Kelley Charvet, Chief Administrative Officer, and Alyssa Egland, Advanced Practice Registered Nurse, both from Community Health Association of Spokane (CHAS) Health, reflect on the organization’s growth since its inception in 1994 as a two exam room clinic in downtown Spokane through 2022, when employees rapidly mobilized to provide primary healthcare at its 20 locations around the Inland Northwest during the COVID-19 pandemic. They also spotlight ways in which CHAS Health supports employees’ mental, physical, professional, and personal wellbeing through its unique approach to building a community of fun within the workplace.
This is “Finding Joy: The Health Care Professional’s Journey to Wellness and Resiliency,” a podcast resource developed by a team of interprofessional education researchers from Washington State University Health Sciences Spokane. They’re promoting wellness among students, faculty, and healthcare professionals during challenging times. Funding is provided by the Health Resources and Services Administration.
I’m Doug Nadvornick.
The Covid pandemic has ramped up the stress level for many health care providers to the point where some dread going to work. The leaders at the Community Health Association of Spokane, or CHAS Health, recognized that early on and took steps to try to protect their employees’ mental health.
Kelley Charvet: “We do try to interject a lot of levity when we can. One of our core values is fun in the workplace and that’s a daily thing that we work on.”
Alyssa Egland: “Each clinic actually has its own morale team, which I think is really unique. They all do different activities and things to help boost morale.”
The CHAS Health approach to workplace culture, next on Finding Joy.
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Kelley Charvet [shar-VAY] is the chief administrative officer at CHAS Health.
Kelley Charvet: “We were founded in 1994 as a non-profit, federally-qualified health center and started in a two-exam-room clinic in downtown Spokane.”
In 28 years, CHAS has grown into an organization with 20 locations around the Inland Northwest. It serves more than 100-thousand patients a year.
Kelley Charvet: “We provide a broad spectrum of primary health care: medical, dental, pharmacy, behavioral health and a whole lot of specialty services to help support families in our community. The organization came into existence because of a need to serve the uninsured and underserved of our community and it was very apparent early on that there was a large need out there. We have clinics as far north as Deer Park and as far south as the Lewiston-Clarkston valley. The reason for going into some of those locations, really, has been those communities asking us to move in because of a lack of services that existed there.”
During the pandemic, CHAS developed partnerships with government health organizations. It worked early on with the Spokane Regional Health District to provide Covid testing at community sites, including the Spokane County Fair and Expo Center. And it initially provided the staffing for the Washington Department of Health’s first community Covid vaccination clinic in Spokane, at the Spokane Arena.
Charvet says CHAS has had to be nimble to take on the new duties, in addition to covering all of its other bases.
Kelley Charvet: “Things were changing sometimes every hour and we were quickly trying to analyze and adjust to what the needs were. Then, with each new wave, we had to deal with staffing shortages and supply shortages and CDC changes. It’s been a wild ride. We’re trying to do strategic planning in the midst of the crisis so that we weren’t losing that momentum and so it was like, every time we’d get ready to start to make another change, it was like, oh no, here comes another new wave and then we were dealing with the crisis of the day again.”
Charvet and her colleagues recognized the roller coaster was taking its toll on their employees so they went back to that core value of having fun at work.
Kelley Charvet: “We have all-staff events. Once a year, we close all of our clinic locations to provide an opportunity to say thank you to our staff. That’s pure fun. We do costume contests and prizes and games and opportunities for people to have community and exhale a little bit. In addition to those things we do drawings and prizes randomly and trivia and things across our system. Every team is regularly working on the morale side of things too.”
Nurse practitioner Alyssa Egland is on one of those teams.
Alyssa Egland: “For example, at my previous clinic out in the valley, they started just little things. One of the things was Hug in a Mug. It was started with one person. They would get a mug of their choice and fill it with candy or little fun things, put it on someone’s desk. You don’t know who left it for you and then you were supposed to do the same thing for one of your other colleagues to spread a little joy within our clinics. Our morale team now out at the Cheney clinic, they’re constantly buying us coffee at Starbuck’s, which people really like and just little things like that.”
Doug: “How does it help you?”
Alyssa Egland: “Last week I had a really rough day in clinic and I knew the next day I was going to get a coffee from our morale team and it was just something to look forward to and it was a little thing that showed me that my company cares about me and it was a thank you for what you do.”
Doug: “Beyond just the little bennies like that, does it help you develop deeper relationships with your co-workers?”
Alyssa Egland: “Absolutely. I think CHAS really does encourage working as a team and having fun and being able to live within a shared experience of caring for our patients because working in a community health setting and primarily caring for patients who have Medicare, Medicaid, they’re uninsured, they’re undocumented, there a lot of barriers that can make it really challenging to provide the best care for these patients. Being able to work as a team and have fun, make things light when it can be hard, I think is really important and I think that that really helps decrease burnout.”
We’re talking with Alyssa Egland, a nurse practitioner, and Kelley Charvet, the chief administrative officer at CHAS Health in Spokane.
Charvet says the organization works to keep current with what its employees are thinking.
Kelley Charvet: “Their biggest issue, really, through the pandemic was child care. We can’t necessarily solve the bigger issue of child care shortage issues in our area. We can work with our community partners to strategize about that, but can we help to alleviate some of the financial burden and we can. We implemented, just this year, a child care stipend to help support our working families. We’re always trying to figure out how to do things a little better, how do we alleviate some of the stresses that they have outside of work that do affect work so that they can concentrate on what’s going on, day to day.”
Doug: “Over the last two years, what is your turnover like? Has it been a low turnover or have you been like a lot of other organizations where people are coming in and out the door?”
Kelley Charvet: “We’ve had some significantly low turnover numbers, which has been great, but this past year it did creep a little bit. We’re still lower than national averages. I think that there were, as many saw throughout Covid, you get to a point where you have to stay home to take care of a child who’s doing at-home school and so people did make those choices. What’s best for my family? We saw some folks that relocated out of the area because those stresses were put onto them or I’ve always wanted to live wherever and the employment markets allow for that right now. I’m so thankful that we are in a good position. Our turnover rates have been lower than we had expected them to be. From that perspective I think we’re in a good position.”
Doug: “How would you assess the overall health, mental health of your organization? Is it a stronger organization than before all of this hit us?”
Kelley Charvet: “I’ve always felt, especially in recent years, that the organization just has such resilience and has always worked together to meet whatever needs were in front of us. One thing that stood out to me during Covid was their willingness for individuals to do anything we asked. For awhile we had dental clinics closed, right at the beginning, and people were, from our dental teams, we had dentists that were greeting patients that were coming to clinics. They were the first people our patients saw. We had people from our dental team join our maintenance teams, so they were painting exam rooms, things that you would never ask a professional in a certain field to do and everybody really came together and did whatever it took. We had core teams at our administration office in kind of a large area where we were just all there, working on a new work flow quickly and so we could quickly problem solve that issue, to get that communication out, implement across the system, showcase for us that we really could do anything we set our minds to. We also had the ability to move quickly, so despite how big we are, we still have the ability to move quickly and make quick decisions and impact the community quickly. The pandemic has pushed us to the place where I feel like we’re even more solidified than we ever have been. We’re definitely in a much better position from that chaos perspective than we were even six months ago.”
That’s Kelley Charvet. We finish with nurse practitioner Alyssa Egland.
Alyssa Egland: “I think one of the biggest challenges during the pandemic is that, at least for me, it’s been really hard for me to get some of my patients in to see specialists within our community. I think a lot of people are seeking medical care and I’m not sure what’s going on on the side of the specialists, whether they’re limiting how many patients they’re seeing a day, but for me it’s been really challenging to get patients in to see specialists. There are times I feel patients are being treated in my office for things that would be more appropriate for a rheumatologist or a cardiologist. But through CHAS we have a lot of really awesome resources to help me with that, one of those things being a lot of opportunity to consult with specialists within CHAS. So, for example, just yesterday actually, I contacted one of our providers who specializes in rheumatology and I asked him if he could look at an x-ray with me that I had gotten back. We also have an electronic consultation service where I can type out a patient case and include labs or imaging and send it to a specialist who will then look at my questions and they’ll send back a consult note within 24-48 hours. That has been so helpful, especially as a new nurse practitioner and a service that I really appreciated.”
Alyssa Egland emphasizes that she doesn’t speak for everyone at CHAS, but she thinks the general sentiment mirrors hers.
Alyssa Egland: “I feel like in an organization that’s as large as ours that sometimes there can feel like there’s a divide between administrators and providers and MAs and nurses and I personally don’t really feel that divide. Our CEO and our medical directors are very visible. They’re out in the clinics. Our CEO, he comes around once a month, hand delivers our Employee of the Month awards with a handwritten thank you card. He’s out there handing out swag bags. He’s constantly there. Same thing with Dr. Wiser, who’s one of our medical directors. She’s always out there and I just really appreciate that and I think that there is a lot of cool things that CHAS does for their employees that I really wish that some of these other big organizations within our community, I wish that they would do that as well, because I know, as an employee, it makes me feel really good and, on the days that it’s really hard, I’m reminded that I work for a really cool company.”
Alyssa Egland is a nurse practitioner at CHAS Health in Cheney. Kelley Charvet is its chief administrative officer.
The Interprofessional Opioid Curriculum team wishes to thank the following individuals for their invaluable contributions to this project:
This episode of “Finding Joy” was produced by Doug Nadvornick from Spokane Public Radio.
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