Catholic Health World - January 2024

New year, new focus 2 Spiritual gifts 3 Executive changes 7 PERIODICAL RATE PUBLICATION

JANUARY 2024 VOLUME 40, NUMBER 1

Our Lady of the Lake partners to develop rapid test for sepsis

‘I AM SO BLESSED’

FDA-approved tool identifies patients who are likely to have or develop condition

Longtime workers cite many reasons for loyalty to ministry facilities

By DALE SINGER

By VALERIE SCHREMP HAHN

High turnover, worker shortages and burnout are taking a toll on workplaces these days. ❖ U.S. Surgeon General Vivek Murthy lists workplace well-being among his priorities. “We can build workplaces that are engines of well-being, showing workers that they matter, that their work matters, and that they have the workplace resources and support necessary to flourish,” he writes on his website, hhs.gov/surgeon general. ❖ To offer insight on what keeps workers dedicated and motivated, Catholic Health World reached out across Catholic health care systems to ask several longtime employees why they have stayed where they are.

SEE THEIR STORIES ON PAGE 4

Sally Muehlius, a nurse with SSM Health St. Agnes Hospital Family Birth Suites, prepares Anna Martin and her newborn son, Luka, for their return home. Muehlius has been with SSM Health St. Agnes Hospital for 50 years.

It took nearly 10 years to develop a rapid test for sepsis, the all-too-common, often deadly condition that hospitalizes 1.7 million American adults each year.

With the new test known as IntelliSep, which a team at Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana, helped develop, doctors can diagnose sepsis in less than 10 minutes — a game changer for a condition that can become serious quickly but has been stubbornly difficult to detect.

“If your family’s going to get one disease that has life-threatening potential, that one is sepsis,” said Dr. Christopher Thomas, Continued on 5

Providence reaches across globe to strengthen Malawian health care system

By LISA EISENHAUER

Fahad Tahir, Tony Heard and Dr. Shubhada Jagasia chat during a ribbon cutting event in September for a women’s pavilion at Ascension Saint Thomas’ Midtown campus. Tahir is president and CEO of Ascension Saint Thomas and ministry market executive for Ascension Tennessee, Heard is chair of the Ascension Saint Thomas Board of Directors and Jagasia is president and CEO of Ascension Saint Thomas Hospital’s Midtown and West campuses.

When talking about her work in Malawi, Dr. Anna McDonald sometimes shares the story about a box of sutures that saved 28 lives.

McDonald fills her luggage with medical supplies every year when she makes the trip from Seattle, where she is a faculty member with the Swedish First Hill Family Medicine Residency program, part of Providence St. Joseph Health, to a 400-bed hospital in Mangochi, Malawi. She has been collaborating since 2015 with colleagues in the southeastern African nation to develop

Drs. Anna McDonald and Emmanuel Mkolokosa use a point-of-care ultrasound at the bedside at the hospital in Mangochi, Malawi, where Mkolokosa is head of pediatrics. McDonald, a Seattle-based physician, collaborates with colleagues at the hospital to offer training in family medicine. Her work is supported by Providence St. Joseph Health.

Ascension Saint Thomas CEO focuses on building ‘culture of trust’ in booming market To take on health disparity, ministry providers Continued on 8

By JULIE MINDA

A burst of growth in Nashville, Tennessee, is fueling expansion of the city’s health care providers, but at the same time the city is experiencing some growing pains.

As president and CEO of the 16-hospital Ascension Saint Thomas and ministry market executive for Ascension Tennessee, Fahad Tahir says the boom has come with significant workforce and access-to-care demands.

According to an analysis this summer

from the Nashville Area Chamber of Commerce, the metropolitan area has emerged as one of the top five in the nation for job growth post-COVID. The chamber put that rate at 10% from February 2020 through June 2023. Meanwhile, the Census Bureau says the population grew to 684,000 last year, as compared to just over 601,000 in 2010.

Tahir assumed his current role in early 2023. He also is a CHA board trustee and a 2011 recipient of CHA’s Tomorrow’s Continued on 6

change up how they connect with, serve men

By JULIE MINDA

The data is stark: Men die an average of five years earlier than women. Men are at higher risk than women for many serious diseases, including heart disease, lung cancer and HIV. Men also face unique health problems that don’t affect women, like prostate cancer.

This is all revealed in analysis by Healthy

People 2030, a framework created by the U.S. Department of Health and Human Services. Healthy People is among various sources warning that men are at greatly heightened risk for many medical and mental health concerns, as compared to women.

Ministry systems, facilities and affiliates are among those identifying the disparity, Continued on 7

2 CATHOLIC HEALTH WORLD January 2024

New year, new focus CHA opposes provision in pending bill that would lead to Medicare cuts on digital-first content the health of communities by preventing health care.”

By VALERIE SCHREMP HAHN

As we ring in the new year, Catholic Health World also is ringing in some changes to get our stories to readers more quickly and to give staff more time to focus on coverage.

First, we will be making better use of our website, chausa.org/chw. Breaking stories, such as new CEO appointments, will appear there first, as will most of our coverage of innovative programs, forwardthinking leaders and challenging issues across Catholic health care. We will send out weekly emails to point readers to the newest content.

We also plan to offer more visual elements — such as slideshows and videos — on the website. We have seen Catholic health systems making smart use of these features on their websites and in their social media. We hope to tap some of those same resources to elevate our coverage.

Second, we are scaling back our print issues to once a month. Each issue will continue to provide compelling stories, but we’ll be keeping most of them shorter, in line with reader preferences. In some cases, we will point readers to longer versions of stories online.

Moving to this digital-first strategy will better align Catholic Health World with how other news organizations are operating.

The approach also is more environmentally friendly, since we’ll be cutting back on our paper use. Most importantly, we will have more time and energy to report on topics of interest to CHA members.

What will remain consistent as we start this new year and this new strategy is our commitment to keeping our readers informed on how CHA and its members are leading in advancing the best medical practices and in providing equitable access to quality health care.

— Lisa Eisenhauer Editor, Catholic Health World

Catholic Health World (ISSN 87564068) is published monthly and copyrighted © by the Catholic Health Association of the United States.

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Opinions, quotes and views appearing in Catholic Health World do not necessarily reflect those of CHA and do not represent an endorsement by CHA. Acceptance of advertising for publication does not constitute approval or endorse­ ment by the publication or CHA. All advertising is subject to review before acceptance.

Vice President Communications and Marketing Brian P. Reardon

Associate Editor Valerie Schremp Hahn vhahn@chausa.org 314-253-3410

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CHA is speaking out against a provision in a bill making its way through Congress that could result in about $4 billion in cuts to hospitals.

The House passed the Lower Costs, More Transparency Act on Dec. 11 on a bipartisan 320-71 vote, sending the measure to the Senate. CHA is concerned about a “site-neutral” provision of the act that would level payments for drug administration regardless of where that service is provided.

CHA President and CEO Sr. Mary Haddad, RSM, sent a letter to representatives Dec. 7 to express concerns about the act.

She pointed out that hospitals continue to face the challenges of increased labor, drug and supply costs as well as shortages of staff and supplies.

“We ask that Congress support the work of our members by protecting the essential policies and programs that are critical to

any cuts in federal spending in Medicare and Medicaid,” she wrote. “Specifically, we urge you to reject policies that reduce reimbursements under the Medicare program, especially site-neutral proposals.”

Sr. Mary pointed out that site-neutral proposals don’t account for the difference in care offered at hospital outpatient departments versus other places, such as physician offices and ambulatory surgical centers. Hospital outpatient departments are better equipped to handle sicker patients and emergencies and often provide around-the-clock critical care to communities, she said.

“This site-neutral proposal also must be rejected in light of providers’ continued fiscal challenges, especially in rural and underserved areas,” she wrote. “As Catholic health care providers, we are committed to reducing health disparities, promoting health equity and ensuring that everyone in our nation has access to affordable

Opponents fear the site-neutral provision on drug administration in the pending bill could lead to other similar revisions in Medicare payment policies and more funding cuts. The Federation of American Hospitals, the American Hospital Association, and the Association of American Medical Colleges also have spoken out against the site-neutral provision.

CHA supports other items in the bill, such as money for the Community Health Center Fund; delaying $8 billion in cuts to Medicaid hospital payments; extending funding for the National Health Service Corps, which provides scholarships and loans to medical students; extending funding for the Teaching Health Center Graduate Medical Education Program; and extending funding for the Special Diabetes Program and the Special Diabetes Program for Indians.

The bill is H.R. 5378. vhahn@chausa.org

Foundations

of Catholic Health Care Leadership JANUARY 30 — MARCH 21, 2024

✦F oundations Live is an interactive eight-week (virtual) program with sessions each Thursday from 1–3:30 p.m. ET BUILD COMMUNITY

✦E ngage in meaningful dialogue with ministry colleagues from your system and across the country.

Register at chausa.org/foundationslive

Questions?

Email formation@chausa.org or call 800-230-7823

Upcoming Events from The Catholic Health Association Webinar — Embracing Change: Head, Heart, Hands Jan. 16 | 1 – 2 p.m. ET

Friday15 — CHA Prayer & Reflection Member Update Jan. 19 | 11 – 11:15 a.m. ET

Faith Community Nurses Networking Call Feb. 5 | 1 – 2 p.m. ET

Global Health Networking Call Feb. 7 | 1 – 2:30 p.m. ET

United Against Human Trafficking Networking Call

Webinar — IRS 990, Schedule H: An Overview and Update on Current Tax-Exemption Issues Feb. 20 | 1 – 2:30 p.m. ET

Diversity and Disparities Networking Call Feb. 21 | 2 – 3 p.m. ET

Feb. 12 | Noon – 1 p.m. ET We Will Empower Bold Change to Elevate Human Flourishing.SM © Catholic Health Association of the United States, January 2024

We Will Empower Bold Change to Elevate Human Flourishing. chausa.org/calendar

SM

January 2024 CATHOLIC HEALTH WORLD 3

St. Joseph’s/Candler makes crucifixes available to patients as part of spiritual care approach

By JULIE MINDA

For about 20 years, St. Joseph’s/Candler in Savannah, Georgia, has placed crucifixes in every patient room at both its 330-bed Catholic hospital — St. Joseph’s Hospital — and at its 384-bed Methodist hospital — Candler Hospital.

Then, around the time the pandemic began, hospital leadership began noticing that an increasing number of crucifixes were going missing. Speaking with nursing and pastoral care teams, the leaders learned that it had become increasingly common for patients to request upon discharge to take home the crucifixes. And, in a couple of cases, people had just taken the crucifixes from the rooms.

St. Joseph’s/Candler leadership decided that the hospitals should offer crucifixes to every inpatient as part of the organization’s spiritual care programming.

The crucifixes that St. Joseph’s/Candler offers patients are 10 inches long and 5 inches wide. The risen Christ is in gold

St. Joseph’s/Candler in Savannah, Georgia, places crucifixes in patient rooms and offers crucifixes at no cost for patients to take home with them.

embellishment. Before the crucifixes are placed in a room or given to a patient, they are blessed by a priest from the pastoral care department.

Paul P. Hinchey, president and CEO of St. Joseph’s/Candler for more than 30 years, says, “We wanted the crucifix — the risen Christ in all His glory — to be a symbol of hope to our patients. We know a lot goes on in patient rooms, and we have the cru- Hinchey cifixes on the wall at the end of their bed, so they can meditate or pray.”

Hinchey says he has been shocked at the number of crucifixes the two hospitals have given out in the last several years. The hospitals give out 250-400 a year.

St. Joseph’s/Candler prioritizes spiritual care, and so it ensures that the 12 chaplains who serve the two hospitals are rounding daily. It is often during those rounds that chaplains will offer patients a crucifix. Hinchey said many people don’t know

During centennial year, St. Mary’s in West Virginia honors past, focuses on advancing mission

By JULIE MINDA

As St. Mary’s Medical Center in Huntington, West Virginia, marks its centennial this year, it is not just celebrating the past. It also is incorporating formation activities into its observances to help employees gain new insights into how they can shape the hospital’s future.

The hospital launched its anniversary year with a November celebration involving members of the Pallottine Missionary Sisters, the congregation that founded St. Mary’s. During the festivities, Huntington Mayor Steve Williams named a city square in honor of the sisters. This year, anniversary activities will continue with a devotional book release, the dedication of a historical timeline, a Hospital Week celebration, a gala, a parade, a carnival and health fair, a summer luau for employees and a football tailgate. The centennial will conclude with a dinner and Mass in November.

Rev. Greg Creasy, St. Mary’s director of spiritual care and mission integration, is spearheading the commemorations. “We are not just talking about where we’ve come from but also where we’re heading,” he says. “We’re talking about, after a century of caring, the Rev. Creasy legacy continues.”

One of the formation elements St. Mary’s

Sr. Joanne Obrochta, SAC, and a fellow nurse care for a patient at St. Mary’s Medical Center in Huntington, West Virginia, in the late 1950s. Sr. Obrochta began with St. Mary’s after her 1951 graduation from nursing school and continues to minister to patients today through her volunteer work in the hospital’s department of spiritual care. In a message recorded for the “100 People, 100 Reasons” campaign, she spoke of her 70 years of service at the hospital.

is using to help employees process this concept is the weekly messages Rev. Creasy sends to staff. He’s now tying the messages, called “Seeds of Faith,” to anniversary themes. For instance, one message explains how St. Mary’s founding sisters trusted God’s provision, even when finances were very lean, and challenges employees to ask how they are doing the same. Another message describes how the sisters wanted to include everyone in their mission even when other hospitals were exclusionary. It asks how employees now are being inclusive.

Also Rev. Creasy and his wife, Robin Creasy, who worked for many years at St. Mary’s, are releasing this month a prayer and devotions book. The book is centered on St. Mary’s legacy and how past and present employees have lived out — and con-

tinue to live out — St. Mary’s values. The acronym of those values — compassion, hospitality, reverence, interdependence, stewardship and trust — is CHRIST. Rev. Creasy also will be weaving centennial themes into an ongoing leadership formation series he runs that draws in part on CHA formation resources.

St. Mary’s also is curating stories of past and present employees and other stakeholders. The hospital’s “100 People, 100 Reasons” story collection highlights people who have been part of the hospital’s legacy and the many reasons they are devoted to St. Mary’s.

St. Mary’s traces its roots to 1912, when four sisters from a congregation founded by St. Vincent Pallotti departed Bremerhaven, Germany, to serve in the United States.

They twice cheated calamity. First, when

St. Mary’s main entrance around 1950 and the hospital’s main entrance now. The hospital is celebrating its 100th year.

where to buy crucifixes and so they appreciate the gift from the hospital. The chaplains do not carry the crucifixes with them. They or other staff members can alert a small team in the mission department, affectionately referred to as the “crucifix squad,” to deliver the crucifixes.

Hinchey hears from nursing and pastoral care staff that patients express gratitude for the gift. One man who was dying said the crucifix in his room had been comforting and he wanted one for his home. He said upon his death his son would have the crucifix to remember him.

Another patient had similarly told the care team that the crucifix had provided a source of hope during the tribulations of surgery. The patient wanted to continue to have that visual reminder of hope at home.

“These crucifixes are becoming part of our brand,” says Hinchey, “and that is really, really neat.” jminda@chausa.org

one of the sisters’ travel documents were not in order, all four had to delay the voyage they had planned on the Titanic, instead boarding a ship departing later. Once they arrived in the U.S., they had to delay a train trip they’d planned to Stella Niagara, New York, where they were to learn English with a congregation of St. Francis sisters. The train that they were to take wrecked and many of its passengers died.

The very fortunate sisters began their U.S. ministry in Richwood, West Virginia, opening a school there in 1912 and a hospital in 1913. In 1921, the Pallottine sisters opened another hospital, in Buckhannon, West Virginia. They then accepted the Wheeling, West Virginia, bishop’s invitation to establish a hospital in Huntington.

The sisters and local volunteers converted an abandoned school and gymnasium into the 35-bed hospital and convent that opened Nov. 6, 1924.

Initially the sisters did all the work at the hospital, nursing the sick and injured, cooking, cleaning, ironing and growing their own fruits and vegetables. Recognizing the need for more staff, the sisters in 1926 began a nursing school at St. Mary’s that remains today.

St. Mary’s was the only hospital in the region during that era that had an “open medical staff.” St. Mary’s did not bar its physicians from also having admitting privileges at other hospitals. The open policy promoted its swift growth.

Over the past century, St. Mary’s has expanded to its current 393-bed capacity. It has 2,600 employees.

In 2012, St. Mary’s partnered with a community organization to build an $18 million satellite campus 20 miles away in Ironton, Ohio.

In 2014, the sisters ceded governance of the hospital, entering into an agreement for Cabell Huntington Hospital to run St. Mary’s. In 2018, Cabell Huntington Hospital acquired St. Mary’s, with both hospitals now under the Mountain Health Network parent system. Last year, Mountain Health Network joined with nearby Marshall Health and Marshall University to form an integrated academic health system. That system, called Marshall Health Network, includes four hospitals. Amid all the changes, St. Mary’s has maintained its Catholic identity.

Rev. Creasy acknowledges recent changes have brought some angst, but he says that St. Mary’s and its leadership are focusing on their commitment to the hospital’s faith-based mission. “We are emphasizing the values,” he says. “We’re focusing on how we’re all living out the values and carrying out our vocations.” jminda@chausa.org

4 CATHOLIC HEALTH WORLD January 2024

Longtime employees From page 1

Bonnie Goldsberry 48 years at Benedictine Living Community — Dickinson, North Dakota

Bonnie Goldsberry, 64, has lived in Dickinson, a city of about 26,000, all her life. That means in her role as activity director at Benedictine Living Community — Dickinson she encounters familiar faces.

She’s worked with former teachers, her dentist, even her mother, who now lives at the eldercare facility.

“The majority of these people are lifelong residents that I have known all my life, that have built this community to what it is today,” she said. “I am very driven to serve them because they have given so much to this community.”

Goldsberry started at the facility in November 1975 as a certified nursing assistant, staying in that role for several years until becoming activity assistant and finally activity director. She fills in occasionally as a nursing assistant.

Simply being present for the residents is part of the job for everyone on staff in Goldsberry’s view. “Everyone needs to be out there, because that’s where you get the real joy,” she said. “That’s where you make the big difference. Being with them.”

As activity director, Goldsberry arranges crafts and games for the residents, transports them from area to area, helps them select meals, and organizes activities with the outside community. For Halloween the facility welcomed 500 trick-or-treaters, the first major community event since the pandemic.

Goldsberry finds it most difficult in her job to see residents in the middle stages of dementia who don’t fully understand why they are at the facility. It is also difficult for her when residents die, since she has known many of them and their families for so long. She tries to go to their funeral and memorial services, she said.

Goldsberry has advice for anyone who wants to work in a nursing facility: exercise compassion, which includes being careful with body language and words. These residents didn’t aspire to live in a nursing home, she said.

“You need to provide a little bit of love in everybody’s heart to make it better for them,” she said. “And if you don’t have that, then don’t even start. But if you want to experience real joy, come to a nursing home because you’ll get it. You’ll get tenfold back what you give.”

Sally Muehlius, at left, a longtime nurse at SSM Health St. Agnes Hospital, shares her knowledge and experience with her colleagues, including Josie Birschbach, a fellow nurse.

all dads have been allowed to stay with the mothers since.

Muehlius gets to know families, learning about their lives, and she likes to joke around and have fun. She takes time to show inexperienced parents how to feed, swaddle, and hold their babies.

“It is a very good feeling to see that they are a little more comfortable,” she said. “And as you see them through two days here, they’re doing more things on their own.”

She said the most rewarding part of her job is when a mother gives birth after a particularly long labor and delivery. “When the baby finally comes in, everything’s going well, that is the best,” she said.

Many mothers apologize to her after giving birth. They feel bad for not saying thank you or for taking so long. “To hear them apologize is like, oh, my gosh, that’s crazy,” she said. “I’m just so happy everyone is doing well.”

Muehlius doesn’t plan to retire soon.

She works five shifts every two weeks, which still allows her to travel and have plenty of free time. “I get people who wonder, am I crazy?” she said. “It’s a good feeling knowing I can (retire) if I want, but I like it this way.”

Sally Muehlius 50 years at SSM Health St. Agnes Hospital — Fond du Lac, Wisconsin

Sally Muehlius can’t guess how many babies she’s helped usher into the world.

The registered nurse first started working at SSM Health St. Agnes Hospital in 1973.

After one month in a medical unit, a position opened up in obstetrics, where she had hoped to work.

“I slipped in and never left,” she said.

She’s been lucky to have great, reliable co-workers and bosses over the years.

“They’re helpful, and not running the other way,” Muehlius said.

There’s always something new to learn, and Muehlius, 70, marvels at the changes she’s seen over the years. Now, babies mostly stay with their mothers, and the nursery is smaller and mainly for sick babies. Computer charting that she said takes longer has replaced paper charting.

Mothers automatically get IVs, and pain medications have evolved from gas to cervical blocks to epidurals.

“When I first started here, if the couple wasn’t married, the dad couldn’t go in for the birth. You’d have dads crying,” she said.

That changed soon after she started, and

Pete Goeckner 50 years at HSHS St. Anthony’s Memorial Hospital in Effingham, Illinois

Pete Goeckner, 67, a maintenance mechanic at HSHS St. Anthony's Memorial Hospital in Effingham, Illinois, started working there as a teenager.

Pete Goeckner never knows what’s in store for him when he comes to work each morning at HSHS St. Anthony’s Memorial Hospital. He logs in and checks to see what work orders await: a leaky pipe, a malfunctioning hospital bed, an uncooperative ice machine.

Goeckner, 67, faces each problem with a good attitude and usually has some dad jokes to share with whomever he encounters. “Some of them do laugh, and some of them roll their eyes,” he said.

He started at the hospital part time when he was 16 years old, first working as a dishwasher and then as a cook’s helper. Most of the time he’s spent in maintenance.

“I was real green,” said Goeckner with his tongue-in-cheek humor. “I’ve learned everything that I know now, which ain’t much, on the job.”

His official title is maintenance mechanic, and he works with a crew that handles work orders and does preventative maintenance, such as lubricating equipment. The crew plows the grounds and sidewalks when it snows. Members take turns staying on call for emergencies.

“Pete is so consistent on every job he is given,” said John Cordery, manager of plant operations at the hospital. “He reviews the work order and runs through the possible problem scenarios before heading out. He has a smile and greeting for everyone he encounters on the way to the job location, whether a colleague, doctor, patient or visitor.”

Since Goeckner grew up in the area and lives in nearby Teutopolis, Illinois, he often runs into people he knows at the hospital.

He likes the people at his job and being in

the company of other dedicated, long-term employees.

“I get along with maybe 99% of the people,” he said. “You can’t have 100.”

He said he feels supported by an employer that always supplies what he needs to do his job.

“

Pete is so consistent on every job he is given. ... He has a smile and greeting for everyone he encounters on the way to the job location, whether a colleague, doctor, patient or visitor.”

— John Cordery

He thinks he will retire soon, having recovered from recent shoulder surgery.

But he’s not sure. His son threw a retirement party for him a few years ago when he first planned to retire, but he put those plans on hold when his home’s garage and its contents burned in a fire.

Over the years, he’s had opportunities to work elsewhere, he said. He can’t see himself working in a factory or doing the same thing every day.

“I’m not a job jumper,” he said. “If I like something, I stay with it, or tried to. Have I threatened to go to other places? I’m not saying I haven’t. But was I serious? Probably not. I like what I do.”

January 2024 CATHOLIC HEALTH WORLD 5

Nina Mayes About 62 years at Bon Secours St. Francis Downtown — Greenville, South Carolina

Nina Mayes ticks off the specialties she makes for hungry staff, patients and visitors at Bon Secours St. Francis Downtown hospital: bacon, sausage and egg biscuits, lemon pound cake, banana pudding and a pineapple upside down cake with a glaze she makes from the juice drained from the can.

“Then I spread that pineapple glaze on top, and I just give it a little bit of (yellow) food coloring to give it color, and it just stands out,” she said.

Mayes, 80, has been with the hospital for about 62 years, minus a couple short breaks to work elsewhere. She comes to work every morning at 4:30 a.m., and usually leaves between 1 and 2 p.m. She said she’s never called in sick and is never late for work.

She’s even stayed overnight at the hospital during bad weather.

Mayes started working at the hospital in the laundry department during summers in high school. After graduating in 1961, she started working in food service as a baker.

“I was almost like a human sponge,” she said. “And I was just trying to soak up everything.”

She trained on a brick-lined oven, and back then, everything was made from scratch, including fresh rolls she produced daily. Now, the rolls arrive as pre-made dough. She just has to poof and bake them.

Still, she still makes about two-thirds of the hospital’s baked goods from scratch.

She loves trying new things in the kitchen and being creative.

Nina Mayes, 80, has worked for decades at Bon Secours St. Francis Downtown in Greenville, South Carolina, most of it in food service as a baker. This photo is from her work area in the late 1980s, when bakers wore white uniforms.

“You know what? It keeps me motivated,” she said. “Some of the things really aren’t from scratch all the time, but you can tweak it. At least that’s what the young people say.”

She likes working for the hospital because she knows what her supervisors expect of her even as they give her a lot of

autonomy.

“Over the years things change,” she said.

“I can’t say I’m always happy with changes but figure you always can compromise. If you let things get negative, that will spoil everything.”

She has no plans to retire soon and likes staying busy at the hospital. “Each

Rapid sepsis test From page 1

medical director of system quality and patient safety at Franciscan Missionaries of Our Lady Health System, Our Lake of the Lake’s parent.

Dr. Mark Laperouse, medical director of Our Lady of the Lake’s emerThomas gency department, added that the test is the first new one in a long time for use in emergency rooms, where patients with sepsis most often present.

“We’re part of something groundbreaking and we have a test that never existed before,” Laperouse said. “It’s hard to really talk about that Laperouse without getting goose bumps.”

Threat to health, risk of death The Centers for Disease Control and Prevention says sepsis is the body’s extreme reaction to an infection. The CDC calls developing a protocol to deal with sepsis “essential to optimize patient care.” The agency notes at least 350,000 patients who develop sepsis die or are discharged to hospice every year.

Patients who survive sepsis are at increased risk for negative health outcomes, for being unable to return to work and for death, the agency says.

An organization called the Sepsis Alliance, which provides information for health care providers as well as patients and their families, puts the cost of sepsis care for hospitals and skilled nursing centers at $62 billion a year. That figure is the highest for any condition, the alliance says.

Identifying the ‘likely septic’ IntelliSep was developed by Cytovale, a San Francisco-based medical diagnostics company, in partnership with a quality and research team at Our Lady of the Lake. The test, done through a blood sample, analyzes white blood cells and quickly classifies patients into three distinct bands.

Band one patients have the lowest probability of developing sepsis, while band

The IntelliSep test analyzes white blood cells from a standard blood draw to determine a patient’s likelihood for developing sepsis.

About

1.7 MILLION

adults in America develop sepsis.

1 IN 3

people who dies in a hospital bed had sepsis during that hospitalization.

At least

350,000

adults who develop sepsis die during their hospitalization or are discharged to hospice.

Sepsis, or the infection it causes, starts before hospitalization in nearly

87%

of cases.

Source: Centers for Disease Control and Prevention

three patients have the highest probability. In that case, hospital personnel can be mobilized with a sepsis alert.

“We’re making the entire hospital more efficient by making sure we’re treating the correct people,” Laperouse said. “Instead of saying everyone is possibly septic, now we have people that are likely septic and likely not septic. It is amazing watching what’s happening to the entire hospital because of the way we’re focused on this disease process.”

Mysterious illness Despite the prevalence of sepsis, Thomas said, the condition can be a mys-

tery to the general public.

“Over half of the United States, in terms of the patients, don’t know what sepsis is as opposed to cancer or acute myocardial infarction, heart attack or stroke,” he said. “On the provider side, it’s the number one cause of hospitalization in the United States. It’s the number one cause of readmission to the hospital in the United States.”

Thomas almost lost his father to sepsis when, after a routine prostate biopsy, his father developed a fever and became acutely confused.

“I think they did a fantastic job at the time,” he said, “but I often think about if the test had been there at that time, there would have been some trajectory for me to understand what I was dealing with.”

For patients who survive sepsis, Thomas added, about half have some alteration of their life related to a complication called post-sepsis syndrome. That condition involves physical and emotional symptoms, such as fatigue and insomnia, that can last for months, the Sepsis Alliance says.

‘An extra tool’ Thomas was giving lectures on sepsis about 10 years ago when he learned that a fast-working test was in development. He expressed interest in becoming involved in the research that led to IntelliSep and presented the idea to Dr. Hollis O’Neal, medi-

and every day you only have that day, and I try to make the best of it,” she said. “I’m so blessed.”

For more profiles, including two married couples who have worked in the same hospital system long term, visit chausa.org/chw. vhahn@chausa.org

cal director of research, and other medical leaders at Our Lady of the Lake.

Nine years of testing followed. The test got approval from the Food and Drug Administration in 2022. It was introduced at the hospital last summer.

Now that the rapid test is in use, Laperouse said, “We’re watching patients benefit from it, both sick and non-sick patients. It’s an extra tool that we’ve just never had to make decisions on patients that are presenting to the emergency department.”

Thomas sees IntelliSep as an advancement in health equity. “If you look at sepsis numbers, disadvantaged groups have worse outcomes in sepsis because unfortunately, nationally, when you have to take a history or when you have areas that are underserved, they may delay in time of presentation or they may have more comorbidities,” he explained. “So, by putting in an objective measure on a disease, that’s the most significant diagnosis across our health system.”

He added that use of the test has “allowed us to be very clear from a mission perspective that independent of environment, independent of background, every patient is going to get the same chance for optimal health, which is our definition of health equity: giving an optimal opportunity to achieve optimal health outcomes in the patients we’re privileged to serve.”

The use of IntelliSep began at Our Lady of the Lake, with plans to expand to other parts of the Franciscan Missionaries of Our Lady Health System. Laperouse said the wider use will create data that can be analyzed to maximize the effectiveness of the test.

“We’re doing this unselfishly and we’re making sure we take notes along the entire way, because not everyone’s going to be able to expend the resources like we have done just since August first,” Laperouse said, referring to the date when Our Lady of the Lake began using the sepsis test.

He added: “We’re making sure any facility that ends up using this product will have the blueprints and the road map to be successful. And if we can do that one hospital at a time, one region at a time, one hospital system at a time, we’re going to change the outcomes of so many people in this country and maybe the world, hopefully.”

6 CATHOLIC HEALTH WORLD January 2024

New boats in youth rowing league named in honor of Sisters of Mercy Mercy joined the dedication in November of a fleet of six new boats that will be used by students in a rowing league aimed at fostering diversity, equity and inclusion in the Oklahoma City metro region.

The boats will be used in Riversport OKC’s OpportUNITY Initiative, which Mercy is sponsoring. The program provides rowing scholarships to students who might not otherwise have access to the sport in Oklahoma City.

“When we were approached to sup-

Boats to be used in a program in Oklahoma City to teach rowing to students bear the names of six Sisters of Mercy. The rowing initiative is sponsored by Mercy.

port this amazing program, it was an easy ‘yes’ for Mercy to be involved,” Dr. Jesse Campbell, regional physician executive at Mercy, said in a release. “In the way that we

believe everyone deserves access to highquality health care, every student should have access to high-quality team sports and world-class training facilities that position

them for success long into their future.”

Mercy co-workers voted on names for each of the new boats and selected six Sisters of Mercy who have served in Oklahoma in recent years. Those chosen were Sr. Rose Power, Sr. Emerita Stoulig, Sr. Miriam Terese Alvarado, Sr. Coletta Massoth, Sr. Mary Claver and Sr. Carolyn Stoutz. The boats were dedicated in their honor on the anniversary of the death of Mercy foundress Catherine McAuley.

“We realized the tradition of naming boats after women was the perfect way to pay tribute to our own Sisters of Mercy, hundreds of whom have served Oklahomans long before Oklahoma was a state,” said Jim Gebhart, community president of Mercy Hospital Oklahoma City.

everyone’s responsibility to address access gaps.

Tennessee is one of the 10 states that have not expanded Medicaid, and so hundreds of thousands of citizens in the state do not have access to it. Along with the Tennessee Hospital Association, Ascension and CHA, we are advocating for 100% access and coverage. We’re also looking at other policies that burden families. We work with like-minded organizations to join together to advocate for our patients and community members. In Catholic health care, we proactively seek to support the most vulnerable in our country. To do so in a sustainable way, we have to consider the policy context and guide national policy proactively to enable the impact of our mission.

Bishop Joseph Mark Spalding of Nashville, Tennessee, joins Fahad Tahir at Ascension Saint Thomas’ annual medical mission in April at the Nashville Fairgrounds.

Tahir is president and CEO of Ascension Saint Thomas and ministry market executive for Ascension Tennessee.

Nashville CEO From page 1

Leaders award. He spoke to Catholic Health World about how Ascension Saint Thomas is responding to the opportunities and challenges of Nashville’s success. His responses have been edited for length and clarity.

What does Nashville’s boom time look like?

The region is growing, and we have a growing job market. Our market is among the top for manufacturing in the U.S., including increasingly for electric vehicles and batteries. Our tax climate is attractive, as is our cost of living. There’s a warm and kind southern feel — which some call “Nashville nice” — and there’s been a natural collaborative environment in the business and health care communities, where we are trying to make each other better.

But the challenge for our region has been keeping up with all the growth. There’s been tension on the infrastructure, including for transportation and housing. Unfortunately, we see the classic inequity in Nashville, and now it’s more pronounced and pressing on the poor and vulnerable, many of them are African American.

You need to name a problem to address it, and I’m proud of Nashville because I see a recognition and a sense of ownership of the problems by the city and community leaders.

You’ve spoken in the past about Ascension Saint Thomas being a “health care destination.” What does that mean?

Nashville has been referred to as the health care services capital of the U.S. We’re strong in terms of our investor-owned, academic and nonprofit health care. And we at Ascension Saint Thomas want to be a health care destination among these great providers.

To do that we need to offer the best of health care services along with an experience which reflects the warmth and compassion that we are known for. We have to be intentional in how we do this.

We’ve built up the largest cardiac network in the region. We’re increasing our use of robotic technology as an elective surgical destination. We have the largest spine program in the region, treating some of the most complex spine conditions. We deliver more babies than any other hospital or health system in the state. We’ve developed a cutting-edge brain tumor program. We treat our physicians as thought partners and innovators and work to avoid the bureaucracy of an academic medical system, and that is enabling our clinical experts to look ahead to develop what is needed for our growing region.

our patients but also for physicians, nurses and team members. We need to ensure we have the workforce we need. And there are shortages of talent available, given both the current state of our industry and the unique level of demand in our area.

The other big challenge is access. We need to ensure we make it easy for our physicians, clinicians and patients to access the system — it needs to be frictionless. We think through the experience of physicians, clinicians and patients. We think through every stage of the care journey and make it as easy as possible.

Essentially, when it comes to challenges, I reflect on how we differentiate ourselves in an environment with a lot of health care providers, we don’t want to just be like everyone else. We listen to what our physicians, clinicians and patients are saying and we look at the long view to stay on track.

How are you using those “thought partners” to determine how best to grow?

We want to provide health care access anytime for our growing community that has a more pronounced need for services and access. So we’re looking at where geographically this growth is happening and what the disease burden is there. We are sensitive to financial affordability issues, since there are more financial pressures on families now, so we’re looking at affordability of care too. So, for instance, we’ve developed a network of ambulatory surgery centers, and this environment lets us offer certain appropriate surgeries for patients close to home and in a more affordable setting. We’ve done similar things with our freestanding imaging centers throughout the region, and with cardiology and certain subspecialist outreach clinics offered in the community.

What are the implications of not addressing the access issues appropriately?

At Ascension nationally, we’ve made a purposeful commitment to equity. We focus on our clinical quality goals, and we look at all our service lines and programming with an eye towards equity. There are national disparities that we need to address. All should have access to care, and that’s what we’re charged to do and to lead on.

But if it’s not addressed, it means a chronic disease burden will grow in its negative impact on the individual patient but also in aggregate on our community as a whole. And that can also have an effect on our region’s success: Chronic disease affects upward mobility, it affects productivity, and that can make Nashville a less attractive destination for future employers.

What are some of the greatest challenges Ascension Saint Thomas is facing in the near term?

We don’t just want to be a destination for

What has Ascension Saint Thomas’ focus been when it comes to advocacy?

Ascension nationally has a very involved and highly engaged advocacy team, but it’s

What has Ascension Saint Thomas been doing when it comes to diversity, equity and inclusion goals?

Ascension has the ABIDE framework that we use to ensure that we’re appropriately addressing those goals. (ABIDE stands for appreciation, belongingness, inclusivity, diversity and equity.) We look at diversity, equity and inclusion when it comes to patient health equity, maternal morbidity and mortality. For instance, given that we are a destination for women, especially when it comes to maternal care, that position comes with a responsibility. We address the disparities about the care Black women get, we have programs to address the disparities, such as unconscious bias training.

What has Ascension Saint Thomas been focusing on when it comes to environmental stewardship?

Ascension has an environmental stewardship commitment — we are heading toward zero waste by 2040. We’re using evidence-based, science-based methods, including for our new facility construction, energy use standards and maintenance.

We’re working with community organizations to build tree canopies to address air quality. We’re sensitive to food waste.

Those are just some of the examples of the response we have to the challenge of reducing waste.

What is ahead for Ascension Saint Thomas?

During this past year, I’ve been listening and seeking input, visiting and getting to know and understand the caregivers and their experience. Society has changed and the workforce has changed but we have to start by being present and to be willing to adapt. We must challenge ourselves as an organization to make a big organization feel small in terms of culture. It’s about building a culture of trust. We’re energizing the organization to build and have confidence in who we are. We are building our destination programming, we’re modernizing our campuses, expanding our geographic footprint to serve our community close to home, we’re adding clinical services and expanding services to the community. And we have the goal to deliver all this care in a warm, faith-based environment in care settings across the region. jminda@chausa.org

March January 1,2024 2022 CATHOLIC HEALTH WORLD 7

KEEPING UP PRESIDENTS/CEOS

ADMINISTRATIVE CHANGES

Trinity Health of Livonia, Michigan, has announced these changes: Dr. Norvell “Van” Coots is retiring this month as president and CEO of Holy Cross Health in Silver Spring, Maryland; and Lorraine Lutton will retire in April as president and CEO of Mount Carmel Health System in Columbus, Ohio.

Terika Richardson to senior executive vice president and chief operating officer of CommonSpirit Health.

Michael Scialdone to senior vice president and chief financial officer of Hospital Sisters Health System Scialdone

Men’s health From page 1

prioritizing it, working to understand it and responding to it. Several experts from such ministry sites and affiliates urge health care providers to approach men’s health differently than women’s health to ensure men get the care they need.

“It’s really difficult to get guys to care for themselves and to prioritize their health,” says Dr. Chris Funes, president of Health Leaders Network ACO, the value-based care arm of Funes Franciscan Missionaries of Our Lady Health System.

Funes says the medical system “has to meet men where we are. We have to do this with intentionality. We have to give men alternatives” for how they access care.

Numerous interconnected issues Ministry and ministry-affiliated experts have similar and additional concerns to those raised in the Healthy People analysis.

Funes says hypertension, diabetes and mental health are top concerns for men, as revealed by data from Health Leaders Network.

Dr. Kevin McVary, who founded the Men’s Health Center at Loyola Medicine in Maywood, Illinois, in March 2020, says many of the conditions that put men at great risk are interrelated, including diabetes, sleep conditions, urological conditions, gastrointestinal disease and sexual dysfunction.

Dr. Kevin Enger, a urologist with SSM Health St. Joseph Hospital — St. Charles in Missouri, says that prostate cancer is a significant risk for men.

Aaron Perry, CEO and founder of Rebalanced-Life Wellness Association of Enger Madison, Wisconsin, says that all of these concerns, as well as heart disease and stroke, endanger men. He notes there is a particular threat to Black men. “The data says that Black men’s health is in crisis,” he says.

SSM Health has partnered with RebalancedLife to open Men’s Health & Education Centers at Perry barbershops in the greater Madison area.

SSM Health also has partnered on delivering care to men who are clients of the centers and of health care sites operated by Rebalanced-Life.

Biological, behavioral risk factors McVary says men’s increased vulnerability when it comes to morbidity and mortality is because they are both biologically and behaviorally more prone to disease and injury than women. For instance, males tend to be risk takers, feeling they are “bullet-proof,” he says. Data shows men tend to smoke at greater rates and to be much more likely to have car accidents and be killed by guns than women.

Additionally, men tend to ignore or deny that they have health problems, McVary says.

Funes adds that it is common for women to be the ones in the household who con-

of Springfield, Illinois.

Julie D. Keese to vice president and chief financial officer for Holy Cross Health of Silver Spring, Maryland, and for the Maryland region of Trinity Health.

GRANT Avera Health has received a three-year, $950,000 grant from the U.S. Department

of Justice to increase access to trained sexual assault nurse examiners for victims of interpersonal violence. The grant funds both virtual and in-person training for nurse examiners as well as a nurse examiner preceptorship program and trauma-specific training for mental health professionals.

The grant also will fund additional support services and resources for victims.

Providence raises awareness about men’s mental health concerns One aspect of the men’s health crisis that is gaining increased attention is mental health.

Providence St. Joseph Health focused on the concern on International Men’s Day, Nov. 19. That day had the theme of “Zero Male Suicide.”

In a blog entry, Providence says that men are nearly four times more likely than women to commit suicide.

The blog entry contains insights about this and other aspects of the mental health crisis for men, from Tyson Payne, Providence medical director for psychology.

He notes that many men and women experience similar mental health concerns, with both having pronounced issues with depression and anxiety. However, often societal attitudes say that women should talk about their feelings while men should not. This can lead to unexpressed feelings and shame for men.

Payne says that it is important for society to normalize the idea that men struggle with mental well-being just like women do. Society should normalize men connecting with others and talking about their feelings rather than isolating themselves.

Normalizing a healthy response to men’s mental health is a goal of the Zero Suicide Initiative that Providence started two years ago. As part of this effort, Providence primary care providers screen their patients for depression and suicide at regular intervals.

Providers also emphasize that it is good to talk about such concerns rather than isolating. Providence encourages providers to follow up with patients experiencing mental health concerns, to point them toward support.

The blog entry can be accessed at shorturl.at/eERY6.

tact health care providers, schedule medical appointments and seek screenings. He laughs at the fact that even though he is a physician, he relies on his attorney wife to schedule medical appointments and had to be prodded by her to get necessary medical screenings.

McVary says that men in lower-income brackets often have worse health conditions than affluent men and also more barriers to seeking care. For instance, they may have difficulty getting time off from work to seek care.

Perry says many of the Black men that Rebalanced-Life’s health care sites serve are financially strapped. Many are uninsured and can’t afford to pay for health care out of pocket. Some don’t have reliable transportation, so they must take public transit. Some have had to show up very early to medical appointments because

Dr. Kevin McVary, at left, consults with colleagues at Loyola Medicine in Maywood, Illinois. McVary is the founder of Loyola’s Men’s Health Center.

they took public transportation, and then they’ve been called out for loitering outside those medical facilities.

Perry adds that many Black men have felt unheard by clinicians, or they don’t trust care providers, so they avoid the health system entirely, potentially leaving untended health problems to fester.

Location, location, location Funes says it has been key for Health Leaders Network to understand men’s care avoidance and counter it through persistent outreach. For instance, if male patients have not sought care on the recommended schedule, a care management team member will contact them to help make the needed appointments. Primary care providers are prompted to check in with their male patients during office visits to ensure they are getting recommended screenings.

The providers also explain to those patients why the screenings are so important and how easy they are to set up. There is follow-up to ensure the men completed the needed screenings.

The FMOLHS facilities are increasingly offering video appointments and providing home monitoring equipment for men with schedule and transportation barriers.

Funes explains, “It has taken a change in mentality — recognizing that we are not just caring for the willing.” For those who are reticent to seek care, he says, “it’s our responsibility to reach them.”

Outreach and education have been a priority for SSM Health’s Enger as well.

His office has helped to arrange prostate screening education events. He has presented on the importance of cancer screenings at churches and other venues. And he strongly encourages his patients who have survived prostate cancer, as well as their family members, to “evangelize” to others about how important screenings are.

The Men’s Health Center that McVary helped to found in suburban Chicago also values outreach. Its team is very active with educational messages about men’s health on social media and through direct messages to patients. The center also has been hosting men’s health seminars in-person and over livestream that have been well attended by men and women, and that have

led to many men seeking care.

McVary notes that it was important in the development of the center to think about it differently, since it was for men.

To ease access barriers, developers chose a location away from the bustling Loyola Medicine campus — in a more suburban area with free parking and proximity to major thoroughfares.

The Men’s Health Center has been so successful at drawing men in and easing their health care access that another facility in the Loyola Medicine network, MacNeal Hospital, plans to replicate the model.

Loyola Medicine is part of Trinity Health.

McVary notes that the Men’s Health Center is looking to expand its services beyond its current location, which is in a relatively affluent part of greater Chicago.

He says it is a priority for the center to make sure that these types of tailored services are not just available to people with means.

Trusted places Providing access to people with lower incomes was a top priority when Perry’s Rebalanced-Life began partnering with SSM Health in 2016 to open men’s health education outposts at Madison-area barbershops. Perry says he wanted to set up the shops where men who lacked health care access were during their daily routines.

Rebalanced-Life since has helped set up three health education centers at barbershops. The organization also has opened two free health clinics and a dental center and provides behavioral health care in the community.

Perry, who is a national advocate on Black men’s health, says it’s been heartening to him to see men return to the health care system and get the attention they need for their medical concerns.

The key is that “we’re going to the locations where the men go,” he says. “We’re going to places they trust and feel safe in.

There, guys are very willing to open up and talk about their health problems.”

Visit chausa.org/chw to learn about a Bon Secours Mercy Health location that also is using barbershop outreach to connect with men. jminda@chausa.org

8 CATHOLIC HEALTH WORLD January 2024

IN BRIEF HSHS St. Mary’s to undertake $90 million renovation HSHS St. Mary’s Hospital in Decatur, Illinois, is moving forward on a $90 million renovation. The construction will update clinical spaces, improve patient room amenities and enhance the patient experience, says a St. Mary’s press release.

The project includes four new state-ofthe-art operating rooms. Other updates include a redesign of clinical and nonclinical spaces as well as continued expansion of service lines, such as the newly added robotic navigation system for neurosurgery.

Renovations are planned through 2026.

Theresa Rutherford, president and CEO of St. Mary’s, says in the release that new operating rooms, a better layout, modern patient rooms and other improvements will increase the quality of patient care.

CHRISTUS Santa Rosa expands footprint to meet growing needs CHRISTUS Santa Rosa Health System is expanding its CHRISTUS Santa Rosa Hospital — Westover Hills campus in the

A rendering shows the four-story tower planned as part of the expansion of the CHRISTUS Santa Rosa Hospital — Westover Hills campus in San Antonio. The tower will have postpartum rooms, a newborn nursery, an obstetrics emergency room unit, adult intensive care beds, neonatal intensive care beds and a pharmacy.

fast-growing community of San Antonio.

Construction is nearly complete on a larger emergency department. The project consists of 16 additional private treatment

rooms, seven fast-track bays to treat less emergent cases, as well as CT, X-ray, and lab services within the department.

Construction also is underway on a new

Malawi From page 1

and run its first family medicine training program.

In 2021, the day after she arrived, two colleagues from the Mangochi hospital told her the facility that serves a rural population of about 1.5 million was out of sutures, so patients in need of lifesaving surgeries were being sent elsewhere. She grabbed three boxes of surgical thread from her unpacked suitcase and handed them over.

“That same night, 14 women had emergency C-sections,” McDonald says. “That’s 14 women and 14 babies whose lives were saved by one box of sutures.”

Bidirectional learning Hand-carrying basic medical supplies into a country of 20 million people with fewer than 1,000 physicians is a small part of Providence’s commitment to Malawi.

The centerpiece is helping to fund what amounts to a full-time faculty position at Malawi’s Kamuzu University of Health Sciences, the nation’s only medical school.

McDonald splits that faculty post with Dr. Jacob Nettleton, another Seattle-based family practitioner. Both spend one semester a year in Mangochi teaching medical students and health care leaders.

The pair also serve as clinical directors of a bidirectional education program for doctors in training from Providence and Malawi. Providence sends up to 14 U.S. residents to Mangochi every year for fourweek stays to learn how doctors there provide care in a low-resource setting and to offer mentorship to local medical students and other clinicians on principles of family medicine. Providence also sponsors up to three Malawian clinicians annually for a family medicine rotation in Seattle.

McDonald calls the two-way learning aspect of Providence’s Malawi program “critically important.” She believes care providers from both sides of the Atlantic gain insight from the exposure to radically different care settings.

“I’ve said many times that I will take U.S. residents to Malawi on the condition that the Malawian trainees get to come here,” she says. “If one of those things falls apart, the whole thing falls apart. We’re not going to do a unidirectional program.”

Supportive partnership The U.S. Agency for International Development reports that Malawi has made dramatic gains in health in the last two decades. Its advances include reducing infant mortality by more than half and the number of AIDS deaths by 73%.

A visiting U.S. resident takes a rest with the pediatrics team after morning rounds at the hospital in Mangochi, Malawi. Providence St. Joseph Health sends up to 14 residents to the hospital in southeastern Africa every year as part of a bidirectional education program. The system also co-sponsors a family medicine rotation in Seattle for up to three Malawian clinicians.

Still, with only one medical school, about 30 hospitals and a ratio of two physicians per 100,000 residents, the need for an improved health care infrastructure in Malawi remains evident.

Since 2017 Providence has partnered to strengthen Malawi’s health care system with Kamuzu University of Health Sciences, the Swedish First Hill Family Medicine Residency program and the nonprofit Seed Global Health.

Carrie Schonwald, director of global programs for Providence, explains that the overall goal of the system’s global efforts is to promote equity and resiliency in health care.

“The real work of global health is, first of all, to support community-driven initiatives and goals and, second of all, to do it in a way that builds out sustainability and capacity,” Schonwald adds. “Locally driven clinical training falls into that category, but only if it is meeting an identified need and done well.”

As part of ensuring that its global assistance programs promote sustainability and eschew dependency, Providence is one of the signatories of the Brocher Declaration.

Among other things, that pledge commits organizations to respect the culture and empower communities in the host country.

Hands-off assistance In Malawi, Providence providers get to

see the challenges and resourcefulness of their counterparts in a nation where the average annual salary is $640.

While on the rotation, the Providence caregivers mentor and train on Providence’s holistic approach to family medicine, but they don’t provide hands-on patient care since they lack Malawian medical licensing.

McDonald explains that the entire program is based on principles of decolonization and equity. “What I say to every resident before they come to Malawi is, ‘Imagine if a Malawian physician were fresh off the plane and walked into Swedish Hospital and just started laying their hands on patients, that would never happen, right?’”

McDonald notes. “Expat status does not make someone an expert.”

Even though their exposure to Malawian health care is hands-off, Providence clinicians report that the experience deepens their understanding of some aspects of care, such as tropical disease management, and strengthens their delivery skills for underserved populations.

From learners to leaders The Malawian physicians who come to Seattle get a six-week immersion in family medicine at Swedish. They also take part in a global health leadership program through the University of Washington and they become co-presenters at the annual Ameri-

four-story tower that will sit adjacent to the hospital. CHRISTUS expects the tower to be completed in 2025.

The 164,000-square-foot tower will accommodate 30 private postpartum rooms, a newborn nursery, a obstetrics emergency room unit equipped with private rooms, 44 new adult intensive care beds, 20 neonatal intensive care beds and an expanded pharmacy.

The Greg and Bekki Kowalski family, known in San Antonio for their culinary and hospitality services, demonstrated their support for the maternal fetal care program expansion by making a $1 million pledge.

Plans are also in place for construction to start next year on a fourth medical plaza just across from the main entrance of the CHRISTUS Santa Rosa Hospital —Westover Hills. This building will include an ambulatory surgical center to meet the increasing need for outpatient surgical services.

Additionally, CHRISTUS Children’s will add specialty pediatric clinics to the hospital campus next year.

can Academy of Family Physicians’ Global Family Medicine Forum.

McDonald says one of her main points of pride in the exchange program is that several of the 10 Malawians who have done Seattle rotations have moved into leadership roles in the family medicine department at Kamuzu University. “It’s just awesome to watch them go from first-year residents to now running and directing the department,” she says.

McDonald collaborated with colleagues in Malawi to start the postgraduate family medicine training program at Kamuzu University in 2015, just seven years after Malawi’s Ministry of Health recognized family medicine as a discipline.

She says her work in Malawi is “a huge lesson in gratitude and humility.”

“I just can’t say enough about how much I have learned and how much I’ve grown as a clinician, as an educator, as a human being,” she adds. “When you just see the incredible resilience and ingenuity and persistence of my Malawian colleagues who work in these incredibly difficult circumstances and yet keep showing up to work every day, it’s just completely humbling.”

Following founders’ path Providence’s assistance to Malawi, under the umbrella of Providence Global Programs, goes beyond educational exchanges and hand-carrying basic supplies across the divide.

The system also has provided five handheld point-of-care ultrasound machines to the Mangochi hospital and funded training on how to operate the devices for a core group who can in turn train others.

In addition, during the COVID pandemic when the caregiver exchange was put on hold, Providence redirected its funding to the building of a medical skills simulation lab in Malawi to train clinicians on lifesaving techniques. Since 2021, the system also has worked with Catholic Relief Services to improve water, hygiene and sanitation across Malawi.

Schonwald says of Providence’s work in Malawi and in other parts of the globe: “Our true mission and our calling in this incredible organization is to follow the footsteps of the Sisters of Providence and St. Joseph to serve beyond borders, to serve alongside communities, to partner deeply in community-led initiatives, and to do that always with the idea in mind of decolonization, not to further the inequities that systems have developed to perpetuate for a very, very long time.” leisenhauer@chausa.org