Latest / Becker’s Healthcare Podcast / David Rahija, PT, MBA, FACHE, President of Northwest Community Hospital at Endeavor Health

Transcript

David Rahija, PT, MBA, FACHE, President of Northwest Community Hospital at Endeavor Health · Becker’s Healthcare Podcast

0:02
The most important health care decisions don't happen
0:05
in isolation.
0:06
They happen when leaders come together.
0:08
Becker's sixteenth annual meeting brings together more than
0:11
3,500
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hospital and health system executives this April in
0:15
Chicago.
0:16
With 800 speakers from Ascension,
0:18
Cleveland Clinic, CommonSpirit and more, the conversations get
0:22
real. Leaders will share how their scenario planning
0:24
for policy shifts, breaking through value based care
0:27
barriers, and building clinical teams that translate
0:46
Hello, everyone, and welcome to the Becker's Healthcare
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Podcast.
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I'm Mackenzie Bean, associate vice president and managing
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editor of Becker's Hospital Review.
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Today, I am so thrilled to be joined
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by Dave Rehia, who is the president of
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Endeavor Health Northwest Community Hospital.
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Hi, Dave. Thanks for joining the podcast. How
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are you doing today? Doing well, Mackenzie. Thanks
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for having me on. Appreciate it. Of course.
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I mean, it's a pleasure to have you
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back. I know you've been on the podcast
1:14
before.
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For any listeners who might be hearing you
1:17
for the first time, I was hoping you
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could just tell us a little bit more
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about yourself, your career, and then, of course,
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Northwest Community Hospital.
1:26
Yeah. Thanks, Mackenzie.
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Dave Rahim. I've, been part of Endeavor Health
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now for seventeen years.
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Just, as an overview, Endeavor Health,
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is
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a health system in the Chicago Suburbs and
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Chicagoland, including Chicago,
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consisting of nine hospitals over 300 ambulatory sites
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of care. We take care of,
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almost 1.4,
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million patients a year,
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with our incredible team of 27,000
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team members.
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I've,
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Endeavor Health is relatively
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a newer health system,
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by name. It is, actually coming together for
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successful
2:05
health systems over the last five years. North
2:08
Shore University Health Systems and health system in
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the Northern Suburbs Of Chicago,
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Swedish Hospital in, the North
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part of the city, Northwest Community Hospital in
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the Northwest Suburbs Of Chicago,
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and Edward Elmhurst
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Health at,
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which is in the Western Suburbs Of Chicago.
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We are we came together,
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a really like minded, not for profit, community
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based
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health system dedicated to excellence,
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and, serving our communities.
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And it's been a great ride.
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I've, as I mentioned, I've been part of
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the health system for seventeen years,
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starting at Glenbrook Hospital, started our Orthopedic and
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Spine Specialty Hospital in Skokie,
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president of operations of,
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the Endeavor Medical Group, as we brought together
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the four
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employed medical groups. And I have now, the
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privilege and pleasure,
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almost a year now serving at Northwest Community
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Hospital, which is our biggest of our nine
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hospitals,
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licensed for 500 beds, multiple off sites,
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and it's really been,
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a pleasure,
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and, I guess, that privilege
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of serving this community.
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Absolutely. And as you said, you're,
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almost a year into your new president role.
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As you reflect back on the last twelve
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months, what would you say is the most
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important initiative that you've led? Can you tell
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us more about it, and what sort of
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results have you seen so far?
3:37
Sure. Yeah, Mackenzie. As I think about where
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we are in the evolution of our health
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system, we really are challenging ourselves as a
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health system to come together,
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and not just be a collection of hospitals
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or collection of provider practices,
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like most health systems across the country,
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but really challenging ourselves to be a truly
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integrated system of care across the continuum of
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care.
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Northwest Community obviously is a big part of
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that just given its size.
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Each of the hospital presidents within Endeavor also,
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are executives over clinical service lines for all
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of Endeavor.
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Working with our physician or singular physician executives
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for each service line,
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minor surgical services across all of Denver,
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neurosciences,
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and rehab.
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To answer your question, Mackenzie, really working on
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bringing together,
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integrating, and creating consistent and seamless
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seamless care,
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service lines across all of Endeavor, across all
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of Chicagoland. I would say that is a
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lot of work. It takes a lot of
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bringing,
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stakeholders together,
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but really challenging everyone to,
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put your best practices on the table.
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Let's do best practice research, but at the
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end of the day, how do we reduce
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unnecessary clinical variation
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and really settle on a singular
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Endeavor Health Way,
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best practice
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across all of our service lines. And so
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that has been a lot of the work
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that, we've been doing,
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this past year and I would say with,
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with very good success.
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It's
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been really gratifying to see all of our,
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clinical experts, our leaders, our team members coming
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together
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really focused with the patient in the center
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on designing,
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what does seamless,
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care safe, seamless, and personal care look like
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across,
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the entire continuum of care from the office
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to the hospital,
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to post acute if if necessary,
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back to the office,
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and how do we do that in a
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seamless fashion?
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It's,
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it's a big body of work, but, it
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potentially
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is gonna really differentiate us in the Chicago
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market.
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Yeah. No small task like you said, but
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but so so crucial to really achieve, like
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you said, that true integration,
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especially across,
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those specialties that you're overseeing.
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I'm curious, how are you gonna carry this
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work ahead in 2026?
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What's coming down the pipeline as you also
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think about some of the headwinds that health
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systems nationwide are facing right now?
6:16
Sure. Yeah. I I would think,
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to that end, relative to integration, our single
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biggest project within Endeavor is, taking three instances
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of Epic
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and going to a singular instance of Epic
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for all of Endeavor Health.
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All nine hospitals, all of our offsites,
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our entire enterprise,
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working off a singular platform.
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That is really gonna be an enabling
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a significant enabling step
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to really allow us to,
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really take our integration
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and differentiation
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to the next level.
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And,
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as you can imagine, anyone who's gone through
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an EMR conversion,
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this is a major major project, but,
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one that the investment of time, resources, and
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energy,
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should produce,
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significant results.
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To your question, Mackenzie, relative to headwinds, obviously,
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The US health care industry is going through,
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a very tumultuous,
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period,
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especially relative to financing.
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Just like the rest of the country, we
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are preparing for
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patients in our communities losing,
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coverage whether that is, through Medicaid, whether that
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is not having access
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or ability to buy plans on,
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the Affordable Care Act exchanges,
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or other means.
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We are committed to our communities,
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as a not for profit health system. So
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really,
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working with our partners, working,
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as a system, and and using all of
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our assets,
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to ensure that we continue
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to, serve and take care of everyone in
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our community,
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but at the same time continue to differentiate
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and grow.
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That is gonna require very much a system
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approach,
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and making probably difficult,
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but, necessary decisions,
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to ensure that we not only survive this
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period but continue to thrive.
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Mhmm. I know. You know, so many systems
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are focused, especially on access right now, acknowledging
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a lot of those,
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you know, federal headwinds as well. And, you
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know, I think that goes hand in hand
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with thinking through
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strategic integration. So I'm curious to, like, hear
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from you and your perspective, specifically honing in
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on, you you know, you said your your
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work in surgical services where we're also seeing,
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you know, heightened demand for inpatient care and
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surgical surgical,
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demands as well.
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How are you thinking about that specifically?
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Yeah. There's no doubt,
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as more and more surgical procedures are moved
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off the inpatient only list,
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we're gonna see,
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especially from our, physicians that are aligned with
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us through independent practice, potentially pull cases,
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to, ambulatory surgery centers where they're aligned.
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We are looking at our, surgical platform to
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ensure that our cost structure,
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is ready for site neutrality,
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and reducing our cost structure,
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with the assumption that we're just gonna get
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paid less for the work that we do.
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So to continue to
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deliver the high quality care, invest in technology,
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utilize it where the evidence,
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shows that it produces the benefit.
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But then looking at how do we,
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using technology, using AI,
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reduce our cost structure knowing that we're just
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gonna get paid less for the work that
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we do.
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It's important to look at synergies,
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and really looking at not just the operating
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room, but the entire,
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perioperative system, everything from SPD,
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to pre and post PACU,
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and really thinking about how do you optimize
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those,
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very
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big and expensive assets,
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and and optimize it to, ultimately reduce the
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total cost.
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We've been spent a lot of time working
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with our care teams and our clinicians,
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ensuring that patients that, are not in an
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inpatient status, they have to go home,
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safely,
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and be discharged
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from our surgical,
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ASU environment.
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And so, we've already been, working towards that,
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knowing what's coming down the pike, and I
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think we're gonna be well positioned.
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That's great. Great to hear. And I appreciate
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you outlining that plan. You know, you also
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mentioned,
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the big,
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transition of taking three instances of Epic to
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one. Can you just speak a little bit
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more about,
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where Endeavor is in that journey? And maybe
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from your perspective,
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what you're most excited for,
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once that, integration is complete?
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Yeah. We're well into that work with the
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with, about half of our hospitals going live,
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in 2026,
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and about the other half going live in
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November
11:09
2026.
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So, we've
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been seating multidisciplinary
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teams now for,
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almost two years,
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preparing for this.
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What it's gonna allow us to do, it's
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gonna allow us to,
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allow our patients and our clinicians to work
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off a singular platform.
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From an access standpoint, it's gonna be easier
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to go to market with the singular service
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line,
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with singular decision trees built in epic
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to get patients to the right provider in
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the right location, the right time, and have
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access to the entire
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network of Endeavor Health.
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In addition for patients,
11:47
Natalie, it will allow access,
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to be more seamless. It opens up, providers
11:53
options to providers across our system, especially subspecialists
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that otherwise would be hard to you'd have
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to go,
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navigate,
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and potentially, it might be a little harder
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to find. It's gonna allow our clinicians also
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to, really work collaboratively and more seamlessly.
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All of our care teams will have access,
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to anything that is done with Endeavor, whether
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that is,
12:18
in an outpatient site in Plainfield or hospital
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in Evanston,
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or a surgery in Arlington Heights. And,
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that singular platform,
12:28
allows our care teams to coordinate, collaborate,
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and ensure that we're providing that seamless care
12:34
across the continuum of care.
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The US health care system obviously is known
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to be fragmented,
12:40
and so this is a giant step forward,
12:44
within our health system to make it more
12:46
seamless.
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And it's exciting work.
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Obviously, EMRs don't treat patients, but it's a
12:52
huge enabling step,
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to allow us to,
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deploy evidence based pathways, evidence based,
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order sets,
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evidence based,
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research
13:04
in a big swoop,
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without having to,
13:08
make modifications in multiple places.
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I think this is gonna be a big
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step forward,
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in,
13:14
the seamlessness
13:15
of our care that we provide to our
13:17
communities.
13:19
For sure. A huge step towards,
13:21
that seamless, highly coordinated care, like you said.
13:25
I wanna end here, taking an opportunity to
13:28
look at,
13:30
how you're thinking about growth in 2026 and
13:33
beyond. I'm curious from your perspective, what do
13:35
you see as some of the best opportunities
13:37
for organizational
13:38
growth, or how are you really defining growth
13:40
right now?
13:42
Yeah. No. We are very much,
13:44
focused on growth. I I think growth, though,
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is gonna be,
13:48
defined on the system level and on the
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service line level,
13:52
instead of each individual
13:54
hospital per se. Again, we've,
13:57
we've moved to singular clinical service lines, singular
14:01
institutes,
14:02
across all of Endeavor Health
14:04
across Chicagoland
14:05
and then,
14:06
ensuring that our strategic and growth plans
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are aligned with optimizing each service line across
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all of Chicagoland.
14:15
And so that, is forcing us to really
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think and make strategic decisions on not what
14:21
is best for any individual hospital campus,
14:24
but what is best for,
14:26
a particular institute or service line,
14:29
and by extension,
14:31
the patients in the that are getting cared
14:33
for in those institutes and service lines across
14:35
all of Endeavor Health.
14:37
And so,
14:38
we are focused on those systemness
14:41
decisions,
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and that starts with growing our front doors,
14:45
making sure that our patients have access,
14:48
to primary care, immediate care, virtual care,
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to get into
14:52
our system and then growing subspecialty access
14:56
across the service lines across all of endeavor.
14:59
That should set us up, to be successful
15:02
not only in a fee for service world,
15:04
but also as we continue to take on
15:06
more risk in a value based world as
15:09
well. So our strategy is well aligned,
15:12
for the headwinds and what the future of
15:15
US health care is gonna
15:17
was gonna come down the pike. But, as
15:19
you know, Mackenzie, Chicago is very competitive.
15:22
There's a lot of very good providers, but
15:24
we are setting ourselves up to be differentiated
15:26
in the Chicago land market,
15:28
and offer a higher level, more coordinated, seamless,
15:34
coordinated care, across our clinical service lines that,
15:39
really will be world class and allow patients
15:42
to get care in their communities close to
15:44
home.
15:45
Mhmm. I'm curious. Is there a specific
15:48
decision,
15:49
that you've made recently that you talked about
15:51
of necessarily maybe what's not best best for
15:53
the hospital, but is best for the service
15:55
line,
15:56
that you could share to help sort of
15:58
paint a picture for the listeners of how
16:00
you're thinking about this and weighing it out?
16:04
Sure. Yeah.
16:05
We've opened,
16:07
across Endeavor,
16:09
several centers of excellence. I mentioned earlier
16:12
that,
16:13
one of the one of the projects I
16:14
led was starting an orthopedic and spine specialty
16:17
hospital
16:21
based in Skokie. We made the decision to
16:23
pull orthopedics
16:24
out of several hospitals,
16:28
within the Endeavor system, then the North Shore
16:30
University Health System,
16:32
and centralized care into the specialty hospital.
16:36
That was a key decision.
16:38
It helps that our p and l accountability
16:41
is on the horizontal service line level,
16:44
because if it was on the vertical,
16:46
hospital level, no hospital president would want orthopedics
16:49
pulled out of their hospital,
16:50
given it's a higher margin service line.
16:54
So that enabling step of aligning,
16:57
where the accountability is from a p and
16:59
l
17:01
allowed us to then make,
17:03
more strategic decisions on, how do we
17:06
develop subspecialized orthopedic care similar,
17:10
to our cardiovascular
17:11
care. We have two
17:13
large,
17:15
cardiovascular pavilions,
17:16
Heart Hospital at Edward Hospital and the Cardiovascular
17:19
Institute Pavilion at Glenbrook Hospital.
17:22
While most of our cardiac care is distributed,
17:25
high volume,
17:26
across all of our Endeavor sites,
17:29
We have centralized open heart surgery,
17:32
TAVRs,
17:34
high complexity, low volume cardiac procedures to those
17:38
those two sites.
17:39
Again,
17:42
difficult decisions, but when what it allows us
17:45
to do, it allows our teams to get
17:47
more subspecialized.
17:48
We can bring in
17:49
the latest and greatest,
17:51
technology,
17:52
and really double down on doing those procedures,
17:55
those high complex, low volume
17:58
procedures better than anyone else.
18:00
So those would be two tangible examples of
18:03
how we have,
18:05
really elevated the care,
18:07
for our communities.
18:09
Great examples. Thanks for sharing those. I think
18:11
it's always helpful for listeners
18:13
to get an inside look in in some
18:15
of those strategy decisions.
18:17
Dave, it's been so interesting speaking with you
18:20
and hearing,
18:21
about some of the work that you've been
18:22
doing at Endeavor, how you're thinking thinking about
18:24
growth, your significant integration efforts. I'm excited to
18:28
follow along and see how this work continues
18:30
in 2026.
18:31
So thank you so much for joining us
18:32
on the podcast.
18:34
Thank you, Mackenzie. Appreciate the opportunity.