Latest / Becker’s Healthcare Podcast / Expanding Rehabilitation’s Role in Patient Recovery and Health System Capacity with Scott Edelman

Transcript

Expanding Rehabilitation’s Role in Patient Recovery and Health System Capacity with Scott Edelman · Becker’s Healthcare Podcast

• 0:00
  Hello, everyone. Welcome to the Becker's Healthcare Clinical
• 0:03
  Leadership podcast. I'm Mackenzie Bean, associate vice president
• 0:06
  and managing editor of Becker's Hospital Review.
• 0:10
  Today, I am so thrilled to join the
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  podcast with Scott Edelman, who is the executive
• 0:15
  director of Burke Rehabilitation.
• 0:17
  Scott, thanks for joining us on the podcast
• 0:19
  today. How are you doing?
• 0:21
  Mackenzie, thank you. I am thrilled to be
• 0:23
  here and so excited.
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  I look at Becker's every day. I listen
• 0:27
  to all the podcasts, so this is an
• 0:29
  absolute thrill for me. Oh my gosh. That's
• 0:31
  so kind of you to say and, a
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  privilege for to have you on the podcast
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  as well. So let's dive in. I'm hoping
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  you can just introduce yourself for our listeners
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  and tell them a little bit more about
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  your career in Burke Rehabilitation.
• 0:44
  Sure. Happy to do that. So thank you
• 0:47
  for again for having me. I'm Scott Edelman.
• 0:49
  I'm proud to serve as the executive director
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  of Burke Rehabilitation.
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  And a little bit about Burke, we're a
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  nationally recognized
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  non for profit health care provider
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  specializing in rehab medicine,
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  clinical research, and graduate medical education.
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  We're also a proud member of the Montefiore
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  Health System, and we just hit our ten
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  year mark.
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  Burke's work, our work, is centered around a
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  simple but powerful message,
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  helping all people recover from life altering illness
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  and regain their independence that defines
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  our patients' quality of life.
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  Every day we see
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  our patients
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  and we care for the individuals that recover
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  from stroke, spinal cord injury, traumatic brain injury,
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  neurological
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  disease, complex orthopedic,
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  cardiac, and pulmonary disease. In fact, we treat
• 1:40
  the most stroke survivors in New York state.
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  Now, Mackenzie, these are people who have experienced
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  a major medical event,
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  often the most difficult moment of their lives,
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  and they arrive at Burke with one goal,
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  to rebuild their lives.
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  Our mission at Burke is to provide the
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  highest quality medical care and get folks back
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  to the life they love.
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  We often say at Burke, we provide something
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  more powerful than treatment.
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  We provide hope to every patient that walks
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  through our doors.
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  Now currently, Burke is a 150 bed rehabilitation
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  hospital centered in White Plains, New York on
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  a beautiful 61 acre campus.
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  The outside is as healing as the inside,
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  but our reach extends far more than our
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  main campus.
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  We also have 15 outpatient centers
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  across the region, and we we provide specialized
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  PT, OT, and speech
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  throughout the Hudson Valley, New York City, and
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  all of our sites are accessible
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  by the tri state areas. So New York,
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  New Jersey, and Connecticut.
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  This year alone, we expect to deliver 200,000
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  220,000
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  outpatient visits. But wait, there's more.
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  We also operate
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  an advanced
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  outpatient physicians practice right on our campus,
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  and we provide specialized care for neurological,
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  musculoskeletal,
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  orthopedic, and chronic functioning conditions.
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  That's the continuum of care.
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  Now, Mackenzie, I'd like to tell you my
• 3:08
  personal journey, because my story is something I'm
• 3:11
  very proud of. I often describe it as
• 3:14
  the mailroom to boardroom story, because it actually
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  is.
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  I began my career at Burke over thirty
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  years ago, yes, in the mailroom.
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  And I had the opportunity to grow throughout
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  multiple roles
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  throughout the organization.
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  Eventually, I became senior vice president and chief
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  financial officer.
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  And today, I have the privilege of serving
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  as the executive director of Burke Rehabilitation.
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  The journey has given me something
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  more valuable than just experience. It's given me
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  as a leader perspective,
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  Perspective and understanding
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  how the hospital operates from the ground up.
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  I understand the pressures faced
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  by my frontline staff,
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  the operational realities of running a hospital,
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  and the responsibilities
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  leaders have to create an environment
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  where everyone can succeed.
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  But most importantly,
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  my journey has taught me that hospitals are
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  not just buildings,
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  profit and loss statements, or balance sheets. Hospitals
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  are people.
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  They have our physicians, our nurses, our therapists,
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  our administrators,
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  the ones that show up every day committed
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  to helping our patients recover.
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  I know that was a long answer.
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  No. It was a a fantastic
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  answer. I mean, I you paint such a
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  helpful picture for the audience of just the
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  scope
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  of Burke Rehabilitation and the important role that
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  you play in the community, and I love
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  what you said about giving that message of
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  hope and helping people rebuild their lives. It's
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  so meaningful.
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  And I'm, I'm just so, interested in your
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  leadership journey as well. Like you said, started
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  in the mail room over thirty years ago.
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  Let's talk more about that. You mentioned it's
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  given you great perspective into the organization.
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  Can you talk more about how that perspective
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  has helped shape the way you lead today,
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  and what advantages does that type of institutional
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  institutional knowledge that you hold really have in
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  the health care landscape today? Yeah. So it's
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  really helped me understand culture in the workforce.
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  Right? So culture
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  is one of the most important drivers of
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  performance.
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  At Burke, we refer to all of our
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  employees as the Burke family.
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  I sent out a monthly newsletter. It's called
• 5:21
  a note from Scott. First line says, dear
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  Burke family. It's not a slogan.
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  It reflects the deep level of commitment and
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  collaboration that exists across our entire organization.
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  And the culture is reflected in our workforce.
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  Over the past five years, our workforce has
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  grown by 18%
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  even in the face of extremely competitive
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  health care labor markets.
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  We've been recognized by one of the best
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  places to work by both nine one four
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  Inc and City and State.
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  And several years ago, we asked our employees
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  to help us define the values that guide
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  our organization.
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  What are the driving principles?
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  And the values they chose were compassion,
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  accountability,
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  respect,
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  exceeding expectations,
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  service excellence.
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  Together, they form the acronym CARES.
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  So it's our BERC Cares model.
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  They're not just
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  letters written on a wall. They're the behavioral
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  expectations
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  that guide us in how we care for
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  patients and how we treat each other.
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  And as a leader, I believe culture is
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  built through presence and engagement.
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  That's why I make it a priority
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  to spend time on the hospital units,
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  spend time at the outpatient centers,
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  talking to staff, talking to patients,
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  listen to ideas,
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  and learning directly from the people who are
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  closest to the work. I start and end
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  my day on the hospital units, and I
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  look forward to it. And when the team
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  doesn't see me, they ask, where is Scott?
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  Is he okay?
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  So that just gives you a little peek
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  into my leadership style. And I also believe
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  the most important thing is
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  just because a leader has a title in
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  an office does not make them a leader.
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  Mhmm. It is through mutual respect, professional equity,
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  getting back to people, closing the loop,
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  and and it's really important to me, our
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  people.
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  Mhmm.
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  It seems like you're really a a model
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  of that on the ground leadership. I'm also
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  I'm also an adjunct professor. I teach graduate
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  school, so I love to give back.
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  So I teach health care leadership,
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  and I teach health care finance on the
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  graduate level. And I'm so happy when my
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  students land great jobs and they contact me
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  later. I just say go get them.
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  That's amazing. I'm sure it's it's so rewarding
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  to see all of that. And to your
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  18% workforce growth in such a competitive market
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  too, that's so impressive.
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  It really I think that culture piece is
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  so so crucial for retention, isn't it? And,
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  Mackenzie, we also have a very low turnover
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  rate too. Mhmm. Do you? The job. Our
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  turnover rate was double digits. Now it's single
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  digits. We made some changes to the compensation
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  philosophy,
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  the medical benefits, and the retirement plan.
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  And,
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  people wanna work here and stay here.
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  Clearly, it's really right that dual focus of
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  being competitive with your benefits, you pay your
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  salary, but then also the culture piece and
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  how are those intertwined, it seems like. Culture
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  is everything. If you don't have a good
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  culture,
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  welcome me to the front lobby. We'll lock
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  up together.
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  There there you go, folks. You heard it
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  here first.
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  Let's switch gears a little bit and look
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  at more,
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  long term strategy. Right? You're leading BERC rehabilitation,
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  and we're at a time in health care
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  where we're seeing significant capacity strain going on
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  in health systems.
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  Curious, how do you sit see inpatient rehabilitation
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  facilities
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  playing a more strategic role in helping to
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  alleviate some of that burden or support patient
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  flow.
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  And from your perspective at Berg, what operational
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  or partnership strategies have really been most effective
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  there in in positioning your role in the
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  broader care continuum?
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  Well, that's a great question. I get that
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  question a lot. So right now, health care
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  is facing enormous pressure. Hospitals across the country
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  are struggling with capacity,
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  crowded emergency departments,
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  workforce shortages, and increasing
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  clinical complexity.
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  One of the most important but often underappreciated
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  solutions
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  is how we respond
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  as an inpatient rehabilitation
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  solution
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  to this crisis.
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  A lot of folks don't understand the difference
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  between
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  an inpatient rehab facility
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  called an IRF and a skilled nursing facility,
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  an SM, and that's NF.
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  But the differences are very significant.
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  Inpatient rehabs provide physician led twenty four hours
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  a day, seven day a week coverage.
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  Patients participate
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  in three hours plus
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  of therapy every day.
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  The level of intensity
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  allows us to care for patients recovering
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  from severe neurological
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  injuries, amputation, stroke,
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  etcetera.
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  When patients receive the right level of rehab
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  at the right times,
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  three things happen.
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  Patients recover faster,
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  acute care hospitals free up beds, and the
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  entire health care system
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  functions more efficiently.
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  So rehab hospitals are simply not the end
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  of the health care journey. It's a bridge
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  that allows patients to return home and regain
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  their independence.
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  So some of the strategies that we have
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  taken Mackenzie has gone out to the acute
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  care hospitals and showing them what the value
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  proposition is. Let us help you with your
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  length to stay, which create capacity,
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  putting in care transition liaisons
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  in the acute hospitals.
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  So when an acute rehab patient is identified,
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  we can move them quickly through the system
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  and get them approved clinically and get them
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  approved on the insurance side. And I have
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  to say, more recently, insurance companies have become
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  a better partner in that sense.
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  So I believe that inpatient rehab facilities
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  are the spigot, the safety valves to create
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  more access in acute hospitals.
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  Really a bridge between the two, like you
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  said. And those care transition liaisons, that's an
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  interesting role. Are those BERC employees who are
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  going into the health acute care health system?
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  They are. So what we do is, you
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  know, we talk to the leadership at the
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  acute hospitals. Let us help you, with your
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  length of stay, Put some of our people
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  in there that when they're referred
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  to IRF, they can explain what the journey
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  is,
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  right, and see who really qualifies because not
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  everyone qualifies.
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  You might be too sick or not sick
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  enough. That's why the destination
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  and the right level of rehab care at
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  the right time is so important.
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  Mhmm. And that coordination and communication
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  between the rehabilitation hospitals and the acute care
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  hospitals,
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  It's everything.
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  Yeah. And and patient safety measures and quality
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  are also
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  something that is another feather in your cap.
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  When you could report back to the acute
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  care hospitals that you have one of the
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  lowest readmission rates in the country post thirty
• 12:04
  day discharge,
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  people are gonna stand up and look.
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  Wow. What do you attribute that success to
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  with your readmissions? I I think we take
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  good care of our patients,
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  start middle and prepare them to function at
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  home for it's in a continuing journey. Go
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  to our outpatient,
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  see our physicians.
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  We provide wraparound services. We check-in,
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  three days after discharge, then we check-in every
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  thirty days. So I think it's once you're
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  here and you come through our organization,
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  the relationship doesn't end at discharge.
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  In fact, it just begins.
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  Mhmm. You stay very, very sticky with your
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  patients Yep. Across the continuum.
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  That's a great,
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  strategy.
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  Let me turn now a bit more to,
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  innovations and investments. As I understand it,
• 12:52
  Burke has invested in on-site dialysis. Correct? CT
• 12:56
  scanner suite, smart bed technology,
• 12:59
  all very exciting. And I know you have
• 13:01
  a larger focus as well expanding outpatient access.
• 13:05
  As executive director, how are you evaluating these
• 13:07
  decisions in terms of which innovations are worth
• 13:10
  the capital investment,
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  considering, you know, how tight margins are for
• 13:14
  many organizations right now? What framework do you
• 13:17
  really use to guide
• 13:18
  those decisions and how you think about growth
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  versus optimization?
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  Right. So, Mackenzie, we're always looking on how
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  do we expand access.
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  So that's opening more outpatient sites with skilled
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  providers.
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  We're in a very very,
• 13:32
  challenging environment, as you said, which means all
• 13:35
  of our investments must be carefully evaluated.
• 13:38
  But our framework is straightforward.
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  If the innovation provides
• 13:43
  better patient safety, accelerates recovery, or increases the
• 13:47
  likelihood
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  that a patient can return home, then it
• 13:50
  is worth pursuing.
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  It might not have an ROI,
• 13:53
  but it might have a statement behind it.
• 13:56
  Right? It may increase our patient satisfaction scores.
• 13:59
  Right? So when we're looking at an investment
• 14:02
  now dialysis was a a fantastic thing to
• 14:05
  put into Burke. Right? Because now we're able
• 14:07
  to take patients that need rehab and on
• 14:10
  dialysis
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  in addition to,
• 14:13
  our CT scanner suite that will be open
• 14:15
  shortly.
• 14:16
  And our smart bed technology
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  is a patient safety,
• 14:21
  enabler. So we're constantly looking for those investments
• 14:24
  that distinguish us from everyone else
• 14:27
  and provides a benefit to the patient.
• 14:30
  Mhmm. That makes sense. A simple framework but
• 14:32
  so powerful. Right?
• 14:35
  I always say, will this improve the recovery
• 14:37
  journey of our patients?
• 14:39
  Because I talk to a lot of family
• 14:40
  members and I talk to a lot of
• 14:42
  patients, and they all say, we love it
• 14:44
  here. It's great. You know, how can I
• 14:47
  help? You know, we have a lot of
• 14:48
  patients that come back as volunteers,
• 14:51
  which is amazing.
• 14:52
  That is. It feels like you've built such
• 14:54
  a strong culture and community with both staff
• 14:57
  and your your patient population.
• 14:59
  Yeah. It starts at the
• 15:00
  first contact. Right? You only have one chance
• 15:02
  to make a first impression. Right? Excellent in
• 15:05
  every interaction.
• 15:06
  Mhmm. So when I have people that come
• 15:08
  see me for a meeting, my first question
• 15:09
  is, how are you greeted at the front
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  desk?
• 15:12
  How many people said hello to you on
• 15:14
  the way to my meeting?
• 15:16
  Right? And that's really important.
• 15:18
  Very much so.
• 15:20
  I wanna end, I guess, just going back
• 15:23
  to that culture piece, it's clear you really
• 15:25
  have ingrained it so much throughout the organization,
• 15:28
  thinking through patient experience,
• 15:30
  culture, the community, the family,
• 15:33
  dynamic.
• 15:34
  What's really been been key to that? You
• 15:35
  said greeting at the front desk. You any
• 15:38
  thoughts there?
• 15:39
  Yeah. I think putting a spotlight on patient
• 15:42
  experience
• 15:43
  was the moment.
• 15:45
  Mhmm. And we did town halls to,
• 15:49
  educate the entire staff. We went to all
• 15:52
  the outpatient sites. I held virtual town halls.
• 15:55
  I think the eye opener was, here's where
• 15:57
  our scores are. Here's where we need to
• 16:00
  be. And the first thing people said is
• 16:02
  that can't be us.
• 16:03
  This must be a joke because our scores
• 16:05
  should be better.
• 16:07
  And letting everyone know that and it's not
• 16:08
  one department called patient experience, we are all
• 16:11
  responsible for patient experience.
• 16:13
  But true leadership in health care means showing
• 16:16
  up every day
• 16:18
  for people who are navigating
• 16:20
  through the most difficult moment of their lives.
• 16:22
  It means supporting everyone. Right? We got through
• 16:25
  COVID together, but now we're post COVID.
• 16:28
  You don't stop what you were doing during
• 16:30
  COVID. You acknowledge.
• 16:31
  You help.
• 16:33
  I I say to people, Mackenzie, in the
• 16:35
  morning, you know, what can I do to
• 16:37
  help? What matters to you? You know, you
• 16:39
  look like you're having a bad day. Tell
• 16:40
  me what's going on.
• 16:42
  Right? And and do something with it. This
• 16:44
  it's not just lip service.
• 16:46
  But more importantly, we're really proud to give
• 16:48
  patients
• 16:49
  something that every recovery journey requires,
• 16:53
  which is hope and independence.
• 16:55
  So you could tell, Mackenzie, I've been in
• 16:57
  my job over three decades. I love what
• 16:59
  I do.
• 17:00
  I love our employees and the patients
• 17:03
  that come in on a stretcher and leave
• 17:04
  on a walker.
• 17:06
  Mhmm. It's just an amazing sight.
• 17:10
  I can tell the passion
• 17:11
  for what you do just shines through. So
• 17:14
  thank you so much for such a enlightening
• 17:16
  discussion, Scott. It truly has been such a
• 17:18
  pleasure.
• 17:19
  We so appreciate you joining us on the
• 17:20
  podcast today. Thank you. Thank you so much,
• 17:23
  Mackenzie.