An extended family cares for patients at an SSM Health hospital in Wisconsin. Twins who are nurses tend to delicate newborns in the same neonatal intensive care unit where they were born at a Hospital Sisters Health System hospital in Illinois. They and other relatives who are colleagues share their stories about how working together brings a special joy to their lives. Pages 4-5
By LISA EISENHAUER
Family dynasties aren’t rare in Pierre, South Dakota. Cattle ranches, body shops, plumbing services and other businesses get passed down through generations. Brandt Becker says it’s no big deal that even in a town of about 14,000 he and his father, Eldon, are surgeons in the same place, Avera St. Mary’s Hospital.
The Beckers are one of the newer dynasties. Eldon came to the capitol city right out of residency in 1989 and stayed. He grew up in North Dakota and broke a
‘Gaming
Guy’ entertains, refocuses patients to smooth their roads to recovery
By VALERIE SCHREMP HAHN
When Jacob Solis comes into a patient’s room at CHRISTUS Children’s in San Antonio with his cart of video games, their eyes brighten.
They know he’s there to distract them, challenge them, relax them or get them moving. Solis is the hospital’s first and only gaming and technology specialist, a role he has had for almost a year.
“Just seeing how they light up once I finish the gaming session, or even when I walk into the room, they just get all excited,” he says.
Continued on 7
‘Forgotten mourners’ Bon Secours program helps kids cope with grief
By VALERIE SCHREMP HAHN
Eruptions are meant to happen inside the volcano room.
Kids who enter the space on a church campus in Newport News, Virginia, can vent their emotions by bouncing on mini trampolines, throwing balls, jumping on pogo sticks, and smacking pool noodles on the floor to make a satisfying “thwack.” They also can drag around an oversized stuffed doll named Max.
“He’s bigger than me, and they can just absolutely beat him up,” said Ariane Walter. “And they love that.”
Walter is the bereavement and volunteer coordinator for a group called KIDZ’NGRIEF, a ministry supported by Bon Secours Mary Immaculate Hospital in Newport News, part of Bon Secours
By DALE SINGER
When 12-year-old Abigail was diagnosed with acute lymphoblastic leukemia, she and her family had to deal with not just serious health implications but long periods out of school, missing out on learning and being with friends.
“Just laying in your bed and watching TV is not always great,” said her mother, Elizabeth Martin. “You need to get up and get that body moving and get your brain moving.”
Abigail and other patients undergoing long-term treatment at Covenant Children’s Hospital in Lubbock, Texas, can ease
the boredom and inactivity in a special schoolroom built by the hospital. It is modeled after an effort at another Providence St. Joseph Health location, Sacred Heart Children’s Hospital in Spokane, Washington. The educational liaison there, Anna E. Christensen, said the hospital realized that medical attention is not the only need for
children undergoing long-term treatment and care.
“They’re here in the hospital,” she said. “They can’t attend school due to chemo, and they’re having huge gaps in their education. So that’s why this program was designed.”
At St. Joseph’s Health Hospital in Syracuse, New York, more than a dozen staffers in the Women and Infant Service unit have given birth since October or will soon.
By DALE SINGER
By abandoning the use of a drug designed to help heal patients but that harms the environment, Ascension hospitals hope to help heal the planet.
The culprit is desflurane, one of a family of anesthetics that has harmful environmental effects. The American Society of Anesthesiologists says that of all inhaled anesthetics, desflurane lasts the longest in the atmosphere — more than 14 years. In terms of greenhouse gases, it is 2,400 times more potent than carbon dioxide.
Comparatively, similar anesthetic gases such as sevoflurane and isoflurane have a much smaller impact on the environment.
Overall, federal officials say, health care is responsible for 8.5% of the nation’s carbon emissions.
Dr. Thomas Aloia, executive vice president and chief operating officer at Ascension, said such numbers made hospital officials take a hard look at possible action to ease any harmful effects, particularly from desflurane.
“I think over the past 10 years we’ve realized that it has an extremely outsized impact on the environment,” he said. “All of these gases are unfortunately pretty inefficient, meaning the amount of gas that goes to the patient is much less than the amount that just escapes the system and leaks out into the environment.”
Aloia said for sevoflurane and isoflurane the potential environmental effects are minor, but desflurane “can have an outsized impact on our ozone.”
“We have the other two gases,” he added. “They’re perfectly safe, perfectly effective. Desflurane doesn’t bring anything unique to the table. So we endeavored to eliminate it.”
Planning for the desflurane phaseout began in 2022, with the actual initiative beginning a year later and the eventual elimination achieved in 2024.
Mercy Medical Center in Cedar Rapids, Iowa, spotlights its advancements and achievements as part of the celebration of its founding in November 1900.
A Trinity Health hospital in southeast Michigan installs a vending machine that dispenses — at no cost — boxes of the medication that can reverse opioid overdose.
waste across all of our sites — effectively a net zero carbon footprint for Ascension, which is a significant aspirational goal.”
Other health care organizations also are phasing out the use of desflurane. Also in 2024, Providence St. Joseph Health noted in a blog post that it had “massively reduced its emissions from anesthetic gases like desflurane and nitrous oxide by 78%.”
Efforts to eliminate the use of desflurane are applauded by Gwyneth Jones, associate director of sustainability solutions for the group Health Care Without Harm. “If you’re in a position where you are involved in taking action to reduce your emissions, which we hope everybody is, then it’s a question of what’s easier than the other things, right? What are the low-hanging fruit?” Jones said. “Our opinion is that anesthetic gases are relatively easy.”
With suitable alternatives available, she added, stopping the use of desflurane is a sensible step to take, in terms of the environment as well as health.
“We’re seeing a real movement of health care professionals — doctors, nurses, all sorts of clinical folks and nonclinical folks — who are coming to understand the role that health care plays in terms of negative effects on the environment from the emissions of the health care sector itself,” she said. “When you work in health care, your primary mission is to care for and improve the health of your patients. So there’s a realization that through the practices of how we provide health care, we sometimes are actually harming our patients.”
Only a small portion of inhaled anesthetics such as desflurane are metabolized by a patient. The remaining exhaled gases become waste emissions that are vented out of the hospital and into the atmosphere. These waste emissions are greenhouse gases. Compared to other anesthetics, desflurane has a much higher greenhouse gas warming potential. It also stays in the atmosphere years longer.
COVID,” Jones said. “It’s cash-strapped in a lot of places. So there are a lot of challenges, a lot of competing priorities. Some folks are much more engaged in this work than others. The good news is that the number of folks engaged in this work and thinking about it is growing.”
Next steps from Ascension
At Ascension, Aloia said, the next target for easing environmental effects is nitrous oxide, the anesthetic commonly referred to as laughing gas.
“We’re not looking to eliminate it but there are two different ways you can deliver it, and one of them has much less environmental impact,” he said. “So it’s more of a logistical change in the delivery mechanism. It is not an elimination effort, but we think it will have multiples more impact than the desflurane did.”
He added that besides rethinking the use of anesthetics that may cause harm, other areas also are receiving attention.
“There are myriad opportunities for recycling of medical devices and other equipment and putting them in the proper receptacles that do engage our workforce and our frontline health care providers,” Aloia said.
Ascension has work groups that are addressing two other topics: waste diversion and healthy communities. VanOsdol said all three work groups are focused on “resiliency, environmental and health equity and community engagement.”
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For Ascension overall, said Thomas VanOsdol, executive vice president and chief mission integration officer, desflurane is a small but key part of a systemwide, multidisciplinary focus and commitment to responsible environmental stewardship and caring for creation in the spirit of Pope Francis in his 2015 encyclical Laudato Sí … On Care for Our Common Home
“This year marks our 13th year of our overall environmental impact and sustainability program that will lead us toward our vision and our objectives for 2030 and 2040,” he said. “The big goal in 2040 is to achieve net zero carbon emissions and net zero
That mindset is growing particularly among younger generations, Jones said.
“With millennials and Gen Z, there are lots of studies that show they’re much more focused and aware and concerned about environmental impact as they take on more roles in the workforce,” Jones said. “They’re also pushing their organizations to have more of a focus on their environmental impact.”
She noted efforts such as the international Race to Zero climate action campaign and other programs that are scientifically based. And, she added, they come at a time when health care is facing a range of challenges.
“The health care sector has a lot of financial constraints, especially coming out of
VanOsdol said Ascension isn’t pursuing its climate initiatives alone. “We’re working very closely with our partners across the Catholic Health Association in this work and sharing information broadly and have co-presented at various symposia, etcetera,” he said.
He noted that Ascension also is a founding member of a consortium of U.S. hospitals called the Health Care Climate Council that is focused on environmental impact and sustainability.
Aloia said there is one driver behind Ascension’s environmental efforts. “This work is completely linked into our mission,” he said, “because we know that any adverse environmental impacts will disproportionately affect vulnerable populations in our communities.”
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By JULIE MINDA
A partnership that CommonSpirit Health and Morehouse School of Medicine launched in 2021 already is making headway in ticking up the nation’s count of aspiring clinicians. Many of the students and residents are of diverse backgrounds and are in the pipeline to a medical career through the More in Common Alliance.
According to CommonSpirit, the alliance will increase medical education opportunities for more students from populations underrepresented in medicine, including those who are Black, indigenous and people of color or who are from rural areas. A goal is to help Morehouse medical school double undergraduate enrollment and increase the number of postgraduate residency and fellowship slots. Ultimately the partners want to increase the number of students recruited from communities experiencing a provider shortage.
The partnership is increasing the number of students in each cohort at Morehouse School of Medicine from 125 to 225. The partnership also will establish regional medical campuses at three CommonSpirit facilities and plans to potentially add one more. The partnership has also launched a graduate medical education program at a CommonSpirit hospital and plans to add such programs at six more of the system’s hospitals in the future.
Dr. Veronica Mallett, chief administrative officer of the More in Common Alliance, says the partnership holds promise to improve health care delivery over the long term, particularly by increasing the number of physicians who are attuned to the needs of diverse populations. She says this “really aligns with the vision of CommonSpirit Health of providing the healing presence of God in the people we serve — especially those vulnerable populations — through a lens of social justice.” She says the partnership also is aligned with Morehouse’s vision, “which is about leading the creation and advancement of health equity to achieve health justice. And so, the partnership’s strength really comes from the shared affinity of their mission, vision and values for taking care of these historically marginalized populations.”
Capacity-building
The More in Common Alliance resulted from a chance meeting in 2019 between then-CommonSpirit CEO Lloyd H. Dean and Dr. Valerie Montgomery Rice, president and CEO of Morehouse medical school. Spurred by their mutual concern about the lack of diverse clinicians in the U.S. and the resulting negative impact on care access, they worked with their respective organizations to create the alliance. That effort officially launched about three years ago. CommonSpirit operates 142 hospitals in 24 states. Morehouse medical school is part of Morehouse College, one of the nation’s historically Black colleges and universities. Together, CommonSpirit and Morehouse have contributed about $115 million
toward their More in Common Alliance and are fundraising for additional dollars.
The alliance is using some of the dollars invested by CommonSpirit to erect new facilities on Morehouse’s medical school campus in Atlanta to accommodate the growing cohorts of students and the programming expansion happening as a result of the alliance’s work.
Also, the alliance is establishing regional medical campuses at CommonSpirit’s CHI Memorial Hospital in Chattanooga, Tennessee, with Morehouse School of Medicine students having started rotations in 2021; at Virginia Mason Franciscan Health in Tacoma, Washington, in 2022; and at CHI Saint Joseph Health in Lexington, Kentucky, in 2022; and plans to establish another at Bakersfield Memorial Hospital in California. These regional medical campuses will begin recruiting students from populations in their vicinity that are underrepresented in medicine, including students from rural areas and from racial and ethnic minority populations. Working with Morehouse, these hospitals bolster the undergraduate programs of colleges and universities in their communities to prepare students for the rigors of medical training. After completing their undergraduate education, selected students will get their medical education at Morehouse and then return to their home communities to complete clinical training at their local CommonSpirit hospital.
Through a separate program, multiple CommonSpirit hospitals are working under Morehouse’s sponsorship to establish themselves for the first time as teaching hospitals. Dominican Hospital in Santa Cruz, California, launched its graduate medical education program in the summer. Bakersfield Memorial is preparing to start one this year and Bakersfield Mercy Hospital in 2026. Other sites slated to start graduate medical education programs at a to-be-determined date are St. John’s Regional Medical Center in Oxnard, California, and CHI Memorial Hospital in
Chattanooga. Morehouse School of Medicine has become the sponsoring institution for California Hospital Medical Center in Los Angeles, and CHI St. Vincent Hot Springs in Arkansas so that these established residencies benefit from the expertise provided by the Morehouse medical school.
In connection with the capacity expansions, Morehouse and CommonSpirit are partnering on developing faculty, recruiting students and building up the capabilities of “feeder schools” that can help prepare students for medical training. Morehouse and CommonSpirit also are organizing their facilities into a research-focused network. The network members will help each other to mine data for research and initiate and/ or participate in studies.
Dr. Chrissa Karagiannis is a member of the inaugural class of eight residents training in family medicine at Dominican Hospital, through the More in Common Alliance. She says she’s wanted to be a physician since she was a child, when she witnessed the lifesaving impact of doctors when her grandmother had a stroke.
Karagiannis completed her undergraduate and osteopathic medicine studies close to home in the San Francisco Bay area. During medical school, she became aware of the More in Common Alliance. She says she was instantly interested because of the alliance’s focus on cultivating a diverse pool of residents with a passion to serve vulnerable people. She also liked that the residency would expose her to many care venues. “I prayed that I’d get a match” with the program, she says, and was thrilled when she was selected.
She says the medical staff and other colleagues at Dominican have welcomed her and her fellow residents warmly. She is rotating through every medical depart-
ment of the hospital and in one of its clinics, where she has a panel of patients she sees under her attending physicians’ supervision.
She says she’s building leadership skills and is excited to be among the trailblazers in a new residency program.
Fresh faces
Dominican President and CEO Dr. Nanette Mickiewicz says the program already is benefiting the hospital and promises to be a boon to Dominican and its surrounding community well into the future.
She says the residents are inspiring innovation among the medical staff, they bring a new energy to the campus, and they increase continuity of care for more patients. This is because the residents can see patients both in the inpatient environment as well as in the clinic environment for follow-up care upon discharge.
In the long term, Mickiewicz expects that some of these residents will want to practice in the community where they’ve trained. She says this will help alleviate a critical physician shortage. She notes there is a high cost of living locally so it is difficult to recruit and retain primary care and family medicine physicians, who are paid less than specialists.
Mickiewicz says that in recent years, Dominican has found that many Latino residents have suffered disproportionately negative health outcomes, and that is likely because they distrust the medical system. The very diverse class of residents now serving at Dominican includes Latinos as well as physicians like Karagiannis who grew up locally. Mickiewicz expects community members will be more trusting of clinicians who are from the community or who have a similar background.
Mallett says research shows that concordance between providers and patients improves the relationship.
She has high hopes for the communities where the alliance is active. “Maybe for the first time in a patient’s life they will have a provider who has the same language, the same culture as them. There is an implicit trust that comes from a knowledge of a shared background,” she says.
Karagiannis has witnessed this dynamic firsthand. While she is not Latino, she does speak Spanish, and she has seen that using her second language has improved her relationships with Spanish-speaking patients. She believes patients have a greater understanding of what is said in an appointment when the physician speaks their language.
“I have seen how much it means to patients” to have a provider who they can truly connect with, says Karagiannis. “I’ve seen that us residents are a diverse team, and we work well with the underserved. We truly care about increasing access to medical care. We truly care about improving the health of the community.”
jminda@chausa.org
By VALERIE SCHREMP HAHN
A recently published report calls for change in the way people conduct themselves within global health partnerships and offers practical suggestions.
The Uganda National Academy of Sciences produced the study, called “Enacting an Ethic of Care and Responsibility in Global Health Partnerships.”
The report calls for people worldwide to recognize the “interconnectedness of our global health.” It draws six conclusions and makes six recommendations, including
calling on global health leaders to establish clear communication channels, cultivate shared decision-making, and establish a learning and growth mindset.
Bruce Compton, senior director for global health for CHA, was part of a committee of professionals from around the world who researched and wrote the report. Compton calls the report “a huge win” because its recommendations align with CHA’s “Guiding Principles for Conducting Global Health Activities.”
Compton and several others involved in the study discussed the report during
a webinar in December. Compton talked about his background supporting health care in Haiti. He spent many visits over several years sorting through massive amounts of donated items to identify usable goods from junk.
“It was awful, but I’ve spent the last 25 years ... trying to create an environment where we change those realities,” he said. “And this document, I think, is a real point in time where I feel like we are at the cusp of something real.”
global director for health, nutrition and population, said during the webinar that “cooperation and collaboration is a must. It’s not something that you choose, (it is) something that you have to pursue if you really are serious about achieving the end result.”
Scan to read an extended version of this story.
Juan Pablo Uribe, the World Bank’s
Katthyana Genevieve Aparicio Reyes, a program officer with the World Health Organization, said: “By investing in relationships and building trust, we can turn shared goals into shared successes.”
By VALERIE SCHREMP HAHN
Tawnya Heredia never tires of hearing good things at work about her daughter, Sienna.
“When she first started, they’re like, ‘Wow, she’s so mature, and she handles situations so well. She’s just really confident,’” Tawnya says.
“I can’t do anything under the radar,” Sienna Heredia jokes.
The mother-daughter duo are nurses on the same floor in different medicalsurgical units at PeaceHealth St. Joseph Medical Center in Bellingham, Washington. Tawnya has worked there almost five years; Sienna about four.
They often don’t see each other at work unless they make time for a coffee break.
“It’s really fun to have someone in my family understand what’s going on, and
By JULIE MINDA
Dr. Michelle Flechas knew when she was in high school that she wanted to be a doctor someday. Several friends’ dads were physicians, and, seeing her interest in the medical field, they invited her to shadow them. Years later, during residency rotations, she “fell in love with pediatrics,” she says.
For 27 years, she’s practiced in outpatient pediatrics with Our Lady of the Lake Regional Medical Center in Baton Rouge, Louisiana. She is currently in the hospital’s Pediatrics at Perkins physician office. Our Lady of the Lake is part of Franciscan Missionaries of Our Lady Health System. As of August, in the office right next door is her daughter, Dr. Meaghan Smith. With a grandmother, grandfather, father, mother and aunt all having worked in the medical field, a passion to serve people through health care seems to be in Meaghan’s genes.
Like her mom’s, Meaghan’s interest in
“
It’s really fun to have someone in my family understand what’s going on, and to be able to debrief, because it’s not easy work all the time.”
— Tawnya Heredia
to be able to debrief, because it’s not easy work all the time,” Tawnya says.
“She’s really good at pep talks, and she’ll just dive right in, which I’m not as good at,” says Sienna.
Tawnya was born at St. Joseph. When she was 19, she gave birth to her son Isaiah there, and at age 20, Sienna. It was tough being a young mom, but she and her husband, Misael, stuck it out. She became a medical assistant and for 20 years ran a clinic, where Sienna and her brother often hung out.
“I really can’t remember a time in my life that I didn’t know that I was going to be a nurse,” says Sienna, 27.
find balance in work, parenting, hobbies
By LISA EISENHAUER
Already united by marriage and parenthood, orthopedic surgeon Tara Moncman and neurosurgeon Ryan Moncman were determined to find a way to sync their work lives.
The doctors joined Holy Cross Medical Group in August. The physicians’ group is part of Holy Cross Health in Fort Lauderdale, Florida, a member of Trinity Health.
The Moncmans started dating in 2016, when they were resident physicians at separate hospitals in Philadelphia. They met through Ryan’s roommate, a friend from medical school, who was in the same program as Tara.
Their first post-residency positions were in Orlando, but with different employers. When they were recruited for positions in other cities, the pair — by then married and raising a daughter — made it clear they were a package deal.
medicine was cemented when she was in high school. All her life, she’d accompanied her mom on rounds, so she has always been very comfortable in the medical setting. But when her sister fell ill with ulcerative colitis when Meaghan was in high school, Meaghan was touched by the
She went to nursing school at Eastern Washington University.
She wasn’t sure if she wanted to work elsewhere or come back to Bellingham, in the state’s northwest corner. Her mother had finished nursing school herself, started working at St. Joseph, and encouraged her daughter to apply.
Tawnya thinks God has guided her path. She uses her experiences, including her 100-pound weight loss through diet and exercise, to influence others.
“I think he divinely placed me in this profession so I can actually go to work every day and make an impact in people’s lives,” she says.
Sienna sees divinity in her career path, too: She met her fiancé when his dad was one of her patients.
The wedding is set for the end of June.
Last year, mom and daughter were featured in a video as part of PeaceHealth’s Women of Peace movement to honor and support female caregivers.
“I think people know us, and they know the energy we bring,” Tawnya says. “Whatever we need to accomplish that day and whatever is thrown our way, we’re gonna get through it. Tomorrow’s a new day.” vhahn@chausa.org
care and compassion physicians showed her sister. She wanted to have a healing impact on people someday, too.
Having grown up with a physician mother and psychiatrist father, Meaghan says she knew what to expect in medical school and was not as shell-shocked by the grind as some of her classmates. And now that she has graduated and is practicing in the same office as her mom, she likes that she can use her as a resource when she needs help.
Michelle and Meaghan laugh that the medical field gene seemed to have skipped Flechas’ son — he gets sickened by all conversations his family members have about illness and disease.
Michelle says she has loved her career in pediatrics. She’s found that there is a lot of joy treating children, and she says it’s very gratifying to build relationships with families. In some cases, she’s had three generations of a family as patients.
The Flechas family is close even when the mother-daughter physician duo is not at work — Meaghan and her family have moved into her parents’ neighborhood.
Meaghan and her husband — who himself is a physical therapist — are now expecting their first child. So, the Our Lady of the Lake network may see another member of the Flechas family tree in the physician ranks someday. jminda@chausa.org
“We both said we’ve been in school far too long for either of us to really sacrifice what we wanted, so we have to kind of find the perfect match,” Tara recalls.
Holy Cross proved to be the right fit. It checked the box for being in the south, away from the chilly Northeast where they’d spent most of their lives. And it provided the work-life balance both prioritized.
“I would say, comparatively to our last job, it’s incredible,” Ryan says. “Our quality of life has improved significantly.”
The couple’s paths cross often, sometimes by happenstance when they are both rounding but more often by design. “Mostly he just likes to come in and give me a hard time while I’m operating,” Tara jokes.
The Moncmans plan their weekend on-call shifts together. On those days, they bring their 3-year-old daughter, Margot, along and hand her off to each other as they check in on patients. With another child on the way, they soon will be doing double handoffs.
In addition to living and working together, the Moncmans share a passion for fitness. Tara is a distance runner. One year, she ran ultramarathons in Antarctica, the Gobi Desert in China, the Sahara Desert in Egypt, and the Atacama Desert in Chile. Ryan’s sport is golf. He was a scholar athlete in college.
Tara says Ryan told her when he proposed that he would not be joining her on marathons, and he has held true to that.
During the COVID pandemic, Ryan got Tara hooked on his sport. Now they also hit the links together. “He likes it, because that just means we get to play more often,” Tara says. leisenhauer@chausa.org
By VALERIE SCHREMP HAHN
By their mere presence, nurses Zoey and Justine Obert give hope to the families they serve in the neonatal intensive care unit of HSHS St. John’s Hospital in Springfield, Illinois.
The Oberts were born in the same hospital 23 years ago, nine weeks premature. They weighed 2 pounds, 15 ounces each.
“We try to take breaks with each other. We pack a lunch together. We usually try to get shifts together,” says Justine.
While the twins look alike, their family never learned if they were fraternal or identical. They wear different hairstyles and glasses to help patients and co-workers tell them apart, but that doesn’t always work.
Families of babies find it fascinating when they learn the two are twins, Justine says, asking the sisters to stand next to one another or coaxing the pair to help prank their own relatives.
Besides the fun of working together, they can serve as an example. “We’re one of the success stories,” she says.
Zoey marvels that she gets to “initiate care for a new life that hasn’t been touched by anything at this moment in time. Yes, they look so fragile, but at the same time, they have such a will to live.”
When their mother, Jody Obert, was pregnant, she got devastating news: her baby had spina bifida. She received a blessing from people at their Catholic church in Liberty, Illinois.
The next day, she and her husband, Jeff, learned that the baby didn’t have spina bifida; instead, she was pregnant with twins. Soon she checked in at HSHS St. John’s Hospital, nearly 100 miles away, for preeclampsia. Not long after, the girls were born.
“I will say St. John’s definitely saved our mom’s life,” says Justine.
From a young age, the twins knew they wanted to go into health care. Both of their parents did volunteer work. The girls loved to babysit. “We knew that helping others was what we were meant to do,” says
From page 1
family tradition of business and ranching to become a physician.
After earning degrees in engineering and biology in college, he toyed with the idea of life in a big city. He and his wife decided it wasn’t for them. When he finished his medical training, he accepted a position in Pierre and the family settled in.
By JULIE MINDA
It’s a good thing that pediatric nurse Sarah Schroeder gets along with her family, because every day she goes to work at SSM Health Monroe Hospital in Monroe, Wisconsin, chances are she will run into a relative.
Her dad, Dr. Charles Kind, is a podiatrist; her mom, Theresa Kind, is a physical therapist; her brother, Jacob Kind, is a telemonitor technician on the medicalsurgical unit; her husband, Bryan Schroeder, is a nurse in the intensive care and med-surg units; and her father-in-law, Eric Shroeder, is a multi-modality imagining technician. Sarah Schroeder’s other brother and his wife are podiatry residents, so even more family members someday could be joining the SSM Health Monroe team.
Charles and Theresa met on a blind date decades ago when Charles was in medical school and Theresa in physical therapy school. After they married and started a family, their children learned through them about the joy and pain of working in health care. The younger generation became accustomed to being in the health care setting, and they in time decided to themselves join the field.
Theresa jokes that while the family enjoys chatting together about their work, “sometimes at holiday dinners, it gets to be a little bit of overkill with all the foot talk,” especially now that two more family members are pursuing the podiatry field. The family laughs that it can get to be a little much when the podiatrists start pulling out their phones to share their foot pictures with everyone.
Theresa says a benefit of having so many family members in health care is that they all understand what each other is going through — they understand the need for flexible schedules and that many family
members will have to work on holidays and weekends.
Bryan says having so many family members in health care was especially appreciated during the worst of the COVID pandemic. He was working in the ICU when the pandemic hit, and it was an extremely stressful time to be stationed in that department. “My family understood, when others didn’t,” he says.
Eric adds, “Yes, there are happy stories we have in health care, but there is also the stuff that is on the other side. And we can talk each other through the traumatic things we experience.”
jminda@chausa.org
““ Zoey marvels that she gets to “initiate care for a new life that hasn’t been touched by anything at this moment in time. Yes, they look so fragile, but at the same time, they have such a will to live.” Visit chausa.org/chw to view a slideshow of some
Justine.
They both graduated last year from St. John’s College of Nursing, which, like the hospital, is part of the Hospital Sisters Health System. They interviewed for one open position. But since they both interviewed so well and hospital administrators loved their story, the hospital created another position.
“They’re pretty proud of us,” Zoey says of their parents. “They actually feel like it was a calling for us. Our dad always laughs, he’s like, it’s fitting for you to be where you started.”
“I feel like God is always gearing us toward the right direction,” Justine says. “We just have to listen.” vhahn@chausa.org
“It’s kept me here because of the sense of community and the relationships,” Eldon says.
Brandt fondly recalls as a boy mowing the lawn at the clinic where Eldon saw patients and tagging along as his father rounded. He says the whole family took in stride the demands that a doctor’s duties in a smallish community put on all of them.
He joined his father at St. Mary’s in 2013, never giving much thought to any other profession. “I think it was just really always
Theresa jokes that while the family enjoys chatting together about their work, “sometimes at holiday dinners, it gets to be a little bit of overkill with all the foot talk.”
kind of there,” he says. “It wasn’t like I woke up one day and decided, well, yep, I want to go do this. It was just so much a part of Eldon’s life that spilled over to our lifestyle. It was natural.”
Medicine is an even bigger part of Brandt’s family life than it was Eldon’s. Eldon’s wife is a retired teacher. Brandt’s wife is a nurse for an ear, nose and throat specialist at St. Mary’s.
Brandt says Pierre, situated on the Missouri River and near massive Lake Oahe, is
something of a sportsman’s paradise. The natural beauty is a draw for father and son, who hunt and fish. “I think it’s an unknown until once you’re here,” Brandt says. “You wouldn’t think that we have the water resources that we do.”
Another anchor for the Beckers in Pierre is Avera’s mission to provide whole care for body, mind and spirit. “It fills our cup,” Eldon says. “It’s what gives us joy, and we receive by giving.” leisenhauer@chausa.org
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Hampton Roads, and Bon Secours Hampton Roads Foundation. KIDZ’NGRIEF provides grief support for children ages 3-18 who have suffered a death loss, as well as groups for adults who bring children to the program that meet simultaneously. The group also holds a camp for grieving kids called Mikey’s Camp every November.
“I believe, and I’ve seen that evidence anecdotally, that children are much healthier when they deal out loud with their grief,” said Beth Pile, who
“Harvey, juggling his wife’s estate and other family issues, didn’t have a lot of money to spend on mental health care. “So I looked around, I said, ‘There’s got to be some community resources for this.’ And I came across KIDZ’NGRIEF,” he said.
Harvey said his son has improved emotionally over the years. “And I’m not one to actually talk too much about what’s going on in my personal life, but you know, later on, after a few years, I was able to actually talk about my issues as well,” he said.
The program also has helped him talk to his son and validate the boy’s feelings. “So very often, I’ll just have this nice, candid conversation with him and understanding that if he starts to get emotional about it, I understand where it’s coming from,” Harvey said. “I’m not going to tell him, ‘Buck up.’ I’ll be able to talk him through it and even tell him how I feel.”
Yasmiere “Yaz” Burke, 19, started coming to KIDZ’NGRIEF when she was 12 after her father died of cancer. She now volunteers as a “big buddy” for kids during Mikey’s Camp, which she attended herself. Mikey’s Camp is named for Pile’s late Burmese mountain dog, who was a therapy dog for the kids.
The kids say something, and we just repeat it back to them, which sounds weird, but once you see it in action, it’s kind of amazing. They just start sharing more and more, and you just keep repeating it, and they just keep going and going. It’s like they feel heard, maybe for the first time.”
about 20, with a few more who can step in and substitute. The facilitators commit to a year of service, but some have stayed with the program for years.
Many families hear about the program through school counselors. The group meets twice a month at a church in Newport News. The program is free and there are no geographical boundaries for attendees. “If they can get to us, we’re happy to have them come,” Pile said.
“It was the best part of the year,” Burke said of camp. “Just finding people around you at such a young age that understood you. You go to school and everybody is talking about, ‘Oh, I hate my dad.’ I wish he was in my life.”
She recalled when she was younger, she returned from camp and told her mother: “Mom, dad’s favorite color is blue.” Her mom asked why she said that.
Some people drive an hour and a half to attend sessions.
Last fall, an offshoot after-school program started at three area elementary schools.
Validating emotions
— Ariane Walter
Alex Harvey attends adult meetings while his 12-year-old son attends the ones for kids. When his son was 5, the boy’s mother, Harvey’s estranged wife, died from a firearm accident in a car. Harvey’s son and stepdaughter were in the car at the time.
Burke explained that the camp gave her time to reflect. “Being a constant place where it’s OK to think about your loved one that passed away, it allows you to remember things that you wouldn’t remember in the constant speed of life,” she said.
She added: “When I go into these spaces with these kids, and they’re opening up and they’re telling their story, and they’re telling me their sister loved to go swimming, it reminds me, oh, my dad’s favorite color is blue, and we used to love to go fishing together.”
vhahn@chausa.org
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In Lubbock, where Kaitlyn Bigham joined the staff last spring as a teacher, the job soon became a calling.
“They’ve got so many patients that are falling behind in school because of the oncology treatment and dialysis treatment,” she said, “and they were looking for someone that could help keep them on track as best as possible while they’re going through that treatment. I was just floored. That’s the kind of work that I’ve always wanted to do, just helping kids and giving back to families. I told them that they would have to fire me to get rid of me. This job is God’s work.”
The newly refurbished room on the third floor of the Lubbock hospital is designed to provide long-term patients with educational support and enrichment, including tutoring. Dr. Amy Thompson, Covenant Children’s CEO, said the program grew from concerns that chronic patients too often were having academic problems because of their lengthy absences from school.
“They were either failing a grade, which is not good for them because that takes them out of their peer group,” Thompson said, “or they were not failing a grade but just going on to be unprepared for the next grade above them.”
She knew that Sacred Heart in Spokane had experience in helping such patients stay on track academically, so she went on a tour there. “We walked in,” she recalled, “and I was like, this is the problem that we’re trying to solve — how do we keep these kids on grade level?”
A big part of the answer, Thompson said, was to raise more than $2 million for operational support and renovation of a space on the hospital’s pediatric floor that became
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“It really helps to turn how they’re feeling around.”
Is he the most popular guy in the hospital?
“They call me The Gaming Guy,” Solis responds. And he says they ask other hospital staffers: “When can I see The Gaming Guy?”
Solis’ position is sponsored by Child’s Play Charity, a nonprofit based in Seattle that seeks to improve the lives of children and teens in hospitals through gaming. The organization funded the first pediatric gaming and technology specialists in children’s hospitals in 2017 and now supports 49 gaming technology specialist positions. It has almost 200 hospital partners worldwide. It funds the specialists for two years with the expectation that the hospital will take over after that. Other Catholic hospitals that have a gaming specialist include Elizabeth Seton Children’s Center in Yonkers, New York, and Dell Children’s Medical Center, an Ascension hospital in Austin, Texas.
Child’s Play also offers an online therapeutic video game guide focused on how to be more intentional with choosing specific games for a child.
Solis makes use of games known to help with anxiety or quell boredom and others that can distract from pain. Some patients might need to sit still for an hour while undergoing treatment, so nurses will ask him to play games while the patient sits in a chair. Other patients might need to move, so Solis might get them to walk to the teen
a classroom, complete with a library and science and technology equipment for students to exercise their minds rather than surrender to the boredom that extended medical treatment can bring.
“I know every kid in the world dreams of being able to stay home and play as much Xbox as you ever wanted to play,” she said, “but our chronic kids are like, ‘Oh my gosh, I’m so sick of playing games and watching movies.’”
Thompson added that the kids like the educational support because they don’t fall behind classmates and because of the socialization they get with their teacher.
In Spokane, Colleen Fox, who is chief philanthropy officer for Providence in the Inland Northwest, called the educational effort the passion project of a pediatric oncology social worker, who tracked patients and their families even after their medical treatment was finished.
Fox noted that feelings of isolation and discouragement can be hard-to-treat side effects of long-term hospitalization.
“A lot of kids said, ‘Well, I beat cancer, but I’m failing at life’ because they had these long gaps in education and they were deal-
lounge, where gaming systems are set up, or play an interactive dancing or virtual reality game.
Kirsten Carlile, the senior director of philanthropy and partner experience for Child’s Play, says the use of gaming technology caught on at children’s hospitals during the COVID-19 pandemic, and hospitals have figured out how to deal with firewall and privacy issues. Now, Child’s Play has a waiting list of funding requests for gaming technology specialists.
“So we have to go and actually work with the hospital to say, ‘Are you ready? What do you have for gaming and tech? What are you using?’” Carlile says.
She points out hospitals can use gaming and technology like MRI goggles to distract and keep patients still so they need less sedation, or physical therapists can get kids moving while playing a Wii game. “We’re using (gaming) in ways that are taking the pharmacological interventions away for pediatric, which is huge,” Carlile says. “It’s changing the patient experience, but it’s changing the hospital throughput as well.”
A day’s work
Solis, 38, graduated college with a degree in business administration and a certification in cybersecurity. He has worked as an emergency medical technician and as a program leader for the Boy Scouts of America. He’s loved video gaming since he was 4 and had dreamt of playing or making video games for a living.
“I love working with children, and this was like coming back to work with children again,” he says. “The job sounded great, but it’s also a blessing to help children who are in need during their difficult times here at the hospital, to help them with their stay and to give support to the medical staff.”
ing with the side effects of their chemo and their treatment,” Fox said.
She said the $250,000 annual cost to support the education program comes from local business donors as well as the nonprofit Children’s Miracle Network Hospitals. Sacred Heart has a teacher and a teaching assistant, as well as volunteers who will help kids with coursework as needed.
Close cooperation with area schools is a key to the program’s success, Fox said.
“We do that rather than start our own separate school, because every child that comes to our hospital has a unique situation and a unique treatment time,” she said. “They really wanted to be able to individualize the educational program for different kids at different stages. They’ll work with the school counselors and the teachers to give accurate assessments of sort of what’s been completed, where kids are at academically.”
Fox said the hospital keeps track of the patients involved in the program, to see if the additional help has improved their academic progress. So far, results have been promising.
“I know of at least four students in high school who were getting so far behind that there was just no way they were going to be able to complete traditional high school on time,” she said. “They were able to get their GED while they were in school, so that when they are through treatment, they still are able
A typical day starts with checking the referrals from the team of about 10 child life specialists at the hospital. They will talk to patients and their families to see if they might benefit from a gaming session with Solis.
Solis sees about four or five patients a day for gaming sessions that last 30 to 90 minutes. He helps with other projects, such as fixing a gaming console or making use of a 3D printer. He’s in high demand, so he tries to set up sessions with patients twice a week. If he’s not available, and in the evening and on weekends, patients can use a gaming cart, visit a teen gaming room or play in a kids’ zone.
“I have seen some patients who are the same age and encourage them, like, ‘Hey, let’s go downstairs and let’s play together. Let’s get a group game going, like Mario Kart or Minecraft or Fortnite,’” he says. The activity cheers patients up, helps form friendships and builds morale.
The hospital has gaming systems that the patients can keep in their rooms, and Solis has a gaming cart with Nintendo Switch, Xbox, PlayStation, and a VR Oculus for older children and teens. Patients are provided with a secure user account.
Solis communicates with other hospital gaming specialists through a Child’s Play account on the messaging platform Slack, where they bounce around ideas and suggestions. He asked for other specialists’ advice on a weekly video gaming show he started in June, called Game Time with Jacob, that plays on the hospital’s closed circuit television network. During the program, Solis gives viewers tips and tricks on the games available at the hospital and talks to them about games as he plays.
“I try to make it entertaining,” he says. “Sometimes, I host with patients, too. One
to have that accomplishment and be able to kind of move forward with their lives.”
Abigail’s future
In Lubbock, Abigail is in the last stage of her treatment, with a projected end date for chemotherapy of July 10. Her mother said the special emphasis on keeping up with her schoolwork has played a key role in her recovery.
“Right now, she is testing negative for leukemia,” Martin said. “So everything that we’re doing is to prevent the leukemia from coming back.
“She’s on what’s called modified homebound, enrolled in a middle school where she goes as her body is able. It’s kind of fluid. Based on her needs, if she’s able to go to school, then that’s where we have her. If she’s having a lot of pain that day or she’s sick, we have her at the house with a homebound teacher provided by our district. She’s a seventh grader and she is academically on track, so that’s a huge blessing.”
Martin added that what the hospital education effort does goes beyond book learning.
She said her daughter has been helping other kids who have the same diagnosis by “talking through it with them and let them know that it is scary in the beginning, but that they can do it and there’s people there that will help them.
“She’s had to grow up a lot,” Martin said of Abigail. “But she also has seen the benefit of what people have poured into her and she wants to pour into others, so I’m grateful for that.”
In the Covenant Children’s classroom and beyond, Martin said her daughter has been surrounded by a nurturing environment.
“I am so grateful for Covenant and her care team,” Martin said, “from the child life specialists to the schools, to the doctors, to the nurses. Even the custodial and cafeteria staff come in and check on her. It is definitely a place where healing happens for the whole child, not just the physical but the emotional, the spiritual, the mind, the body — all of it. They do wraparound care, and that classroom is a huge part of that.”
patient wasn’t able to leave the room, so I set up the gaming show in his room, and we played Minecraft together and we made a show. It’s a great experience for patients who would like to do something new: host a game show and play video games for everyone to watch.”
Some patients play with their parents and Solis gives them tips, too. He prides himself on being an expert.
“When they play with me, I make it interesting. I know the game,” he says. “I talk to them about video games, and sometimes I make it challenging for them, so they want to play more to maybe beat me, or we team up on a hard video game.”
And, yes, if he thinks the patient would gain confidence or benefit from the encouragement of winning, he lets them. But that’s tough sometimes, he jokes.
Solis says doctors and other caregivers are “thrilled” and also “just shocked” to have him on staff. “A lot of doctors and nurses don’t know how to play, and the patients will ask them questions, and they say, ‘I don’t know,’” he says. “They love that I come and help them or show a few things.”
Caregivers also are grateful that Solis can help distract and support patients if they need to get a shot or have an IV placed. He encourages other hospitals that don’t employ gaming technology specialists to investigate the benefits.
“Some patients are just not feeling so well, and they’re not in the mood to play,” Solis says. “But to get them to cross that line and to play — it’s challenging, and it’s very rewarding for them and me. It’s a great blessing.”
vhahn@chausa.org
By LISA EISENHAUER
Dr. Ray Moreno, chief medical officer at Providence St. Vincent Medical Center in Portland, Oregon, was part of a state task force charged with coming up with ideas to address hospital discharge delays.
In November, the Joint Task Force on Hospital Discharge Challenges released a 105-page report with its nine recommendations on how to address challenges the report says persist “as hospitals serve an aging population with growing needs for mental health, addiction, and housing supports that the traditional post-acute care model was not designed to address.”
Moreno spoke with Catholic Health World about the work of the task force. His answers have been edited for length and clarity. Providence St. Vincent is part of the Providence St. Joseph Health system.
How did you come to be part of the task force? I was nominated, and I was happy to be. I think the reason they tapped me on the shoulder was in September 2022 I had the opportunity to talk about the impact of discharge delays on hospital capacity at an Oregon Senate hearing. I had been looking at the data on length of stay, collaborating with many Providence colleagues. As we were looking at the data, there was this staggering realization that the impact of patients stuck in the hospital was very, very large.
How significant a concern has hospital discharge been for Providence facilities in Oregon? We looked at a year’s worth of data spanning September 2022 through August 2023. We were looking at how long patients are staying in the hospital that is longer than is expected. There’s a certain amount of expected time based on their conditions, ages, the complaints that they come in for. When you add the extra time across our eight Providence hospitals, it was 5,700 extra days per month.
If the expected average length of stay for a patient is about five days, you take that 5,700 days and divide that by five, that gives you over 1,100 extra patients that you could care for a month, if you could solve
Nine
Update eligibility processes and workflows for long-term services and supports.
Waive or streamline asset testing for long-term services and supports.
Increase support for legal guardians.
Refine the regulatory framework to support complex care.
Expand medical respite statewide.
Engage coordinated care organizations and dual-eligible special needs plans.
Update reimbursement methods for adult foster homes.
Extend the post-hospital extended care benefit to up to 100 days.
Leverage existing initiatives to develop the post-acute workforce pipeline.
this global problem of people being in the hospital longer than expected.
What do you see as the major factors that are driving discharge delays? Some patients are truly very complex, medically, and sick, for sure. That’s part of it. But the eligibility assessment and approval for long-term services and support take a long time, so that accounts for some of the delay. Sometimes there are simply no places that have space. Sometimes patients don’t have their own decisional capacity, and there’s not an identified person who has that capacity. It can take months for someone to get an Oregon-appointed state public guardian.
What do you see as the task force’s key recommendations? One that I think is important is updating the eligibility process and the workflows for obtaining long-term services and support. The eligibility assessment has two parts — a medical/ functional assessment of what the patient needs to help them with their daily living and a financial assessment. By statute, there are 45 days that that assessment can take if you’re in a hospital. That’s 45 days that patient could be waiting in the hospital. So there was a lot of support on the task force for streamlining that process.
Another recommendation that I think
will be impactful is having Oregon Health Plan (the state’s version of Medicaid) increase skilled nursing coverage from 20 days to 100. That would capture many patients who are kind of stuck.
Any other recommendations that stand out? I think there are a couple of things that you could broadly lump together, under the heading of fixing the economics. For example, during the pandemic, when we were particularly constrained, there was a hospital decompression initiative. For a period of time, the state said to our adult foster homes, we know that it’s difficult to take care of sick people with multiple things going on in a system that was designed a couple of decades ago for folks that weren’t as sick. So the state had a one-time incentive of, in addition to the regular payment, an extra $10,000 — $5,000 up front, and $5,000 in the future, if that patient was still living with them. It was amazing. At that price point, these places were able to pull extra resources and staff into their facilities. And we saw a moment of rapid decompression of the hospital.
It’s very clear that we have to figure out how to have a contemporary model of reimbursement for the various places that take care of people after the hospital in a way that is affordable and reflects the cost of taking care of folks who are too complex to be at home, but not complex enough to be in the hospital.
By LISA EISENHAUER
Health care systems and hospitals need to have response plans at the ready in the event of a cyberattack, including how to get clear, timely and factual information to the public and to patients, says Jon Conradi, a veteran crisis communicator.
“Failure to address a crisis can, of course, result in operational response and communications breakdowns, longer turnaround to bring about full resolution and mitigation of the issue, negative impact on long-term reputation and actual harm to being able to provide care,” Conradi warned during a discussion in early December for communications staffers from across the Catholic health care ministry. CHA sponsored the online discussion.
As a partner at the firm PLUS Communications, Conradi leads public affairs campaigns, provides strategic counsel and manages media relations for clients, including national organizations.
Conradi noted that health care is “an industry that is so often targeted by cyber criminals and other bad actors online.”
Handled well, Conradi said, the communications response to a cyberattack can even become an opportunity to frame the system’s response in a positive light. He said that can be done by spotlighting the system’s quick and thorough action to counter the attack, its efforts to inform the public and to protect anyone affected, and its cooperation with law enforcement to find the source of the attack.
To stay in the know, Conradi said it is vital for communicators to be in the room when others are detailing what occurred and making decisions about how to respond.
Conradi stressed that communicators must stick to verified facts as they release information on a cyberattack. “You don’t want to get ahead of your skis and put out something that then later has to be corrected or walked back,” he pointed out.
He also emphasized the need to have a ready go-to online site that can be activated as a clearinghouse for public- and patientfacing resources.
Angie Longing to president of CHI St. Vincent Morrilton in Arkansas. She will continue as chief nurse executive for the CHI St. Vincent Arkansas market, which covers CommonSpirit Health’s facilities in central and southwest Arkansas. Longing succeeds Bubba Arnold, who retired in September.
Providence St. Joseph Health and organizations within Providence have made these changes:
Dr. Darryl A. Elmouchi to Providence St. Joseph Health chief operating officer. He replaces Erik Wexler, who became Providence president and CEO Jan. 1. Cindy Mahal to chief administrative officer of Providence St. Joseph Medical Center in Burbank, California.
Scott Foster-Edwards to chief executive of Providence Clinical Network’s Puget Sound region.
Mila Sprouse to Providence Swedish North Puget Sound chief nursing officer. In this role, she will oversee nursing at Providence Regional Medical Center in Everett, Washington, as well as at the Swedish Edmonds hospital and Swedish Mill Creek facility, which has an emergency department and outpatient care.
Organizations within Ascension have made these changes:
Dr. Richard Fogel transitioned from his role as Ascension executive vice president and chief clinical officer to the new role of chief health outcomes officer Jan. 1. He will retire on June 30.
Ascension Senior Vice President and Chief Medical Officer Dr. Thomas Aloia succeeded Fogel as EVP and CCO. Ascension is undertaking a search for a new system CMO to succeed Aloia.
Kevin Bruce to chief administrative officer at Ascension Saint Thomas Hickman Hospital in Centerville, Tennessee.
Stay silent
Delay notification of public/affected parties
Dismiss patient/ public concerns
Hide information
are delivering a consistent message
Prioritize patient communications, directing them toward resources as needed
Provide a strict timeline for resolution until you have all the necessary information
Cast blame until you know for certain the cause of the cyber incident/ data breach
Organizations within Trinity Health have made these changes:
Julie Edmunds Smith to chief financial officer of Trinity Health New York.
Maggy Perez-Dickens to president of Holy Cross Medical Group. She also will be on the Holy Cross Health senior leadership team. Holy Cross is in Fort Lauderdale, Florida, and is part of Trinity Health.
Dr. John Mohart to executive vice president and chief operating officer of Chesterfield, Missouri-based Mercy.
Dr. Brent Meier to SSM Health northern Wisconsin region clinical vice president and market physician leader as well as vice president of medical affairs for St. Agnes Hospital in Fond du Lac and Ripon Community and Waupun Memorial hospitals.
» For more Keeping Up, go to chausa.org/chw