By LISA EISENHAUER
The system was formed in 2000 when the Sisters of the Presentation of the Blessed Virgin Mary of Aberdeen and the Benedic tine Sisters of Yankton Sacred Heart Mon astery combined their sponsored health ministries.AveraHealth opened Avera Mental Behavioral Health in 2006 in Sioux Falls, South Dakota, putting its mental health inpatient and outpatient care on par with its medical services. Earlier this year, the cen ter, now the Avera Behavioral Health Hos pital, added a four-story wing with several new services including 24/7 mental health urgent care, residential addiction care ser vices for youth and a day hospital program for Asyouth.ithas broadened access to men tal health services, Avera Health also has
“She inspired us through her visionary and principled leadership and was a constant source of joy to everyone around her.”
He points out that most of the subsidies
Sr. Mary Roch Rocklage’s visionary ministry spanned more than six decades
By JULIE MINDA
By LISA EISENHAUER
Research has shown that rural populations in the U.S. have health vulnerabilities that set them at higher risk of shortened lives, as compared with their suburban and urban counterparts.
The health ministry and career of Sr. Rocklage, affectionately known as “Sr. Roch,” spanned more than 60 years. It started when she was a staff nurse at a Sis ters of Mercy hospital in St. Louis and con tinued through her pivotal role establishing and leading Mercy.
Sr. Mary Roch Rocklage, RSM, the found ress of Chesterfield, Missouri-based Mercy health system, died Aug. 23, at 87, following a lengthy illness.
Rural hospitals explore how best to expand care access
Ministry executives applaud passage of major legislation, still wish for more
Sr. Mary Haddad, RSM, CHA presi dent and chief executive officer, said: “Sr.
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Three executives who run Catholic hospitals in rural communities fear the health status of the populations they serve could worsen because many people are more reticent to seek in-person care than they were before the pandemic, perhaps fearing COVID-19 contagion or the cost of obtaining care.
As health care delivery systems have waxed and waned in their commitment to mental health care over the decades, Avera Health and its predecessors have remained steadfast in efforts to increase access to — and reduce the stigma of — mental health care in rural areas.
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The Inflation Reduction Act addresses climate change by offering incentives to expand the use of clean energy, such as that generated by wind turbines like these in Livermore, California. In its many provisions, the act also addresses health care access and costs.
Roch shaped health care in this country at a time when women had little voice. She influenced many by her visionary leader ship and passionate commitment to create
Divining new approaches to address these and other challenges is a priority.
Providence Clinical Academy 5 Holy Name Honey 8 SSM Health staff embrace Ukrainian refugees 3 Continued on 2
Avera hotline gives stressed clinicians a place to vent, access treatment
Large numbers of nurses have been leav ing their jobs at hospitals, long-term care campuses and other health care facilities to accept high-dollar positions with nurse staffing agencies or to transition to other jobs that have better schedule flexibility andThepay.pandemic exodus has left health care facilities short-staffed and overly reli ant on the same outside labor contractors that recruited away their nurses.
To help restore staffing equilibrium and sanity, health care facilities have been seek ing to understand more about why nurses are leaving. And they are using that intelli gence to develop new programs and offer ings that incentivize nurses to stay, and that attract new recruits.
While executives within the Catholic health ministry agree there’s much to cel ebrate in the Inflation Reduction Act, the measure signed Aug. 16 by President Joe Biden left a few of their hopes at least tem porarily dashed.
Donald H. Lloyd II is president and chief executive of St. Claire HealthCare in Morehead, Kentucky. With 159 beds, St. Claire is the largest rural hospital in Eastern
KetchikanPeaceHealthMedicalCenterisacriticalaccesshospitallocatedinacountyofabout13,700peopleinsoutheastAlaska.Ruralhospitalscareforpopulationsofpeoplewhoareatgreaterriskforpoorhealthascomparedwithpeopleinsuburbsorcities.
“This is a tremendous loss for Mercy and
A Mercy staffer uses the Mercy Works on Demand app, which allows nurses to pick up extra shifts at Mercy hospitals.
describe his reaction to the act as “bub bling, overflowing enthusiasm.” Neverthe less, he is disappointed that the measure doesn’t provide any financial support for nonprofit hospitals like those within his sys tem that have been financially drained by the demand for COVID-19 care and by the spike in labor costs.
all who loved Sr. Roch,” said Steve Mackin, Mercy president and chief executive officer.
Mike Slubowski, president and chief executive of Trinity Health, says he would
Catholic morenurses’innovatesystems,healthfacilitiestoanswercallforflexibility
Sr. Mary Roch Rocklage, RSM
“We are listening to the voice of nurses and creating programs to respond,” says Robin Johnson, chief nursing officer at Bon Secours Memorial Regional Medical Center in Richmond, Virginia.
By JULIE MINDA
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‘Choosing rent over medicine’
Dr. Bryan Miller is physician executive with Franciscan Missionaries of Our Lady Health System and interim president of FMOLHS’ Northshore market, which includes Our Lady of the Angels Hospital in Bogalusa, Louisiana. He said Our Lady of the Angels has seen a dis turbing decrease in people accessing care, and it also has seen an increase in concerns related to hunger, housing and employment.
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According to a CHA policy brief, rural hospitals and health facilities confront the challenge of serving an increasingly vul nerable and diverse community stretched across a wide geographic service area, while also facing staffing shortages.
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The increased need coupled with the ris ing cost and challenge of operating a hospi tal and other health care facilities in a rural community have “left health care provid ers with difficult choices,” such as discon tinuing services or closing sites, the white paper said. Exacerbating the situation are the decreasing investments in rural health infrastructure generally and a health care reimbursement scheme that is incompat ible with the exigencies of providing care in ruralTheareas.National Rural Health Associa tion said in its 2022 Policy Agenda that the pandemic has ravaged rural practices financially, disrupted rural economies and eroded care access, creating what that asso ciation calls “medical deserts.”
Lloyd
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Retaining gains
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St. Claire established mobile hotspots in parking lots at its Morehead medical pavilion and four of St. Claire’s rural clin ics and invited patients there. St. Claire staff went to patients’ cars with iPads to facilitate patients’ visits with physicians and other clinicians.Additionally, St. Claire provided tele medicine care to COVID patients recuper ating at home after a hospital visit. Through the COVID Care at Home program, patients
Clay O’Dell, a CHA director of advo cacy, said not only is it important for gov
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St. Claire in Appalachia also has seen a falloff in use of outpatient care. Outpatient visits dropped by 35% in the initial stages of the pandemic. While visits are returning to prepandemic levels, “we still see very acute clinical conditions as a result of patients delaying care,” Lloyd said. St. Claire is start ing a marketing campaign to try to convince them to Lloydreturn.said St. Claire and other rural providers are engaged in critical work. The community members that rural providers care for are very often poor, marginalized and disenfranchised from the socioeco nomic resources that people in suburban and urban areas enjoy.
from The Catholic Health Association
with moderate symptoms of COVID were discharged from the emergency depart ment with medications and medical equip ment to manage their condition from home. St. Claire’s postacute care team managed their care through virtual appointments, phone calls and access to on-call providers.
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“Our parish is telemedicineimpoverished,veryandisnotworkingforeveryone.So,we’redoingallwecantomakesurethatfinancialissuesarenotareasonpeoplearestayinghome.”
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— Dr. Bryan Miller
Nestled in the foothills of the Appala chians, St. Claire developed a creative workaround early in the pandemic when it found that many community members did not have the broadband connections at home that they needed to link with St. Claire’s cli nicians online.
Associate Editor Julie 314-253-3412jminda@chausa.orgMinda
To address the concerns, Our Lady of the Angels opened a seven-day-a-week urgent care clinic and plans to open two more.
Frontline staff work in one of St. Claire HealthCare’s medical-surgical nursing units. The integrated health system is based in Morehead, Kentucky, an Appalachia community of about 7,000 people. Many in its 11-county service area struggle with socioeconomic stressors and health care access.
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Fast ramp-up
The ministry hospital executives inter viewed for this article said while they expanded telehealth capacity during the pandemic more infrastructure expansion work is Whenneeded.COVID-19 shut down — or sig nificantly decreased access to — in-person care, the federal government provided money to expand telemedicine technology by building broadband infrastructure. This comes on top of significant gains that have been made in broadband coverage in rural areas in the past decade. Nevertheless, rural patients are considerably less likely than city dwellers to have broadband service at home that would support telemedicine appointments via video. According to a Pew Research Center survey in early 2021, seven in 10 rural Americans have a home broad band connection.
Dori Stevens, chief administrative offi cer of PeaceHealth Ketchikan Medical Center in Alaska, said it was because pay ers allowed for the reimbursement of tele medicine that rural providers were able to use technology so much to patients’ advantage. Peace Health is advocating to retain those allowances, so providers can build upon theirInprogress.itsrural health policy brief, CHA said it supports the “continuation of the telehealth flex ibilities and financing provided during the COVID-19 pandemic as well as increased investments in broadband and point-ofservice telehealth technologies to ensure greater access to care especially for individ uals living in rural areas.”
It also has created a “clinician care part ners” team that follows up with patients with pronounced socioeconomic chal lenges and helps address those concerns. For instance, they ask if the patient has reli able transportation and problem-solves if the person does not. Our Lady of the Angels has been expanding its partnerships with local social service agencies to provide aid to patients in need.
Kentucky. Lloyd said rural facilities like St. Claire “are so important to the communities they serve.” He noted that, like many other rural hospitals across the U.S., St. Claire was founded to be a safety net hospital and continues that mission to Currently,today.about 80% of its patients are insured under Medicaid or Medi care. “We have very narrow margins, and we are under constant financial strain, but we can pay the bills, and we meet the needs of our population,” said Lloyd.
Judith 314-253-3410jvandewater@chausa.orgVandeWater
Prioritizing health care access to rural populations is essential to the ministry’s mission to promote health equity and con tinue to care for the poor and vulnerable, LloydVisitsaid.chausa.org/chworld to learn about financial challenges in rural health care.
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Sicker
But even the best technology will be use less if people are not trying to access care.
ernment agencies to make permanent the emergency authorizations that allowed telehealth to thrive during the pandemic — it also is important for those agencies to allow for flexibility on the part of providers. He said there are various types of technol ogy that health care providers have been using to increase access to care for patients, including teleconferencing, Skyping, tele phone service and texting. He said all of these can be valuable links between provid ers and patients, and reimbursement poli cies should reflect that.
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Miller believes these phenomena of decreased care seeking and increased per sonal struggles are interrelated. “My biggest concern is that overall volumes are soften ing, we’re not seeing the same volumes as pre-COVID, perhaps because of the finan cial strains in the country. I believe people are choosing rent over medicine.”
The CHA brief said rural communities have higher rates of suicide, smoking and obesity, and less access to healthy food options than urban and suburban areas. Rural dwellers are more likely than urban ites to die prematurely of heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke. CHA’s anal ysis is based on data from the Centers for Disease Control and Prevention.
He said he is concerned people may not be coming to appointments because they can’t afford gas. “Appointment no-shows are over 20% in the outpatient environment and climbing. Our parish is very impov erished, and telemedicine is not working for everyone. So, we’re doing all we can to make sure that financial issues are not a rea son people are staying home.”
Stevens
are OK,” she says. “I feel like there might be more people who need it, and we are hop ing that they will be able to work here soon.”
Even though they qualify for some gov ernment assistance as refugees, Selivanova says her family isn’t applying. “For now, we
Early on, she seldom slept while she stayed in touch with her family eight time zones away as they hunkered down in their hometown of Cherkasy, about 120 miles southeast of Kiev. They took shelter during air raids in a cellar with only enough room for the four of them to sit.
On its website at chausa.org/global-health/Ukraine, CHA offers information on programs and support being provided by Catholic agencies and partners to Ukrainians impacted by the war.
Llewellyn says the adults in the fami lies she is helping are similarly determined to find work while they decide whether they want to apply to stay indefinitely in the United States or return to Ukraine. She is hopeful some of them could eventually land jobs at St. Mary’s once they have work permits.Thehospital has given gift cards to the families and her colleagues have rallied around them with financial and other sup port. Friends from Llewellyn’s church have done the same, as have strangers from acrossTheMadison.children, who are ages 4-12, are attending Charis Classical Academy, a private Christian school co-founded by a friend of Llewellyn’s. The school and the parents of other students are covering the tuition of the Ukrainian children.
When Canada announced a visa program for Ukrainian refu gees, Selivanova helped her fam ily apply. By the time those visas came through, the United States had opened up a similar program so her family was able to change their destination to Madison.
Yana Selivanova, second from left, has made room for her mother, father and her brother and his fiancée at her apartment since they fled from Ukraine and reached her in Madison, Wisconsin. Selivanova, a pharmacy technician at SSM Health St. Mary’s Hospital — Madison, hadn’t seen her family since she left Ukraine on a student visa in 2013.
“I couldn’t believe it until I actually saw them in the airport,” Selivanova says. “It was our only wish — birthday wish, Christmas wish — for all nine years to finally meet.”
Another of Llewellyn’s friends, who is a certified English as a second language teacher, has volunteered his expertise to the families. Strangers have helped arrange swimming and soccer lessons for the children.“Things
like that, God just, it seems, answers immediately,” Llewellyn says.
‘We need to step up’
In addition to assisting the families in Madison, Llewellyn and her husband joined volun teers from a nonprofit Christian group in May on a weeklong trip to offer support to about 200 Ukrainian refugees in the Czech Republic.Therefugees were all con nected before the war through a Christian school in Kiev. The families the Llewellyns are help ing to resettle in Madison are part of the same group.
Llewellyn
“We have two little boys and they each had their own bedrooms in the new house and they probably stayed in their bedrooms for just a couple weeks,” Llewellyn says. “We put our boys in my husband’s office so that the families could have three bedrooms of theirTheown.”first refugee family who stayed with the Llewellyns have moved into a church parsonage along with two other Ukrai nian refugee families. The other family still lives with the Llewellyns. Llewellyn and her husband, Ben, an American whom she met while he was on a missionary trip to Ukraine, are helping support all four of the Ukrainian families — nine adults and nine children in Llewellyn,all.a native of Ukraine who works full time as a registered nurse in the mater nity department at SSM Health St. Mary’s Hospital — Madison, assists the families as they look for permanent housing, register their children for school, secure transporta tion, apply for work permits, learn to speak English and more.
September 15, 2022 CATHOLIC HEALTH WORLD 3
the garden,” she says. “They’ve just been very helpful and supportive.”
After Maria Llewellyn and her hus band bought the land for their new home last summer, they picnicked there and her husband prayed that the house would host manyShepeople.jokes now that per haps he should have been more careful about what he prayed for. Since moving into their house in Madison, Wisconsin, near the end of February, the couple have rarely been alone there with their boys. The Llewellyns have boarded two families of five from her native Ukraine, one after the other. Both families fled Ukraine after Rus sia invaded Feb. 24.
By LISA EISENHAUER
SSM Health staffers in Wisconsin host Ukrainians seeking refuge
With the war in Ukraine being eclipsed by other news, Llewellyn says she worries that Americans will forget about the ongo ing suffering of Ukrainians. “We need to step up and do what we can to help,” she says.Llewellyn was honored in June with SSM Health’s Presidential Coin. Laura Kaiser, the system’s president and chief executive, presented the award virtually. It recognizes the highest level of excellence in delivering SSM Health’s mission to reveal the heal ing presence of God through exceptional health care. Kaiser chairs the CHA Board of Trustees.
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In early March, they joined the mass exodus from Ukraine, crossing Moldova, Romania and Slovakia to reach Poland, where Selivanova says they planned to wait out the con flict and return home in a couple of weeks. The ongoing violence, however, prompted them to look for ways to get farther from Ukraine and closer to Selivanova.
Long-awaited reunion
Selivanova hadn’t seen her family since she settled in Wisconsin in 2013 after ini tially coming as a student and then getting a work visa. She says her decision not to return to Ukraine was influenced by Rus sia’s 2014 takeover of Crimea in Southern Ukraine. “I thought maybe I shouldn’t go back for some time to see how it’s going to turn out,” she says.
This photo taken by Maria Llewellyn, a registered nurse at SSM Health St. Mary’s Hospital — Madison in Wisconsin, is of the first meal her family shared with the Sokors. They are one of four Ukrainian refugee families the Llewellyns have welcomed and the second that has shared their home. Ben Llewellyn is at left and the Llewellyns’ two young sons are at right.
St. Mary’s pharmacy technician Yana Selivanova made room in her two-bedroom apartment for her parents, her brother and his fiancée. They’ve been living with her since the four managed to reach Madison from Ukraine at the end of May.
Listen to ‘Healthtwo-partCHA’sCalls’podcastepisodeontheCatholicresponseforUkraine.
Selivanova says support from her St. Mary’s colleagues has helped her cope with the stress of having her family in a war zone and then with making them comfortable in Madison. Her manager gave her extra breaks to check on her family in Ukraine, collect her thoughts and pray; other col leagues offered her moral support and brought her treats.
She’s tried to be something of a Ukrai nian ambassador among her friends and colleagues in Madison, happy to talk about her homeland’s history and traditions. The Russian invasion, however, has tested her usual optimism.
leisenhauer@chausa.org
Many staffing models launched dur ing the pandemic mimic what travel agen cies offer nurses, in terms of geographic and schedule flexibility. In most programs, nurses can self-schedule for shifts at hospi tals in multiple geographic areas, but within the same health system.
tion equivalent to the one they are in, but in another Trinity Health facility. The sys tem has 88 hospitals, 131 continuing care locations and a network of other sites in 25 states.
Meeting individuals’ needs
The executives say that using hybrid in-person/virtual teams comprised of cli nicians with a mix of experience levels enables the systems to staff for efficiency because the virtual teams can plug in where and when they are needed. Also, says Tre panier, it helps retain seasoned nurses. He explains that many nurses had been leav ing bedside nursing because of the heavy physical demands and the difficulty of meeting patients’ care needs while keeping up with administrative tasks. In virtual work assignments, the nurses do not have those physical demands and they are not pulled between bedside care and paperwork.
The nursing executives say some top reasons nurses cite for leaving the profes sion is that they are burnt out and that they do not feel safe, in large part because vio lence toward staff is increasing. Systems have been giving more attention to these concerns.Providence has taken numerous steps, including installing panic buttons in some locations and having more officers patrol with canines in emergency departments. Canine patrols have been shown to reduce tension in health care settings.
Call
Worsening shortages of nursing pro gram faculty threaten to limit schools’ capacity to continue educating the number of students they have up to now, much less to increase how many students they can graduate. Health systems are exploring how to attract more nurses to teaching and more students to clinical professions.
Stacie Call is chief nursing offi cer for Mercy Health in the Lorain and Youngstown, Ohio, markets of Bon Sec
4 CATHOLIC HEALTH WORLD September 15, 2022
Dina Bush is vice president and chief nursing officer of the Intermountain Healthcare Peaks Region. It takes in parts of Colorado and Montana and includes eight hospitals. Bush says nurses who are interested in flexible postings participate in cross training so they can move fluidly among care sites in the service area. The program is called Internal Traveler.
Smoothing the way for student nurses
majority of documentation in the electronic medical record as well as coordinating dis charges to other levels of care or authoriza tions to receive home care.
Schedule flexibility
Bon Secours Mercy Health’s Nursing Flex Team operates as an internal travel agency for its nurses who opt to move within more than 30 hospitals in four of the states where the system operates. There are three tiers: in the first, nurses stay in one facility or community, moving between units or specialties; in the second tier, they can move within their region; and in the third, they can travel to any Bon Secours Mercy Health facility.
Its “My Health Matters” program encourages mental health check-ins among peers and provides additional men tal health resources to associates who are struggling emotionally. My Health Matters is part of No One Cares Alone, Providence’s mental wellness program for staff.
Bush Landstrom
In the system’s new extern program, nursing students follow a structured path to accepting a nursing position at a Bon Sec ours Mercy Health facility after completion of their clinical rotations. These students are
From page 1
Virtual nurse
The preparation to become a licensed practical nurse involves less academic rigor and less time than the education and train ing required to become a registered nurse, but the licensed practical nurse role can be a steppingstone to more education and advanced nursing licenses.
Trinity Health, Intermountain and Bon Secours Mercy Health are increasingly employing licensed practical nurses to sup plement in-person and virtual care teams.
coreNursesstaff. see only slots they are qualified for. The harder a shift is to fill, the more money Mercy offers from the outset to find a taker. It posts open shifts 14 days in advance.Togain entry to the gig-work nurse scheduling platform, nurses apply to Mercy and go through a screening process which includes an Developedinterview.byacompany called Trusted Health, the app and online platform allow nurses to slot themselves for up to 30 hours per week at the Mercy facilities that are on the platform. Mercy piloted Works on Demand in its Springfield, Missouri, market and has rolled it out to its other markets.
Trepanier
“We are listening to the voice of nurses and creating programs to respond.”
— Robin Johnson
CommonSpirit Health also has created an internal nationwide staffing agency to enable its nurses to work at CommonSpirit facilities in the 21 states where the system operates, according to Aug. 22 reporting in Modern Healthcare. The company has 140 hospitals.Chesterfield, Missouri-based Mercy has more than 40 acute care, managed and spe cialty hospitals in four midwestern states. This spring it began offering Mercy Works on Demand. This platform allows Mercy’s full- and part-time nurses to self-schedule for extra shifts before they are opened up a week later to nurses not part of Mercy's
Johnson
Nurses want flexibility
Registered nurse shortages that wors ened significantly during the pandemic will continue into the foreseeable future.
Betty Jo Rocchio, Mercy senior vice president and chief nursing officer, says of Works on Demand, “Nurses are telling us
Systems are trying new staffing models, inpatient telenursing, wellness programming
Chief nursing executives in Catho lic health systems have been addressing that hard reality in part by adapting staff ing models, by bringing telehealth nurs ing to inpatient care and by providing mental health resources to counter burn out. They’ve also devel oped additional programs to attract and train nurse graduates.Sylvain “Syl” Trepanier, Providence St. Joseph Health chief nursing officer, says it’s time to start build ing something new. If providers stick to the same model for the nurse work environ ment, staffing shortages will only get worse.
Providence, Trinity Health and Inter mountain Healthcare are among systems that have been honing virtual telehealth nurse teams to free up bedside nurses to concentrate on hands-on patient care. (SCL Health merged with Intermountain in April.)Though each system’s implementation varies slightly, the general idea is that hos pitals are assembling care teams that are a mix of in-person, bedside clinicians and cli nicians who are accessible to inpatients via telehealth.AtProvidence hospitals, a model cur rently under development has a nurse and certified nurse assistant working as a dyad at the bedside. Certified nurse assistants can feed and bathe patients and assist with other activities of daily living and can pro vide basic care under a nurse’s supervi sion. Each bedside dyad is assigned specific patients during their shifts. These dyads are supported by virtual team members includ ing case managers and registered nurses.
Outside nurses who use Works on Demand do not earn paid time off, nor do they qualify for health insurance or other benefits, but they can pick the shifts they want, when and where they want.
The scope of practice of licensed prac tical nurses varies by state, but generally speaking they provide more basic patient care including taking vital signs, adminis tering many medications, dressing wounds and attending to catheters and intravenous
lines. They help to keep patients comfort able and must work under the supervision of registered nurses and other clinicians.
ours Mercy Health. She explains that once accepted into one of the tiers in the flex team, nurses can selfschedule using an app on their smartphone or other device. The local and regional assignments last six weeks and the system wide assignments last 12 weeks. For the system-level tier, Bon Secours Mercy Health provides resources for housing and travel.
Robin Johnson, chief nursing officer at Bon Sec ours Memorial Regional Medical Center in Rich mond, Virginia, says that Bon Secours Mercy Health's Richmond market had tran sitioned to an all registered nurse workforce in its hospitals, but with pandemic-related nursing shortages and the pay commanded by registered nurses, it has reintroduced licensed practical nurses into its staffing Intermountainmodel.Healthcare also is hir ing more licensed practi cal nurses and is having those nurses work to the top of their license. Dina Bush is vice president and chief nursing officer of the Intermountain Healthcare Peaks Region in Montana and Colorado. She says that system has had very positive feedback from care teams about the addition of the licensed practical nurses.
paired with experienced registered nurses in the hospitals where they want to be hired. The students rotate through multiple units in the hospitals to determine which one is most of interest. There is a 70% retention rate for the externs after graduation.
By JULIE MINDA
In May, SSM Health started an extern ship program that has nursing students training and working alongside SSM Health staff nurses in multiple clinical depart ments, including on patient floors, and in behavioral health, emergency rooms, and labor and delivery. The externs are paid hourly and receive tuition reimbursement. SSM Health is working with universities so that externs can receive college credit for theirCurrently,externship.78
Ministry systems use new approaches to improve working environment for nurses
Bon Secours Mercy Health has initi ated within the last year an education sup port program with the Guild Education company. Bon Secours Mercy Health pays 100% of all part-time and full-time associ ates’ tuition and fees for certain clinical pro grams, including nursing, medical assistant, and laboratory studies. Bon Secours Mercy Health also provides tuition assistance and tuition reimbursement for 115 academic programs, undergraduate degrees, graduate degrees, and nursing degrees.
Shifting team dynamics
Heavy physical demands led many nurses to consider leaving the profession. Some systems are now offering these seasoned clinicians the option to provide inpatient care virtually. Another draw: Virtual nurses are not pulled between bedside care and paperwork.
Members of the virtual team can be from any of the seven states where Provi dence is located. They can be summoned at the touch of a patient call button. A sep arate button calls the bedside team. Vir tual team members talk with patients over video screens about their treatment and discharge plans. The virtual team’s behindthe-scenes work includes taking care of the
Trinity Health, which operates mainly in the midwest and northeastern U.S., cre ated a mobile workforce program called FirstChoice. Gay Landstrom, Trinity Health senior vice president and chief nursing offi cer, says nurses can apply to move to a posi
Providence and CommonSpirit Health are among systems offering a greater level of structured support to newly hired nurses. Coursework through Providence Clinical Academy is a requirement for new nurses and an option for seasoned nurses in that system.CommonSpirit worked with Dignity Health Global Education, an affiliate of CommonSpirit’s Dignity Health subsidiary, to create a standardized nurse residency program that it offers online to all of its new nurses. On the platform, nurses can get education, mentorship, guidance and clini cal training as they begin to practice in the hospital setting.
Safety, well-being
Gay Landstrom, Trinity Health senior vice president and chief nursing officer, says that system is pairing seasoned nurses with licensed practical nurses, with some of the care delivered at the bedside and some through virtual connections. The vir tual team members — all of them are registered nurses — are doing many of the tasks that do not require hands-on care, such as discharge planning and instruction. They also are mentors and coaches to the bedside team, especially for younger and less experienced nurses.
students from 17 universi ties in five states — Missouri, Illinois, Ken tucky, Arkansas and Ohio — are taking part in SSM Health’s program.
Trepanier says, “The most important aspect of our work is our people, and we must ensure that they stay safe” and that they have access to the resources they need to be emotionally and mentally healthy.
Laura Allison, a nurse in the medical oncology unit at Providence Alaska Medi cal Center in Anchorage, completed the residency track of the academy when she joined the hospital in 2018. She is now a preceptor for new nurses going through the academy.Allison says the program was a safety net for her as she started her first job out of nurs
The nursing executives say these flexible options, so rare in the past, are here to stay.
The flexible scheduling is a hit with nurse managers too. Karla VanHorn, nurse manager at Mercy Hospital Springfield, says, “I used to spend so much time calling our nurses during their free time and ask ing them to pick up shifts so I could get the schedule filled.” Now, nurses are viewing the open shifts on their apps and applying on their own for the ones they are interested in.
He since has moved from the orthope dic unit to the trauma unit to the neurology unit, relying on academy courses to prepare him for each new assignment. Reinhardt says the people who taught the courses and who served as preceptors challenged him to “chase my goals.”
“Providence wanted to decrease the varia tion in practice (in how nurse onboarding was done) and be more mindful in demon strating value and incorporating data and research into this programming,” Trepanier explains.Theacademy’s programming includes didactic instruction. The curriculum designed by Providence subject matter experts uses content curated from pro fessional nursing organizations. There is instruction in medical-surgical, telemetry, critical care, cardiovascular lab, emergency, perinatal care, oncology, orthopedics, case management, ambulatory, perioperative, pediatrics, home health as well as other areas. Work with a preceptor is a main draw in the fellowship program.
Dollars and cents
ing they have been able to hire nurses who had worked at nurse staffing companies. They attribute this slight boost in part to flexible scheduling options. Mission and culture also attract nurses to Catholic hos pitals, the executives say.
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jminda@chausa.org
Providence standardizes nurse education, training, mentorship
Landstrom says, “There has been a big shift. Though I’m not sure that we have a good understanding of the new workforce dynamics, we do know nurses’ needs have shifted. They need more flexibility.”
As a new mom, registered nurse Madysen Feeney gave up full-time night shifts at a Mercy hospital in favor of “gig” nursing work. Using an app, she slots herself for one or two 12-hour emergency room shifts each week that fit with her family’s schedule. Here, Feeney and her husband Luke pose with baby Ellie.
New connections
By JULIE MINDA
Both the fellow and resident tracks include self-directed training and training delivered to small groups of nurses.
jminda@chausa.org
Madysen Feeney had worked at Mercy Hospital Lebanon in Missouri as a night shift nurse but after returning to that shift from maternity leave in late 2021 she found the full-time hours to be overly taxing. She heard about gig nursing and applied to be on the Works on Demand roster. Since early this year, she’s been filling one or two 12-hour shifts per week, usually on weekends.Nurses can only sign up for shifts in departments they have experience in. Fee ney has found an abundance of emergency room shifts on weekends. Gig nursing has enabled her to supplement her fam ily’s income, maintain connections at two Mercy hospitals, continue to practice her skills and return to the bedside nursing she loves. “It’s been a blessing,” she says.
The nurse executives all say nurses have responded enthusiastically to the ability to control their own schedules in whole or in part and it's helped their systems hold onto nurses who’d considered leaving during the pandemic.Landstrom says Trinity Health “retained a good number of nurses with these flex ible options. And contract workers learned about the program from our (in-house) nurses. A growing number (of contract nurses) have been talking with our nurses and learning how much they like our FirstChoice program. The best marketing is the nurses already in the program.”
Two tracks
So far more than 10,000 nurses across Providence have graduated from the clini cal academy, which does not offer degrees.
The recent nursing graduates enter a nurse resident track; nurses preparing for clinical specialties enter as fellows. Partici pants pay nothing to take part in the acad emy. They participate during their working hours.The academy provides a mix of online, in-person and training on simulators as well as preceptorships, in which the nurses are paired one-on-one with an experi enced nurse for hands-on patient care. For the simulations, the academy usually uses high-fidelity medical manikins.
systems have not been able to match the salaries for-profit travel nursing companies may pay, they are able to sweeten the pay for staff nurses in their internal travel nurs ing programs to stay competitive.
September 15, 2022 CATHOLIC HEALTH WORLD 5
The National Academy of Medicine rec ommends that hospitals have nurse resi dencies that include preceptorships to close the confidence and skill gap between edu cation and nursing practice. Trepanier says although Providence facilities have offered preceptorships in all patient care settings for decades, before the academy was estab lished there was great variation among Providence hospitals in the orientation pro tocols for new nurses. Many new nurses at Providence facilities had expressed unease about how ready they were for solo handson Innursing.2016,around the time that Providence
Health & Services and St. Joseph Health merged to form the Providence system, leadership began developing and roll ing out the clinical academy at all its sites.
While these nursing executives say their
For nurses fresh out of nursing school, jumping immediately into hands-on care for patients can feel as foreboding as plung ing into deep water to learn how to swim. Even seasoned nurses can feel a bit at sea when they start a new assignment in a spe cialized medical unit. By building a stan dardized education, training and mentor ship program for new nurses and for those moving into specialty roles, Providence St. Joseph Health has created the equivalent of water wings for these newbies.
Trepanierwishes. says there is a “big emphasis on communication and how to best sup port mental health for both the nurse and theProgrampatients.”evaluation has shown that par ticipation in the academy has had a positive impact on nurse engagement and retention and has improved patient care.
what they want and need, and we are doing something about it. They want flexibility, a schedule that lets them meet their personal obligations and a work setting that matches their skills and interests.”
“We can’t keep doing things like we did them before,” she says.
According to information from Inter mountain, the salary rate for the Internal Traveler positions is “competitive and fixed across all of our markets.”
Trepanier says the academy enables nurses “to avoid the reality shock of transi tion and this allows for better outcomes for the nurses and for the organization. We’ve seen that the nurses have an increased level of competency and confidence. We’ve seen a higher level of engagement and retention with the nurses who go through the Clinical Academy.”
‘Wrapping our arms around’
Through the coursework and preceptor ship, “we are wrapping our arms around” new nurses and fellows, giving them the support they need to do their jobs to the best of their ability, says Trepanier.
The program is expanding: the number of graduates doubled from 2020 to 2021. The graduate count is expected to triple from 2021 to this Incomingyear.nurses in the residency pro gram enter a 12-month Clinical Academy track, which includes 10-24 weeks of time with a preceptor depending on the clini cal specialty. Participants can learn stan dard operating practices in clinical quality, safety, self-care and informatics and other areas. They get instruction on how to pro tect themselves against workplace violence and how to communicate with patients at the end of life, in order to understand their care
Another big plus was she got the oppor tunity to build relationships with other new nurses and meet people across the hospital.James Reinhardt, a staff nurse at Provi dence Sacred Heart Medical Center in Spokane, Washington, also was new to nursing when he enrolled in the academy in 2020. He says he learned practical lessons including how to have difficult conver sations with patients. “It was comforting to know how I might be able to handle these complex, emotional situations.”
Now some ministry systems are report
Nurse residents and fellows from Providence Sacred Heart Medical Center and Providence Holy Family Hospital in Spokane, Washington, get familiar with the contents of a code cart. The July 2021 exercise in a simulation lab was part of a Providence Clinical Academy "MedSurg Transition to Practice
Class."Reinhardt
ing school. Clinical precepting was vital to her confidence and skill building since she didn’t get as much handson training as she would have liked to have had in nursing school. “You’re not just thrown out on the floor, you’re given the time and you’re at a pace that you can ask questions,” she says.
Sylvain “Syl” Trepanier, chief nursing executive for Renton, Washington-based Providence St. Joseph Health, says any newly minted nurse or seasoned nurse entering a new field of medicine in any of the seven-state system’s 52 hospitals can take part in Providence Clinical Academy. The program is a requirement for the new nurses and an option for the seasoned nurses. It is available to nurses in all Provi dence care settings.
Allison
Federal officials will negotiate the prices of certain prescription drugs for the Medicare program. Drugmakers will be required to give rebates if prices rise too steeply. The measure caps at $2,000 overall out-of-pocket drug spending and copays for insulin products at $35 for those on Medicare.
Catholic health groups would have liked the Inflation Reduction Act to require states to extend postpartum coverage for women insured by Medicaid to a year from the current 60-day requirement. Twenty-four states have already done so. The Kaiser Family Foundation says 42% of births are financed by Medicaid.
Smith Bombard
Promoting health equity
INFLATION REDUCTION ACT HIGHLIGHTS
Smith points out that many people have been able to keep their Medicaid coverage during the pandemic because of a federal rule that has prevented states from remov ing anyone from Medicaid enrollment dur ing the public health emergency. Once that emergency declaration ends, Smith says, a couple million people could lose Medicaid coverage, many because states are unable to verify their continued eligibility and oth
Jacquelyn Bombard, executive direc tor of federal relations for Providence, says her system advocated for and applauds the inflation act’s tax credit extensions and other efforts to address health care costs and coverage. She says Providence also is thrilled with the historic investments within the measure to address climate change.
Tax credits extended
Climate impact
Climate
The law earmarks $27 billion for a new Greenhouse Gas Reduction Fund to help communities rapidly acquire and deploy lowand zero-emission products, technologies and services. Of that, $20 billion is for competitive grants to nonprofit organizations that help communities adopt technologies and activities to reduce or avoid greenhouse gas emissions and other forms of air pollution, including $8 billion for projects in low-income and disadvantaged areas.
Slubowski points out that the act’s attempt to drive down the skyrocketing cost of insulin aligns with what Civica Rx is try ing to do. The nonprofit drugmaker jointly owned by Trinity Health, CommonSpirit Health, Providence St. Joseph Health, SSM Health and other nonprofits announced plans earlier this year to market three types of insulin at a fraction of what major manu facturers of the diabetes drug are charging.
“We were hoping, at a minimum, that Congress would’ve used the opportunity to provide financial assistance to us with some of the savings they were going to have on contracting with Big Pharma for better pric ing, by way of example, and revenue from the minimum tax for corporations,” says Slubowski, whose Livonia, Michigan-based system has 88 hospitals and operates in 25 states.Slubowski is referencing two of the legislation’s major provisions. One is to empower federal officials who oversee the Medicare program to negotiate the prices of some prescription drugs for the first time. The other provision imposes a corporate minimum tax of 15%, which the nonpartisan and nonprofit Institute on Tax ation and Economic Policy says will raise $223 billion over a decade.
Other aspects of the Inflation Reduction Act that Smith says address health equity and were priorities for CHA and Catholic health care providers include allowing fed eral officials, for the first time, to negotiate the prices of certain prescription drugs for the Medicare program to lower costs for patients. The act makes other changes to Medicare prescription drug policies too, such as implementation of cap of $2,000 on overall out-of-pocket drug spending for seniors, an increase in subsidies for seniors with incomes up to 150% of the federal pov erty level and rebates if drug prices rise too quickly.
Inflation Reduction Act
Drug costs
She says the law acknowledges that hav ing all stakeholders at the table and forming cross-sector partnerships will be essential to environmental progress.
— Lisa Smith
health care providers got during the pan demic dried up in early 2021, yet 50% of all COVID hospital admissions occurred from October 2021 through February of this year.
CHASlubowskiandother
“The estimates are that it will allow about 3.7 million individuals to retain afford able health insurance coverage, which is tremendous because right now we are at a record high enrollment in marketplace cov erage and it’s a time when there’s also huge inflation, so people’s ability to afford health insurance coverage is truly reduced,” Smith says.In its synopsis of the inflation act’s effects, the Biden administration says the subsidies have reduced the nation’s unin sured rate to a historic low of 8%.
The law provides $3 billion for block grants to community-based nonprofit organizations, or nonprofit-led partnerships, to address the disproportionate environmental and public health harms caused by pollution and climate change in disadvantaged communities.
Bombard notes that U.S. health care has an outsize impact on the environment, contributing an estimated 8.5% of green house gas emissions. Provi dence has made reversing its carbon footprint a prior ity, committing to offset or remove more greenhouse gases from the atmosphere than it emits by 2030.Among the inflation act’s provisions that address climate change are a $27 billion fund to help communities rapidly acquire and deploy low- and zero-emission prod ucts, technologies and services, including with private capital. Of that total, $20 bil lion is for competitive grants to nonprofit organizations that help communities adopt technologies and activities to reduce or avoid air pollution, including $8 billion for projects in low-income and disadvantaged areas.The bill also provides $3 billion for “Environmental and Climate Justice Block Grants” to community-based nonprofit organizations, or nonprofit-led partner ships, to address the disproportionate envi ronmental and public health harms caused by pollution and climate change in disad vantaged communities. The potential uses for the grants include pollution monitoring, prevention and remediation; investments in low- and zero-emissions technologies and infrastructure; and mitigating climate and health risks from urban heat islands, extreme heat, wood heater emissions and wildfires.Bombard says Providence hopes to be among the partners that tap those funds to help improve the air quality in some of the communities it serves. “We feel like Provi dence can’t do this alone, the Catholic min istry can’t do this alone and government can’t do this alone,” she says.
Affordable Care Act subsidies
From page 1
Bombard and the others are hopeful that subsequent legislation will address what they see as the Inflation Reduction Act’s shortcomings. Smith says CHA will continue to champion expanded Medicaid postpartum coverage as well as the closure of a coverage gap in states that have not expanded Medicaid under provisions of the Affordable Care Act. Taken together, those nonexpansion states leave more than 2.2 million low-income individuals — 800,000 of whom are the nation’s poorest women — without access to any health care coverage. She says CHA also will continue to push Congress to provide increased reimburse ment for hospitals and long-term care facil ities as the current payment system is not adequate or Slubowskisustainable.saysTrinity Health will con tinue to join other nonprofit health systems in advocating for financial assistance to keep safety net health care providers from
“When financial results come out and some providers are forced to shut down or limit services — which is already hap pening and will increase to a fever pitch — they will act,” he says. “They will take some action when there’s a crisis.”
Bombard says the Inflation Reduction Act didn’t check all the boxes on Provi dence’s legislative agenda. Like CHA, the health system had urged members of Con gress to require states to extend postpartum coverage for women insured by Medicaid to a year from the current 60 days. California and Oregon are among the 24 states that already have done this, but the other five states in Providence’s footprint — Washing ton, Alaska, Montana, Texas and New Mex ico — have not. The Kaiser Family Founda tion says 42% of U.S. births are financed by Medicaid.Inaddition, earlier iterations of the bill would have expanded funding for gradu ate medical education. That funding didn’t make the final version, to the disappoint ment of Providence. Bombard says the system believed those expanded opportu nities for advanced education would have enhanced retention and recruitment of cer tain clinicians, especially in the rural areas that Providence covers.
Smith explains that the extension of the enhanced premium tax credits could help members of the latter group afford to buy insurance on the health care marketplace if they were to lose Medicaid coverage.
going under. He worries, however, that the situation might have to become more dire before policymakers will act.
Lisa Smith, CHA’s vice president of advo cacy and public policy, said the association advocated for the federal government to be able to negotiate Medicare pre scription drug prices and for the three-year exten sion through 2025 of the enhanced marketplace insurance premium sub sidies contained in the act. The subsidies, which are issued as premium tax credits, were first adopted under the American Res cue Plan Act and had been scheduled to phase out at the end of 2022. Smith says the extension will stave off significant premium increases for millions of people.
“The estimates are that it will allow about 3.7 million individuals to retain affordable health insurance coverage, which is tremendous because right now we are at a record high enrollment in marketplace coverage and it’s a time when there’s also huge inflation ...”
leisenhauer@chausa.org Shutterstock 6 CATHOLIC HEALTH WORLD September 15, 2022
Smith notes that CHA and many Catho lic health systems advocated for the exten sion of the enhanced tax credits in part because the subsidies help advance health equity, one of the goals that the organiza tions are pursuing as part of the CHA-led We Are Called initiative. “Ensuring afford able access to care is always a health equity issue because it impacts low-income and often minority communities,” she explains.
ers because their incomes have gone up.
Environmental & climate justice
The law extends for three years subsidies first adopted under the American Rescue Plan Act. Those enhancements were scheduled to phase out at the end of this year. The extension staves off significant premium increases for millions of people and ensures continued access to health insurance for 3.7 million individuals.
More to be done
Lydia Jumonville assumed the role of interim president and chief executive of Intermountain Healthcare Aug. 22. Jumon ville has been president and chief executive of SCL Health since 2017. SCL merged with Intermountain Healthcare in April. Inter mountain Healthcare announced Aug. 11 that Dr. Marc Harrison was departing as president and chief executive to accept a leadership position with the General Catalyst health care technology company. The Inter mountain Healthcare board is conducting a national search for a permanent replace ment.
Ron Ashworth, a past president and chief executive officer of Mercy, described Sr. Rocklage as a changemaker pursuing the greater good. “She was always assess ing changes that were or were likely to take
The system, now called Mercy, includes more than 40 acute care, managed and specialty hospitals, and a network of other services across Arkansas, Kansas, Missouri and Oklahoma. Mercy has additional out reach ministries in Arkansas, Louisiana, Mississippi and Texas.
ADMINISTRATIVE CHANGES
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After departing as system head in 1999, Sr. Rocklage was chair of Mercy’s board
Charles L. “Chuck” Spicer Jr. to presi dent of Our Lady of the Lake Health. He also will lead the Baton Rouge, Louisiana, market for the Franciscan Missionaries of Our Lady Health System. He was president and chief executive of OU Medicine in Oklahoma City.
Even while forging her impressive career, Sr. Rocklage was singing in the choir at St. Vincent de Paul Catholic Church in St. Louis, teaching scripture to children at an archdiocesan school, and teaching health care administration at Saint Louis Univer sity and Washington University.
Matthew Fry to president and chief executive of HSHS St. John’s Hospital in Springfield, Illinois, effective Sept. 19. He was assistant administrator/chief operating officer at Alta Bates Summit Medical Center in Oakland, California.
At St. John’s Mercy Medical Center in St. Louis, she began as staff nurse and ascended the ranks, including time as direc tor of nursing services. From 1969 to 1979 she was president of the hospital, which is now called Mercy Hospital St. Louis.
St. Louis, helping to tend to her chronically ill mother. After spending a summer caring for a girl with polio, she won a scholarship to St. John’s Hospital School of Nursing, a facility run by the Sisters of Mercy. She joined the order at age 19. She told them at the time, “I’m only here to try this.”
She subsequently was administrator of the Sisters of Mercy’s St. Louis province. In that role, she led the congregation’s dis cernment that resulted in the formation of Sisters of Mercy Health System in 1986 from hospitals run individually by the congrega tion. She became the system’s first presi dent and chief executive officer.
Sr. Mary Roch Rocklage, RSM, sports a T-shirt with the logo of her hometown baseball team, the St. Louis Cardinals, during an event in 2014. Sr. Roch, as she was known, had deep ties to the city of her birth, including establishing and leading Mercy, one of its major health systems; teaching at two of its universities and serving on an archdi ocesan commission focused on human rights.
Ryan/©CHAChris
Dr. Amit Powar to president of Trinity Health Mid-Atlantic’s employed medical group.
March 1, 2022 CATHOLIC HEALTH WORLD 7September 15, 2022
Dr. David Meiners, president of Mercy Hospital St. Louis, said Sr. Rocklage’s posi tivity influenced and energized the system’s culture. “She was always able to approach things with a very positive attitude and I think that translated throughout the minis try. I never once saw her down. I don’t think I ever heard her complain about anything.”
Sr. Rocklage
Dr. Thomas Rohs to regional president and chief executive of Ascension Michigan’s Southwest region, from chief medical officer for that region. The Southwest region covers Ascension Borgess Hospital in Kalamazoo, Ascension Borgess Allegan Hospital in Allegan, Ascension Borgess — Lee Hospital in Dowagiac and Ascension Borgess — Pipp Hospital in Plainwell.
When she won CHA’s Lifetime Achieve ment Award, Sr. Rocklage was asked to reflect on her accomplishments. She told a reporter: “My life has been a life of wonder ful gifts. I never seek, but am always called forth.”“The Mercy ministry is one that is older than we are and will outlive us all,” she said. “Our biggest achievement has been our fidelity to the struggle.”
Born Antoinette Rocklage, she was the third of eight children. She grew up in north
PRESIDENTS AND CEOS
Michael Sutton to president of CHI Medical Group and Mountain Management Services. CHI Memorial Medical Group is part of CommonSpirit Health’s CHI Memorial in Chattanooga, Tennessee.
until 2003. She was the 1999 recipient of CHA’s Sister Concilia Moran Award and a 2014 recipient of CHA’s Lifetime Achieve ment
DuringAward.her career, she played a pivotal role in dozens of organizations, including serving as the chair of the American Hospi tal Association’s board in 2002, the chair of CHA’s Board of Trustees from 1984 to 1985 and CHA’s liaison to the United States Con ference of Catholic Bishops. She served on the Archdiocese of St. Louis’ Commission for Human Rights and Healthcare for the Homeless. She helped to establish St. Louisbased Nurses for Newborns and chaired its board. That safety net organization works with families to prevent infant mortality, child abuse and neglect.
Fry Powar Sutton
place in health care and in the Mercy health care ministry. She laid plans for those changes that made a major difference in the ability of the health care ministry to suc cessfully serve.”
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More Season of Creation resources are available at chausa.org/environment
a strong and vibrant health ministry that would ensure access to quality health care for Sheall.” added that Sr. Rocklage has left a great legacy that will continue to inspire others to be, in Sr. Rocklage’s own words, “a penetrating presence in the world” for years to come.Lynn Britton, who retired in April as Mercy’s president and chief executive offi cer, said Sr. Rocklage mentored him when he began his career at Mercy 30 years ago. “She was a leader with a formidable intel lect and bold vision, and a sister of deep faith and extraordinary compassion,” Brit ton said. “It is no surprise she built a health care system that now serves millions of women, children and men.”
From page 1
Sr. Rocklage earned her nursing diploma in 1959, her bachelor of science in nursing from Chicago’s Saint Xavier College in 1961 and her master’s degree in health adminis tration from Saint Louis University in 1963.
A new series of audio reflections by CHA to celebrate the 2022 Season of Creation
A lot of times we might recommend that it would be fantastic for them to follow up with a provider and that could be counsel ing, which is probably most commonly what we would recommend. We can tell them about the free counseling available through employee assistance programs. Sometimes it might be that they really need to get in to see a psychiatrist or a family practice doc tor to look at medications, because if they’re struggling with depression, depression is an extremely treatable disease.
and get help.
I’d say yes. Our volumes have not been huge. Probably the max volume would be
Why a dedicated hotline just for them?
Are the calls being answered by Avera providers?
They get answered around the clock, seven days a week by our assessment team as part of our behavioral health urgent care. We have either master’s level counselors or sometimes we’ll have a psychiatric nurse who will be answering those calls overnight.
Was it embraced from the start by Avera workers?
It was in stages. Around January of 2021 we launched to Avera and then in June of that same year, we launched to all health care workers in the state.
We realized that this is a pandemic that has struck much, much more than just the Avera footprint or the Avera enterprise. We care a great deal about those who work for the Avera enterprise, but I would say we care a great deal about anybody in our com munity. So, it’s just the right thing to do. I think it’s just kind of who we are, that we should be the hands and feet of Christ to all, not just to those who happen to fit inside the Avera box.
How has Avera gotten the word out about the hotline?
Do the callers get counseling? Referrals?
One of our lofty goals is that we would always be the employer of choice, so what ever we can do to take care of our employ ees makes good sense.
We have a farmer stress hotline that is doing very similar things and the farmer stress hotline likewise ebbs and flows.
We can determine that in time, but we have no intention in the foreseeable future of closing down the health care workers stress hotline. We don’t have people 24 hours a day, seven days a week where this is their only job. This is a part of people’s jobs. Our number that you can call into is 1-800-691-4336. When you call, you’ll have an option: Am I calling for farm stress? Am I calling for health care worker stress? Or am I calling for behavioral health urgent care or other needs? Those same people are answering all three of those lines. We will continue to meet the behavioral health needs of our region in whatever way is necessary.
Rod Donovan, a retired Holy Name Medical Center employee and New Jersey beekeeper, established two beehives in the rooftop garden of the Teaneck, New Jersey, hospital in the spring. At top left, Donovan sets up the beehive boxes in May. At left and above, Donovan harvests the honey in late June. Each hive has one queen and more than 60,000 bees. The hives have produced 60 pounds of raw, or unpasteurized, honey. Top right, bottles of Holy Name Honey on sale this summer in the hospital’s gift shop.
pinpointed services where it has seen spe cific needs. In 2016, the Indian Health Ser vice contracted with the system to provide tele-mental health to all 19 of its Great Plains service areas. In 2019, with extreme weather, trade turmoil and record-low commodity prices making life especially hard for those in the agricultural indus try, Avera Health set up a stress hotline for farmers, their families and others living in ruralWhenareas.pandemic stress and burnout pressed down on Avera Health staff, the sys tem added a stress hotline for its employees across five northern prairie states and quickly made the call line available to all health care facility workers in SouthThomasDakota.Otten, assis tant vice president of behavioral health at Avera Health, spoke with Catholic Health World about the care giver hotline and Avera’s efforts to increase access to mental health care. His comments have been edited for clarity and length.
leisenhauer@chausa.org
Do you think it’s more difficult for health care workers, who are used to being the ones providing care, to seek help?
We do have multiple different angles that we take and this was part of it. Another pro gram we have is called LIGHT. It’s an acro nym for learn, improve, grow, heal, treat. It is really targeting physicians and advanced practice providers. It’s basically an EAP-like service.It’shard for physicians sometimes to reach out for help, to be the one that’s need ing healing. But if you work in this profes sion, the statistics will bear this out, it is a very high-stress profession and a highburnout profession. Maybe doctors don’t want to come for counseling, but life coach ing might be a better fit. In some respects, there’s overlap between those two. You partner with them wherever they’re at and LIGHT is a way where they can reach out
about 10 calls in a week. Sometimes we get two or three calls in a week. You can say four calls a week on average is not big, but it is to those four people. It is to their family. That line mattered a great deal to the people who have been able to either find new hope from that line or get connected to resources and then find hope.
rooftopTHEWHAT'SBUZZ?HolyName'sgardenhaslive-inpollinators
8 CATHOLIC HEALTH WORLD September 15, 2022
What the counselors are going to do on that call is largely listen, talk them through maybe a breathing technique, maybe some coping skills, maybe offer some suggestions or thoughts of ways to deal with what they called about.
If you think back to, at least in our region in that time frame, COVID was spiking again. These workers were doing this remarkable thing of caring for us and we needed to make sure that we were there for them.
When did Avera’s health care worker stress hotline originally launch?
Yes, to both. I would say probably most of the time, it’s just venting with somebody. It might be just debriefing with somebody over the course of 10 minutes. It doesn’t have to be a long call, just an opportunity to get stuff off your chest.
Why did Avera open the hotline to health care workers across South Dakota?
I think it’s a very strong commitment from Avera, but quite honestly, it’s an amaz ing commitment from our community to help us with the philanthropy of this proj ect because it’s a $32 million project. Our goal was to be able to raise $18 million in three years and we raised over $25 million in 16 months. We in fact had the $18 million raised in three months as we went out and talked to people. Our first 42 asks were 42 donors who said yes to a substantial gift.
Will the hotline for health care work ers operate indefinitely?
Otten
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From page 1
I do feel like it is harder for them. They feel like this is what I’m supposed to do, and
This is a community that has gotten behind behavioral health. It touches every body because a very significant number of people have problems with behavioral health. The sisters who founded us — the Benedictine Sisters of Yankton, South Dakota, and the Presentation Sisters of Aberdeen, South Dakota — made a commit ment way back in 2006 to behavioral health when nobody else was because it’s the right thing to do. In fact, the sisters will tell you without behavioral health, the mission of Avera is not complete. It’s a really important component to what we do. It’s healing those who are oftentimes marginalized.
Is the hotline part of a wider strategy at Avera to address the workplace stress and burnout that has plagued the health care sector?
Mental health hotline
I’m the one that’s supposed to be a healer or a helper, not the one who receives the care.
We’ve done marketing in different magazines, like health care magazines and regional magazines, that people might read. We certainly did a lot of internal communi cation. We sent out an email a couple times a week to all employees and we have news letters. We do brief daily lineups in each department where we have talked about it as well. We also marketed the health care workers stress hotline through social media.
Avera Behavioral Health Hospital in Sioux Falls opened a four-story wing ear lier this year. Can you speak in general about Avera’s commitment to providing mental and behavioral health care?