to be

fairer, more flexible and more equitable than the preexisting system and patients will be able to provide their feedback on the new system more easily.

The continuous distribution system considers multiple factors about transplant candidates at once, rather than placing people into rigid, rankordered classifications. While the same types of criteria will be considered in distribution decisions that were considered in the past, no single factor will dominate decisions on organ allocation under the new system. Factors instead are weighted.

The new system has been put in place for lung, kidney, pancreas, liver and intestine donations and is being put in place for heart donations by 2023.

— JULIE MINDA

Scan this code to watch a video on upcoming changes to the organ distribution system.

6

CATHOLIC HEALTH WORLD August 15, 2022

Centura grant program aims to advance social justice, health equity

By JULIE MINDA

Through its Health Equity & Advancement Fund, Centura Health aims to promote social justice, with a focus on health equity in its communities. In its first flight of grants last fall, it gave a total of $1 million to 19 community-based organizations that work directly with vulnerable populations.

This fall, the fund will distribute $5 million more to 61 organizations.

Recipients of the funds are primarily nonprofit community organizations based in or extending services into Colorado or Western Kansas, the states where the 19-hospital Centura system operates.

Centura functions under a joint operating agreement between CommonSpirit Health and AdventHealth.

Centura President and Chief Executive Peter D. Banko says the grants are for groups already working effectively to address Banko inequities so that they can expand their work and attract additional partners and funders.

Centura imperative The grant program is part of a broader effort begun in 2018 when Centura set up a diversity and inclusion advisory council to work on social justice initiatives at the system. When the May 2020 police killing of George Floyd stoked concerns about systemic racism, many associates expressed that they wanted Centura to do more to address inequity, says Banko.

The Centura board responded with a social justice framework that confirms the system’s commitment to diversity and inclusion and lays out the system’s broad goals and philosophy in social justice work.

Centura’s five focus areas are: recognizing and supporting employees, educating and developing them, recruiting and retaining staff, addressing health disparities and making a positive impact in the community. The Health Equity & Advancement Fund program most directly falls under the community impact focus area.

“We view diversity, equity and inclusion work as a marathon, not a sprint — this is a long-term commitment for us,” Banko says.

Centura established diversity and inclusion councils at each of its hospitals and those facilities are represented on the system-level council. The system in November 2020 promoted a Centura physician, Dr. Oswaldo Grenardo, to be its first senior vice president and chief diversity and inclusion officer, to shepherd related efforts.

“We view diversity, equity and inclusion work as a marathon, not a sprint — this is a long-term commitment for us.”

— Peter D. Banko Work now underway includes initiatives to increase the diversity of boards at the system and local levels, and to celebrate diversity through events around the system.

Additionally, Centura is helping clinicians improve care quality by attacking health disparities. Centura clinicians in family medicine and maternal and child health are among those doing focused work addressing disparities.

Centura also has increased its advocacy efforts around diversity, equity and inclusion.

Mission alignment To select grantees during the 2021 funding round, Centura used the results of community health needs assessments to identify the most pressing unmet health care needs in its catchment areas. It solicited input of all its local diversity and inclusion councils.

The system-level diversity and inclusion advisory council and a review committee chose grantees whose programs had the potential to make rapid headway and whose missions and values align with Centura’s. Employees representing a variety of departments, racial and ethnic backgrounds and work positions staff the review committee.

Grants awarded in fall 2021 ranged from $25,000 to nearly $87,000 and run through this month. Those awarded for fall 2022 range from $25,000 to $148,192.

Community members take part in a health services and screenings day at the Center for African American Health in Denver. The center, which works to advance health equity, is a recipient of Centura Health grants.

First-round grants One 2021-2022 grantee is using social media, radio, podcasts and workshops to educate people of color about how to address their chronic health concerns.

Multiple grantees provide health and social services to immigrants and refugees. A primary care clinic is using its grant to bolster its services for people with long-term physical disabilities. Another grant recipient is using its grant to facilitate behavioral health care for people who identify as lesbian, gay, bisexual, transgender, intersexual or asexual.

Other grants support programs for mothers in recovery from substance dependence and for low-income veterans.

Banko says Jesus challenged people to go to where suffering people were to address their needs and that is what Centura is doing — this includes going to where people are suffering in its communities because of racism or race-based health inequities.

Addressing systemic problems Deidre Johnson is chief executive and executive director of the Center for African American Health in Denver. That center

is using the $50,000 it received in fall 2021 from the Health Equity & Advancement Fund to offer its clients help navigating metro-Denver’s health and social service landscape. It also is on the list of recipients of grants going out this fall.

The Center for African American Health has its roots in a 1997 program to unite Black churches in addressing their memJohnson bers’ social service needs.

Today, the organization provides community members with educational programming and warm handoffs to local health and social services providers. Johnson says navigation help is often crucial to people of color being able to successfully access the web of service providers in Denver and to establish trust in a system that has failed to provide equal access and care to the Black community in the past.

“The work we are doing is often not easy, but it’s critical,” Johnson says.

Visit chausa.org/chworld to see Centura’s social justice framework and a list of the grant recipients. jminda@chausa.org

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Joe Mullany has resigned as president and chief executive of HSHS Illinois ministries.

ADMINISTRATIVE CHANGES Scott Opperman to vice president of mission for the Bon Secours Hampton Roads market in Virginia.

Kyle Hreben to chief operating officer of Peace Care in Jersey City, New Jersey, sponsored by the Sisters of St. Joseph of Peace.

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August March15, 1,2022 2022 CATHOLIC HEALTH WORLD

SSM Health clinic From page 1

City Employee Wellness Clinic opened in the summer of 2020. A partnership between the school district, the city of Sun Prairie and SSM Health, it offers no- and low-outof-pocket-cost services to the district’s almost 1,250 employees, to the city’s about 250 employees and to family members of those employees.

Jim Meacham, administrator for directto-employer services for SSM Health, says that while the Sun Prairie employee clinic is not unique, it is distinct in his experience because of the collaboration involved. The clinic Meacham adds services and programs based on the needs of the population under its care.

“We’ve found that this really penetrates the return on investment for our clients because it’s not just an extra layer of health care,” Meacham says.

Special services The special offerings have included curbside COVID-19 and flu testing, vaccination events at school district buildings, a daylong clinic for skin cancer checks, an outdoor walking club to encourage exercise and weight loss, and weekly Zoom sessions on health and wellness topics.

This summer, the clinic is hosting a

women’s health day with screenings and information focused on women’s wellness.

That event was planned at the suggestion of Deanna Hahn, SSM Health’s clinic manager for direct-to-employer services in the Madison, Wisconsin, area that includes Sun Prairie. She works closely with the school district and the city to keep the clinic’s services in line with their needs.

“We are pretty diverse in what we can do and it’s really exciting work to see the impact of managing that Hahn population health,” Hahn says. “We are getting people who don’t normally go to the doctor coming to the clinic to access that care and finding things early.”

Among the clinic’s basic services are acute care for minor afflictions such as earaches and sprains, wellness exams, employment and sports physicals, workplace injury treatment, occupational health services, and management care for heart disease, diabetes, allergies and other conditions.

Patients can schedule appointments by phone or via an online portal. They can usually see a provider in the office or virtually on the same day. While the clinic encourages patients to make appointments, its providers see walk-ins, too.

The clinic is open 7:30 a.m. to 6 p.m.

Monday-Thursday and 7:30 a.m. to 5 p.m.

Friday. The clinic is staffed by a physician’s assistant one day a week and a nurse practitioner the other four. A registered

Bryce, left, and Braeden Vollmer, sons of a school district worker in Sun Prairie, Wisconsin, get flu shots from Jen Banuelos, a registered nurse at the employee wellness clinic for city workers and school district workers and their families. The clinic is a partnership between the city, the school district and SSM Health.

nurse and a medical assistant work at the facility full time.

New location, new options Since its opening, the clinic has been housed at an SSM Health Dean Medical Group site. This fall the district is opening a new high school, which is freeing up space in a district building for the clinic and a professional development center.

Karyn Richmond, wellness coordinator for the Sun Prairie Area School District, says bringing the clinic on site will centralize the location for both school district and city employees. In addition, its location adjacent to the staff professional development center will provide a higher profile among its largest patient group.

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Richmond sees the clinic as a big component of the district’s wellness strategy.

“The clinic is one piece, but it’s a really strong and integral piece,” she adds.

Part of the wellness strategy is to increase access to health care for employees and their families and decrease barriers, including financial ones, Richmond says. Another piece is “proactive wellness,” or getting employees to embrace practices and lifestyles that can reduce their risk for diabetes, obesity and other preventable conditions.

“We want to engage our employee group in proactive wellness activities as much as possible and provide them with the tools and resources to take care of themselves,” Richmond adds.

She points to the walking club that was active last year as an example of how the clinic has helped the district with both parts of the strategy. Jenny Gruber, the clinic’s nurse practitioner, led the club and developed relationships with many participants.

By developing a rapport with participants, Gruber was able to make them feel comfortable scheduling appointments with her at the clinic. Some of the clinic visits resulted in identifying prediabetes, high cholesterol and other underlying health issues and led to treatments and interventions.

Gruber, who has specialized training in healthy weight-loss management, also helped facilitate a weight-loss challenge for district employees in which the participants shed an estimated 350 pounds.

‘Professional marriage’ Richmond says a goal of the district once the clinic opens in its building is to have a mental and behavioral health coach added to its staff to counsel workers on how to cope with stress, including that brought on by the pandemic. The coach would be a bridge between the services offered by the acute care model of the district’s employee assistance program and the longer-term treatment covered by insurers, she explains.

Richmond calls the partnership between the district and the clinic “a beautiful professional marriage.” She communicates with the clinic’s staff almost daily via phone or email to discuss how to augment services, coordinate special events and increase utilization. She promotes the clinic through the district website, newsletters, emails and in-person events and by having wellness representatives in school district buildings who share information with staff.

When the clinic opens at its new site this fall, its staff and supporters plan to invite the whole patient population to a celebration to familiarize more workers with the clinic’s convenience and services.

Since its opening, Meacham says the clinic’s uptake has followed the hoped-for trajectory of its planners. Through midMay, 37% of the employees who had access to the clinic had used its in-person or virtual services. That puts the clinic on track by its third anniversary to reach the 60% utilization milestone that Meacham calls the national standard for successful employerfunded clinics.

“We’re engaging the unengaged and you can see it in the data,” he says. “That’s the model that we’re trying to scale and bring to a lot of other businesses.” leisenhauer@chausa.org

8

CATHOLIC HEALTH WORLD August 15, 2022

With just a whiff of mom on flannel dolls, preemies are soothed

By LISA EISENHAUER

“

When the neonatal intensive care unit team at Providence St. Vincent Medical Center in Portland, Oregon, decided about a decade ago to research how to advance their care of micro-preemies, Kati Knudsen says one finding that repeatedly popped up was how comforting maternal scent is.

The research prompted the team to immediately start making use of “lovey dolls” to capture that scent and keep it next to the tiny infants, who were out of the womb in what is typically just the second trimester of a pregnancy.

“We were going to do kind of a major rollout like six months later of a lot of things to do with small Knudsen baby care, but the literature was so strong around maternal scent that we thought we couldn’t wait and that we needed to get these into our unit quickly,” Knudsen recalls.

She is now lead physical therapist of inpatient pediatrics and NICU at Providence St. Vincent and at Providence Portland Medical Center. For the last several years, the NICU teams at both hospitals have given parents packets with two of the little flannel dolls to keep next to their skin overnight or at least for several hours. The dolls rest close to babies in their incubators.

Evidence-based practice Knudsen says studies have indicated that maternal scent helps with parentnewborn bonding, the establishment of breastfeeding and with infants’ physiological stability.

One such study was published in 1998 in the journal Biology of the Neonate. It found the presence of a mother’s odor seemed to help enhance nipple acceptance and feeding in newborns and diminish crying for distressed infants. A study in the journal

While I sew these, I say a little prayer for the babies who receive them and it just makes me feel good doing this.

”

Winnie Jones holds a batch of lovey dolls she sewed as a volunteer at PeaceHealth Sacred Heart Medical Center at RiverBend in Springfield, Oregon. New parents of sick babies keep the dolls close to their skin to pick up their scent. The scented dolls provide comfort for incubated babies.

Breastfeeding Medicine in November 2020 concluded that the smell of breast milk may be helpful in reducing the pain of newborns during heel-prick blood sampling.

Knudsen says that while the scientific findings aren’t as robust when it comes to whether the scents of fathers or other nongestational parents have physiological

effects on newborns, those odors do seem to help with bonding.

The Providence NICU teams shared their lovey doll pattern with PeaceHealth Sacred Heart Medical Center at RiverBend in Springfield, Oregon. That hospital has been giving lovey doll packets to parents of its NICU patients for about five years.

Nadine Dockey, a physical therapist in PeaceHealth Sacred Heart’s NICU, says smell and taste are among the first senses to develop in utero. “By 28 weeks the infant can recognize smell,” she explains. “They start to recognize mom’s smell, dad’s smell and that’s closely related with the limbic system and the amygdala, parts of the brain tied to emotion and memory.”

Dockey says that in addition to the various physiological effects that studies seem to point to, placing the scent-infused doll a whiff away from the babies generally has a calming effect on them.

Comfort in connection A lovey doll can have a soothing effect on parents, too. Dockey says moms and dads find comfort in knowing that their scent is relaxing their infants during the times when the babes can’t be in their arms.

“Parents can feel helpless in this situation where things did not go maybe according to their plan,” Dockey says. “So, the dolls give parents some control back and some power back in caring for their baby.”

The lovey dolls are made by volunteers at all three Oregon hospitals. At PeaceHealth Sacred Heart, most of them are made by Winnie Jones with material provided by the hospital. She stitches the soft flannel squares together, stuffing them with cotton and tying off the middle section with ribbons.

She started making a few of the dolls every week about four years ago. With the onset of the COVID-19 pandemic, she picked up her pace. Now she makes as many as 24 a week. “While I sew these, I say a little prayer for the babies who receive them and it just makes me feel good doing this,” says Jones, who lives in Eugene, Oregon.

Once the preemies are discharged, the dolls go home with the families as keepsakes. Before the pandemic, Providence Portland hosted annual reunions for NICU families. It wasn’t unusual for parents to tell the NICU nurses that the children even as toddlers were still attached to the toys.

Larson

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Sandberg

Nurse, mother team up Providence Portland’s lovey doll supplies used to come from various volunteers, including Girl Scout troops. In recent years, Karin Larson, a registered nurse in the hospital’s NICU, and her mother, Pat Sandberg, have been making all of them.

Larson says she and her mother took over doll production when quality became an issue. “They weren’t standing up to repeated laundering,” she explains.

She and her mother get together every few months to make the dolls. Her mother, who is 86, handles the part that requires a sewing machine and Larson does the rest.

They produce 30-40 dolls at a time.

“They are quite labor intensive, I will say, for as simple of an item as they look,” Larson says. “We work for hours just to make one batch.”

It’s a labor of love for the duo, bonding them much as the dolls bond the newborns and parents in the NICU. “It’s a fun mother-daughter time for us to connect and visit,” Larson says. “It’s lovely.” leisenhauer@chausa.org